Ankle Sprains: A Twisted or Injured Ankle

A sprain stretches or tears the bands that support the ankle. An exam may be needed to rule out a broken bone.

Why it happens
A fall, sudden twist or uneven surface can overstretch the ankle ligaments. These are bands that connect bones. Previous sprains can leave the ankle vulnerable.

What you may notice
Pain, swelling, bruising or an ankle that feels unstable after a twist or fall.

Understanding the injury
A mild sprain has small ligament tears; a moderate sprain has a partial tear, and a severe sprain may have a complete tear. The amount of pain alone does not show the full injury. X-rays assess bones; an MRI is usually reserved for ongoing symptoms or suspected additional damage. 

Treatment and what to expect
An exam and sometimes x-rays help identify other injuries. Rehabilitation restores movement and strength. Follow the exercise plan even as pain improves; an untreated sprain can lead to repeated giving way. A sprain and a broken bone can occur together. Ask how much weight you may put on the ankle and which activities are safe while it heals. More severe ligament injuries sometimes need surgery. 

When to call
Get prompt care for severe pain or trouble bearing weight. Call if pain or swelling persists, or the ankle keeps giving way.

Your next steps
● Protect the ankle. Follow instructions about walking, a brace, a boot or crutches.
● If advised, ice through a towel for 20 minutes; wait at least 40 minutes before repeating. Elevate the ankle above heart level.
● Begin rehabilitation when your clinician directs. Return to sports only when cleared.

How rehabilitation progresses
Early care protects the ankle and controls swelling. Ask when you may start putting weight on it; prolonged rest is not the whole treatment.

Next come guided movement, strength and balance exercises. Running, cutting and jumping are added later as function returns. A brace or taping may help during the recovery.

Recovery and preventing another sprain
Minor sprains may recover in about 2 weeks, while more severe injuries may need 6 to 12 weeks or longer. These are general ranges. Complete the rehabilitation program, wear shoes suited to your activity and be careful on uneven ground. Surgery is uncommon for an isolated sprain, even when a ligament is fully torn.