An ankle sprain is an injury in which the ligaments of the ankle are stretched or torn by a sudden movement that twists the foot. It is one of the most common injuries in sport and daily life, and it ranges from a mild strain to a complete ligament tear.
Note: If you cannot stand on the foot, if its shape looks clearly changed, or if you feel numbness, seek urgent care promptly.
Symptoms
- Pain around the ankle, often on the outer side
- Swelling that appears quickly
- Bruising or change in skin colour
- Difficulty putting weight on the foot
- A feeling that the ankle is unstable or rolls easily
- Stiffness in ankle movement
Causes
- Landing badly after a jump
- Stepping on uneven ground
- Changing direction quickly during sport
- Tripping or falling
- A previous sprain that was not fully rehabilitated, which can leave the ankle more prone to rolling
- Weak muscles around the ankle or poor balance
Diagnosis
The doctor asks how the injury happened, then examines the ankle for tenderness, swelling and stability. An X-ray may be requested to rule out a broken bone, and an MRI may be used if a more serious injury or damage to cartilage or tendons is suspected.
The severity of a sprain cannot be judged from pain alone, so assessment is advised, especially when pain is severe. A fracture can sometimes look like a sprain.
Treatment options
Non-surgical treatment
Most sprains are treated without surgery. In the early days, simple general measures are used, along with a doctor's review when needed.
- Resting the foot and avoiding movements that increase pain
- Cold packs wrapped in a cloth for short periods
- Raising the foot above heart level when sitting or lying down
- A compression wrap or ankle brace as directed by the doctor
- Physiotherapy to restore movement, strength and balance
Surgical treatment
Surgery is rarely needed. It may be considered if the ankle stays unstable or keeps giving way despite non-surgical treatment and rehabilitation, or if there is an associated injury inside the joint. The surgeon decides after examination and imaging whether surgery is suitable, and arthroscopy may be part of the assessment or treatment in some cases.
Recovery and rehabilitation
Recovery time varies from person to person and is set by the surgeon after assessment. Returning too early, before the ankle has regained strength and stability, can make another sprain more likely.
- Controlling pain and swelling
- Restoring ankle movement
- Strengthening the calf and ankle muscles
- Balance training
- A gradual return to walking, then running and sport
When to see the doctor
See a doctor if any of these occur:
- You cannot stand or walk on the foot
- Severe pain over the ankle bone or the foot
- A pop heard or felt at the time of injury
- The ankle or foot looks out of shape
- Numbness, coldness or colour change in the toes
- Swelling that does not improve, pain that persists, or sprains that keep recurring