Sprained Ankle: Treatment and Recovery

Medically Reviewed by Zilpah Sheikh, MD on February 20, 2024
12 min read

Your ankle joint connects your foot with your lower leg. Three ligaments keep your ankle bones from shifting out of place. A sprained ankle is when one of these ligaments is stretched too far or torn. Anything that stretches your ankle more than it’s used to can hurt a ligament. This usually happens when your foot is turned inward, outward, or twisted. 

If you’ve fallen or twisted or rolled your ankle and you’re in pain and have ankle swelling, you may have sprained your ankle. 

Most sprains happen when ligaments on the outer part of the ankle are hurt. Treatment depends on how much pain you’re in, ranging from resting the ankle and taking an over-the counter medication to going to a doctor for an exam.

Sprained ankle vs. broken ankle

While a sprained ankle involves torn or stretched ligaments, a broken ankle means that at least one of the bones in your ankle is broken. Symptoms of a sprain and break can be the same, including pain, swelling, and bruising. A broken ankle can take up to 6 weeks to heal.

Twisted ankle vs. sprained ankle

The terms “twisted” and “sprained” ankle are often used as replacements for each other, but are they the same thing? No, not really. A twisted ankle describes the motion that comes from your ankle twisting, bending, or rolling in a way that isn’t normal. So while a twisted ankle can hurt and can cause a sprained ankle, they aren’t exactly the same thing. A twisted ankle can be painful but doesn’t necessarily mean you have a sprain.

 

You can sprain your ankle if you:

  • Plant your foot the wrong way when running, stepping up or down, or doing everyday things like getting out of bed
  • Step on an uneven surface, like in a hole
  • Step on someone else while playing sports. (For example, your foot might roll when you’re playing basketball, go up for a rebound, and come down on top of another player’s foot.)

Certain people are more likely to sprain their ankles. Women, children, and teenagers tend to have more sprains. You might also be at higher risk if you:

  • Play sports, especially on an indoor court. For example, playing basketball requires you to jump a lot and reverse the direction you’re running, which can lead to an ankle injury.
  • Have balance problems
  • Wear high heels or shoes that don’t fit well. Your ankles are more likely to be sprained if you wear shoes that don’t support your ankles, or if you wear shoes not made for the activity you’re doing. For example, if you wear shoes made for tennis while playing basketball.
  • Have weak or stiff ankles, such as because of a previous injury. 

If you’ve hurt your ankle before, you’re at higher risk of spraining it again.

 

The inflammation that comes along with a sprained ankle can cause symptoms including:

  • Swelling and bruising. It may be so swollen that you can press on the area with your finger and leave an indent.
  • Pain. Your nerves are more sensitive after a sprain. The joint hurts and may throb. It’s often worse when you press on it, move your foot in certain ways, walk, or stand.
  • Redness and warmth. A sprain causes more blood to flow to the area.
  • Instability. The joint can feel weak when the ligament is totally torn.
  • Trouble walking. A sprain may limit how much you can move your ankle.

Sprained ankle swelling

Swelling can occur either above or below the ankle. Sometimes it can be hard to know if your injured ankle is swollen or not. Visually comparing it to your other ankle can help you figure out if your sprained ankle is swelling.

How long does a sprained ankle stay swollen?

With most ankle sprains, swelling will last 2 to 3 days. However, if your ankle stays swollen for several weeks, you’d want to see a doctor to determine if you have a severe sprain or even a broken ankle.

Sprained ankle symptoms in children

Symptoms of a sprained ankle in your child don’t generally differ from an adult’s symptoms:

  • Swelling, which can appear quickly or may take hours to be visible
  • Pain around the ankle
  • Trouble walking or moving the hurt foot
  • Bruising, which can take 2 to 3 days to appear

Be aware, though, that sprained ankles are not common in younger children. Their growth plates – areas where bones grow at the ends of long bones – are weaker than their tendons or muscles, so instead of a sprain, they’re at higher risk of breaking or fracturing a bone. 

When to call your doctor

You probably won’t need to see your doctor about a sprain. But give them a call if:

  • Your pain is severe or doesn’t get better with over-the-counter medications, elevation, and ice.
  • You can’t walk, or you have severe pain when you do.
  • Your ankle doesn’t feel better within 5 to 7 days.

You might have a bone fracture instead of a sprain if:

  • You have severe pain or pain that doesn’t get better with treatment.
  • Your foot or ankle is twisted or extremely swollen.
  • You can’t walk without pain.
  • You have severe pain when you press your medial malleolus or lateral malleolus, the bony bumps on each side of your ankle.

Your doctor will try to rule out a broken bone or other serious injury. They’ll move your foot and ankle to learn which bones are affected and make sure your nerves and arteries aren’t hurt. They’ll also check that your Achilles tendon, which runs along the back of your ankle, isn’t torn.

You might have X-rays to check for fractures. If your sprain is severe, your doctor may order more imaging tests, including:

  • MRI. This can show torn ligaments, damaged cartilage, bone chips, and other problems.
  • Ultrasound. This shows your doctor what your ligament looks like while you move your ankle.
  • CT scan. This uses X-rays and a computer to make detailed pictures of your bones.

Sprained ankle grades

Doctors grade ankle sprains by how severe they are:

  • Mild (grade I). Your ligaments are stretched but not torn. Your ankle still feels stable. You may have some pain and stiffness.
  • Moderate (grade II). One or more ligaments are partially torn. The joint isn’t totally stable, and you can’t move it as much as usual. You have swelling and moderate pain.
  • Severe (grade III). One or more ligaments are totally torn, and your ankle is unstable. You have a lot of pain and can’t move it.

Home treatment

Doctors recommend RICE:

  • Rest keeps you from hurting the ankle again or putting stress on inflamed tissue. A brace or splint can take pressure off the joint.
  • Ice is probably the best treatment. Put it on your ankle to lower blood flow and help with swelling, redness, and warmth. It can prevent inflammation if you do it quickly after an injury.
  • Compression can keep down swelling. Use an elastic bandage or wrap until the swelling goes down. Always start wrapping at the point farthest from your heart. Don’t wrap so tightly that you cut off the blood flow.
  • Elevation (keeping the injured area up as high as possible) will help your body absorb extra fluid. It’s best to prop your ankle up so that it’s higher than your heart, as with a reclining chair.

Anti-inflammatory pain medications reduce pain and fight swelling. Over-the-counter drugs such as ibuprofen and naproxen work for most people. Check with your doctor first if you have other health conditions or take any other medicines.

How to wrap a sprained ankle

If you want to try to wrap your own ankle, you’ll need to have an elastic adhesive bandage and non-stretch zinc oxide tape. There are four ways you can wrap, or tape, a sprained ankle:

  • Figure 8. This is considered the least supportive way to wrap your sprained ankle, but it does provide support for damaged ligaments.
  • Stirrups. You want to run the tape down the inside of your ankle, under the heel, and back up the outside of your ankle.
  • Heel lock. This method involves wrapping the tape around the ankle and the bottom of your heel multiple times.
  • Basket weave. This method is considered the most supportive way to wrap your sprained ankle.

Sprained ankle exercises

You can start exercises about 48 hours after your sprain and keep doing them until the pain is gone. It’s a good idea to start doing the exercises while sitting on a chair or on the floor. Types of exercises you can do will help with your range of motion, flexibility, and strength include:

  • Flex your ankle. With your heel resting on the floor, point your toes away from you and then pull them toward your body, repeating several times.
  • Draw the alphabet with your big toe. Resting your heel on the floor, use your big toe to draw each letter of the alphabet in the air.
  • Pull your sprained foot outward and inward, using an elastic band for resistance.
  • Stretch your ankle while standing and sitting.
  • Rise up on your toes to stretch your heels.

Medical treatment

If your sprain is severe or isn’t feeling better after about a week, you may need to see a doctor. They might give you a brace or cast to hold your ankle still. You can use crutches to keep weight off it. If you have a severe sprain, have a follow-up appointment 1 or 2 weeks later to make sure you’re healing well and learn whether you might need physical therapy to help with flexibility and strength.

Mild and moderate sprains usually don’t need surgery. You might have it if the sprain is severe or if you’re at higher risk of spraining it again because you play a lot of sports.

Therapy

Sometimes, you may need physical therapy to help your sprained ankle fully heal. The stages of therapy may include:

  1. The therapist assesses your condition and will provide treatment to reduce pain and swelling.
  2. You will do exercises to improve your range of motion and flexibility.
  3. The therapist will start you on exercises to improve your strength and balance.
  4. If you play a sport, the therapist will design exercises to specifically help you perform the moves you need for your sport and also to prevent another injury.

Surgery

Ankle sprains typically do not require surgery. But if you have a severe sprain that won’t heal on its own, your doctor may recommend surgery to repair your ligaments. You could be a candidate for surgery if you:

  • Have pain in your foot and ankle that won’t go away
  • Experience repeated ankle sprains
  • Have an ankle that doesn’t support you when walking or running

There are two main types of procedures to fix your ankle ligaments:

  • Arthroscopy. Doctors make a small cut in your skin and use a camera to look at your damaged ligaments, which helps them decide on the best surgical approach to use.
  • Lateral ankle ligament reconstruction. One method uses sutures, or stitches, to tighten your ligaments, and the other method replaces the damaged ligament with a tendon.

Other problems can develop over time if you don’t treat a sprained ankle, try to do too much before it’s completely healed, or sprain it more than once. These complications include:

  • An unstable joint
  • Pain
  • Arthritis
  • Injuring the other ankle because of changes in how you walk

Can a sprained ankle heal on its own?

Sprained ankles are a common injury and most heal on their own. Treatment or exercises can help strengthen your muscles and prevent spraining your ankle again.

How long does a sprained ankle last?

If your injury was straightforward and you didn’t have complications, symptoms may last as long as 10 to 12 weeks before your ankle feels normal again. But if your sprain was severe, it could take longer and require use of crutches or a walking boot, physical therapy, and even surgery in extreme cases.

When to worry about a sprained ankle

If your sprained ankle is still painful or swollen after several weeks or if you have trouble standing on it, you should have your doctor look at the ankle.

A sprained ankle is more likely to get hurt again, so do what you can to lower your risk:

  • Keep your ankles strong and flexible. Talk to your doctor or physical therapist about strengthening exercises.
  • Wear the right shoes for an activity. Choose stable shoes that support your ankle, such as high-top basketball shoes.
  • If you play a sport, you might want to tape up a weak ankle for extra support. Ask your doctor about a brace if you’ve had more than one sprain.
  • Be sure the playing field or court is clear of any holes or obstacles.
  • Get rid of obstacles or trip hazards in your home and yard.

 

Most ankle sprains heal with no problems. You should feel much better after 2 weeks. Up to a third of people still have some pain after a year.

Once the swelling has gone down and you can walk without pain, you can probably start exercises to build flexibility and strength. Check with your doctor first.

Most sprains happen when ligaments on the outer part of the ankle are hurt. Treatment depends on how much pain you’re in, ranging from resting the ankle and taking an over-the counter medication to going to a doctor for an exam.

You can treat the ankle yourself at home with rest, ice, compression, and elevating it. If you like, you can also take ibuprofen to help with pain.

If your pain is severe early on or you haven’t fully healed after several weeks, you should see a doctor.

How long does it take to recover from a sprained ankle? 

If your injury was straightforward and you didn’t have complications, symptoms may last as long as 10 to 12 weeks before your ankle feels normal again. But if your sprain was severe, it could take longer and require use of crutches or a walking boot, physical therapy, and even surgery in extreme cases.

Can I walk on a sprained ankle?

Yes, you can walk on a sprained ankle, although it will likely hurt at least the first several days. In fact, the ligaments will heal faster if you walk normally as soon as possible after spraining your ankle. 

How do you heal a sprained ankle fast?

The best way to recover from your sprained ankle as quickly as possible is to consistently follow the RICE approach for self-care:

  • Rest keeps you from hurting the ankle again or putting stress on inflamed tissue. A brace or splint can take pressure off the joint.
  • Ice is probably the best treatment. Put it on your ankle to lower blood flow and help with swelling, redness, and warmth. It can prevent inflammation if you do it quickly after an injury.
  • Compression can keep swelling down. Use an elastic bandage or wrap until the swelling goes down. Always start wrapping at the point farthest from your heart. Don’t wrap so tightly that you cut off the blood flow.
  • Elevation (keeping the injured area up as high as possible) will help your body absorb extra fluid. It’s best to prop your ankle up so that it’s higher than your heart, as with a reclining chair.

How do you know if you sprained your ankle?

If you’ve fallen or twisted or rolled your ankle and you’re in pain and have ankle swelling, you may have sprained your ankle.