Mayo Clinic | American Hospital

Overview

A sprained ankle happens when you roll, twist or turn your ankle in an awkward way. This can stretch or tear the tough bands of tissue that help hold your ankle bones together. These tough bands of tissue are called ligaments.

Ligaments stabilize joints and prevent harmful movement. A sprained ankle occurs when the ligaments are stretched too far or tear. Most sprained ankles affect the three ligaments on the outer side of the ankle.

The right treatment depends on how serious the sprain is. You can treat many sprains at home with self-care and pain relievers you can buy without a prescription. But it is helpful to see a healthcare professional, especially one specializing in sports medicine, orthopedics, or physical medicine and rehabilitation, to assess the injury. They may find that you need treatment, such as physical therapy or a brace or cast.

After an ankle sprain, it's important to do exercises that strengthen ankle muscles and improve balance. These exercises help with healing and may prevent future sprains. A physical therapist can teach you how to do the right exercises for your injury.

Symptoms

Symptoms of a sprained ankle depend on how serious the injury is. They may include:

Pain, especially when putting weight on the affected foot.
Tenderness when touching the ankle.
Swelling.
Bruising.
Limited movement in the ankle.
Feeling unstable or like the ankle might give out.
A popping feeling or sound at the moment of injury.

When to see a doctor

If you have pain and swelling in your ankle and you think you may have a sprain, contact your healthcare professional. While self-care may be all you need, it's best to check whether a medical exam is needed. Depending on your symptoms, you may have a torn ligament or a broken bone in your ankle or lower leg.

A sprain happens when the ankle is forced out of its typical position, causing one or more of the ligaments to stretch, partially tear or fully tear.

Common causes of a sprained ankle include:

Twisting your ankle during a fall, especially rolling it inwards.
Landing awkwardly after jumping or pivoting.
Walking or exercising on an uneven surface.
Someone stepping or landing on your foot, often during sports.

Risk factors

Certain things can increase the likelihood of spraining an ankle, including:

Playing sports. Sports that involve jumping, quick direction changes or twisting motions have a higher risk of causing ankle sprains. Examples include basketball, soccer, football, tennis, pickleball and trail running.
Uneven surfaces. Walking or running on uneven ground or playing on poor field conditions increases the risk ankle sprains.
Previous ankle injuries. If you've sprained your ankle before or have had other ankle injuries, you're more likely to injure your ankle again.
Weak ankles. Poor strength or flexibility in the ankle may increase the risk of a sprain, especially during physical activity.
Improper footwear. Wearing high heels, shoes that don't fit properly or the wrong shoes for an activity can make your ankles less stable and increase the risk of injury.

Complications

Not treating a sprained ankle properly, returning to activities too soon or repeatedly spraining your ankle can lead to:

Repeat sprains.
Ongoing ankle pain.
Weak or not stable ankles that give out easily.
Arthritis in the ankle joint.

Prevention

To reduce the risk of a sprained ankle or another ankle injury, follow these guidelines:

Practice balance exercises to improve stability and ankle strength.
Warm up before exercising or playing sports.
Be careful when walking, running or working on uneven surfaces.
Use an ankle support brace or tape if you have a weak or previously injured ankle.
Wear shoes that fit well and are made for your activity.
Limit wearing of high heels to reduce ankle strain.
Only play sports or do activities that your body is conditioned for.
Keep your muscles strong and flexible through regular exercise.

Diagnosis

Diagnosing a sprained ankle typically involves a physical exam of the injured area. Your healthcare professional examines your ankle, foot and lower leg by:

Pressing on the skin around the injury to find tender areas.
Moving your foot to test range of motion and see what positions cause pain.

Tests

If the injury is severe, you may need imaging tests to check for broken bones or ligament damage. These tests may include:

X-ray. During an X-ray, a small amount of radiation passes through your body to produce images of the bones of the ankle. This test is good for ruling out bone fractures.
Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce detailed cross-sectional or 3D images of soft internal structures of the ankle, including ligaments.
CT scan. CT scans can reveal more detail about the bones of the joint. CT scans take X-rays from many different angles and combine them to make cross-sectional or 3D images.
Ultrasound. An ultrasound uses radio waves to produce real-time images. These images help your healthcare professional judge the condition of a ligament or tendon when the foot is in different positions.

Treatment

The right treatment depends on how serious the sprain is. The main goals are to reduce pain and swelling, help the ligament heal, and restore ankle movement, strength and stability.

For severe injuries, your healthcare professional may refer you to a specialist in musculoskeletal injuries, such as an orthopedic surgeon or a doctor specializing in physical medicine and rehabilitation.

Medicines

For most people, pain relievers you can buy without a prescription are enough to manage the pain of a sprained ankle. You can take ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others) to manage pain.

Devices

Walking on a sprained ankle can be painful. You may need crutches until the pain improves. Depending on the severity of the sprain, your healthcare professional may recommend using an elastic bandage, sports tape or an ankle support brace to stabilize the ankle. For a severe sprain, a cast or walking boot may be needed to keep the ankle still while it heals.

Therapy

Once your pain and swelling improve, your healthcare professional recommends exercises to help restore your ankle's movement, strength, flexibility and stability. Your healthcare professional or a physical therapist will guide you on how to progress through these exercises safely.

Strengthening your ankle muscles is key to supporting the joint and preventing future sprains. Balance exercises, such as standing on one leg, help retrain the muscles to work together and improve stability.

If you sprained your ankle while playing sports or exercising, talk with your healthcare professional before resuming activity. Your healthcare professional or physical therapist may have you do specific movement tests to make sure your ankle is strong and stable enough for the sports you play.

Surgery

In rare cases, surgery is needed when the injury doesn't heal or the ankle is still not stable after a long period of physical therapy and rehabilitation exercises. Surgery may be done to:

Repair a ligament that won't heal.
Reconstruct a ligament with tissue from a nearby ligament or tendon.

Self-care

For self-care of an ankle sprain, use the R.I.C.E. approach for the first two or three days:

Rest. Avoid activities that cause pain, swelling or discomfort.
Ice. Use an ice pack or ice slush bath for 15 to 20 minutes and repeat every 2 to 3 hours while you're awake. Always put a thin towel between the ice pack and your skin. If you have vascular disease, diabetes or reduced feeling in your skin, talk with your healthcare professional before using ice.
Compression. To help stop swelling, compress the ankle with an elastic bandage until the swelling stops. Don't block circulation by wrapping too tightly. Begin wrapping at the end farthest from your heart.
Elevation. To reduce swelling, elevate your ankle above the level of your heart, especially at night. Gravity helps reduce swelling by draining excess fluid.

Preparing for an appointment

Schedule an appointment with a healthcare professional or get emergency medical care if your sprained ankle doesn 't improve with self-care or continues to cause pain or instability. If your sprain is severe, you may be referred to a doctor who specializes in sports medicine or orthopedic surgery.