Ankle Sprains

Overview

An ankle sprain is an injury to the tough bands of tissue (ligaments) that hold the ankle bones together. It happens when the ankle twists, rolls, or turns beyond its normal movement, which stretches or tears these ligaments.

Ankle sprains are very common. They are one of the most frequent injuries seen in general practice and emergency departments.

Anyone can sprain an ankle, but it is most common in people who play sports, walk on uneven surfaces, or have had a previous ankle sprain.

Symptoms

Common symptoms

• Pain around the ankle, especially when you put weight on it
• Swelling and bruising
• Tenderness when you touch the ankle
• Difficulty moving the ankle normally
• A feeling that the ankle is giving way

Symptoms in children

• A child may limp or refuse to walk
• Swelling and bruising may appear quickly
• They may cry or complain of pain when the ankle is moved

Symptoms in older adults

• Swelling may be less obvious, but stiffness can be more noticeable
• Bruising may take a day or two to appear
• Balance may feel poor, and there may be a fear of falling

Causes

Main causes

• Twisting the ankle during sports like football, netball, or tennis
• Stepping awkwardly on a curb, stair, or uneven ground
• Wearing shoes that do not provide enough support
• A previous ankle injury that has left the ligaments weaker

Risk factors

• Playing sports that involve jumping, landing, or quick changes of direction
• Having weak ankle muscles or poor balance
• Walking or running on uneven trails
• Being overweight, which puts extra stress on the ankles

When to see a doctor

See a doctor urgently if:

• You cannot put any weight on the ankle
• You have severe pain that is not helped by resting and elevating the leg
• You have numbness or tingling in your foot or toes

Book a routine appointment if:

• Swelling and pain have not improved after a few days
• The ankle still feels weak or unstable after two weeks
• You need advice on when it is safe to return to sport or exercise

Diagnosis

Your doctor will ask how the injury happened and examine your ankle. They will check for swelling, bruising, and tenderness, and may gently move the ankle to see which ligaments are affected.

Tests that may be done

• An X-ray to rule out a broken bone, especially if you cannot bear weight
• An ultrasound or MRI scan if there is a suspected severe ligament tear or injury to other structures

What to expect at your appointment

The doctor may tell you whether you have a mild, moderate, or severe sprain. They will explain what you can do at home and may suggest a support, crutches, or physiotherapy if needed.

Treatment

The first goal is to reduce pain and swelling. This is usually done with rest, ice, compression, and elevation (often called RICE). After the first few days, you can slowly start to move the ankle again and do gentle exercises to help it recover.

Self-care at home

• Rest the ankle for the first 24–48 hours. Keep weight off it as much as you can.
• Apply an ice pack (or a bag of frozen peas wrapped in a tea towel) for 15–20 minutes every 2–3 hours. Do not put ice directly on the skin.
• Wrap the ankle with a soft elastic bandage. It should be snug but not so tight that it causes numbness or tingling.
• Keep the ankle raised on a pillow at or above the level of your heart when you are sitting or lying down.
• Once the initial pain settles, gently move the ankle in circles and spell the alphabet with your foot, unless your doctor advises otherwise.

Medical treatments

Your doctor or pharmacist may recommend or prescribe a pain reliever to help with discomfort, but always ask what is safe for you and never take more than the recommended amount. A brace, ankle support, or crutches may be offered to keep the ankle stable while it heals. Physiotherapy can help you regain strength, balance, and range of motion.

When is surgery considered?

Surgery is rarely needed for an ankle sprain. It is usually only considered if a ligament has completely torn and the ankle remains very unstable even after several months of physiotherapy and rehabilitation.

Living with this condition

You can usually walk on a mildly sprained ankle after a few days, but you may need to take it slowly and use a support. Pain is your guide: if it hurts, stop and rest. As the pain settles, you can gradually return to your normal activities.

Lifestyle tips

• Use an ankle support or sports tape during exercise for the first few weeks after recovery.
• Continue with balance and strengthening exercises even after you feel better.
• Choose supportive footwear, especially on uneven ground.

Diet and exercise

Eating a healthy, balanced diet with enough protein, vitamins, and minerals gives your body what it needs to repair ligaments. Once your doctor or physiotherapist says it is okay, low-impact activities like swimming or cycling can keep you active without jarring your ankle.

Mental health and emotional wellbeing

Being injured can be frustrating, especially if you are used to being active or playing sports. You may feel bored, low, or anxious about getting injured again. This is common. Talking to someone you trust about how you feel can help, and setting small, realistic goals during your recovery can keep you motivated.

Prevention

You cannot prevent every ankle sprain, but you can lower your risk by doing regular balance and strength exercises for your lower legs, warming up before activity, wearing appropriate shoes, and being careful on uneven ground.

Complications

If left untreated

• Chronic pain and weakness in the ankle
• Repeated ankle sprains because of reduced stability
• Long-term difficulty walking or doing sports
• Damage to the joint surface or early arthritis in severe cases

Long-term outlook

The outlook for ankle sprains is very good. Most people recover fully within a few weeks to a few months, depending on how severe the sprain is. With the right care and rehabilitation, most people are able to return to their usual activities and sports.

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