Sprained ankles are common injuries that affect children and adults at all levels of activity. In the United States, there are about 25,000 sprains a day. While common, it’s important to start treatment right away. A neglected sprain or delayed treatment can increase the chances of an ankle sprain happening again or developing other ankle-related issues.
Understanding what happens during a sprain, the different types and how to treat an ankle sprain can help you recognize the injury and take the right steps toward recovery.
Understanding Ankle Sprains
An ankle sprain happens when the ankle ligaments stretch or tear, usually the result of a sudden twist or roll. Ligaments are stretchy fibrous bands that hold bones and joints together — and with 26 foot bones and 33 joints, around 100 ligaments work hard to keep the foot in good working condition. However, our daily activities do not always go to plan.
Common Causes of Ankle Sprains
We can overstretch or tear the ligaments on the outside of the ankle or, less commonly, on the inside of the ankle by:
- Losing balance, falling or tripping.
- Running on uneven surfaces.
- Landing awkwardly after a jump.
- Playing sports that involve rolling or twisting your foot.
Before starting an ankle sprain treatment, you’ll need to know the type of sprain you have.
Types of Ankle Sprains
Sprains are graded based on damage to the ligaments:
- Grade I: Mild stretching or a small tear of ligaments with minimal swelling and slight tenderness.
- Grade II: A partial ligament tear with moderate pain, swelling and some joint instability.
- Grade III: The ligament is torn completely, causing severe pain, significant swelling and marked instability.
Sprains are classified by location:
- Inversion or lateral sprains: The most common type when the ankle rolls inward and the foot turns inward, tearing the ligaments on the outside of the ankle.
- Eversion or medial sprains: Less common as the ankle rolls outward, damaging the ligaments on the inside of the ankle.
- High ankle or syndesmotic sprains: Affecting the ligaments connecting the two lower leg bones — the tibia and fibula — at the top of the ankle.
Immediate Treatment — First 48 to 72 Hours
Prompt and proper care in the first few days after an ankle sprain can significantly impact your recovery. The RICE method — Rest, Ice, Compression and Elevation — is the gold standard for medial and lateral ankle sprain treatment.
Rest Techniques and Duration
Limit movement and avoid putting weight on the injured ankle, using crutches if needed to prevent further damage. Rest usually lasts 24 to 48 hours, but this will vary depending on the grade of sprain.
Ice Application Methods
Apply ice packs to the ankle for 15 to 20 minutes every two to three hours to reduce swelling and pain. You can use a cold pack, bag of ice or frozen vegetables wrapped in a towel. Never apply ice directly to the skin to avoid frostbite. If you don’t have ice on hand, immerse your foot in cold water in the meantime.
Compression Techniques
Once swelling goes down, wrap the ankle snugly but not so tightly that it cuts off circulation. Remove the wrap every few hours to check for numbness or increased pain. A randomized controlled trial found that using an Aircast ankle brace to treat a lateral ligament sprain led to better ankle function at 10 days and one month compared to a standard elastic bandage.
Get professional advice on how to wrap a sprained ankle from your doctor.
Elevation Guidelines
Prop the ankle on pillows when sitting or lying down. Aim for elevation several times a day, especially in the first 48 hours.
Timing and Frequency Recommendations
Continue RICE for the first 48-72 hours or until swelling and pain begin to subside.
Professional Medical Treatment
Many ankle sprains can be managed at home, but some need professional evaluation to heal properly and prevent complications. Knowing when to see a doctor for a sprained ankle is crucial for optimal recovery.
When to See a Doctor
If you have severe pain, can’t bear weight on your ankle or notice significant swelling, it’s important to get medical attention. You should also see a doctor if you notice any deformity, numbness or ongoing instability in your ankle. Keep in mind that ankle fractures can be mistaken for a sprained ankle. If you’re not sure how to tell the difference between a fractured or sprained ankle or your symptoms do not improve after a few days of home care, a professional evaluation is recommended.
Diagnostic Procedures
A healthcare provider will perform a physical examination to check for swelling, bruising and your ankle’s range of motion. Imaging tests like X-rays or an MRI may be ordered to rule out fractures or more serious ligament injuries.
Professional Evaluation Process
During your visit, the doctor will take a detailed history of how the injury happened and your current symptoms. They may also perform ligament stress tests to assess the severity of the sprain.
Treatment Plan Development
Your treatment plan will be tailored to the severity of your injury, your activity level, and your personal recovery goals. This plan may include bracing, physical therapy, or a referral to a specialist if needed.
Emergency Warning Signs
Access immediate medical care if you notice a severe deformity or open wounds around the ankle. Other emergency signs include cold, blue, or numb toes, sudden, severe pain and an inability to move the ankle.
Sprained Ankle Recovery Phases and Timeline
There are two recovery phases for an ankle sprain, each with its own goals and strategies. Understanding these stages helps set realistic expectations and supports a safe return to activity.
Phase 1: Acute Phase
The acute phase of ankle sprain recovery focuses on minimizing pain and swelling while protecting the injured joint. During this stage, it’s important to follow your healthcare provider’s recommendations and avoid activities that could worsen the injury. Early care sets the foundation for a smooth and effective recovery:
- Pain management: Use prescribed or over-the-counter medications as directed.
- Swelling reduction: Continue RICE and monitor for changes.
- Protection methods: Use braces, splints or crutches as recommended.
- Activity modification: Avoid activities that stress the ankle. Focus on gentle movement as tolerated.
- How long does a sprained ankle take to heal? Timelines for a grade I sprain is one to three weeks, about three to six weeks for a grade II sprain, while it takes several months for a grade III sprain to fully heal.
Phase 2: Rehabilitation
Once the initial pain and swelling have subsided, the rehabilitation phase begins. This stage is dedicated to restoring movement, strength and balance in the ankle through targeted exercises. Gradual progress and proper guidance ensure a safe return to daily activities and sports:
- Exercise progression: Gradually introduce range-of-motion and stretching exercises.
- Mobility exercises: Ankle circles, alphabet exercises and towel stretches.
- Strengthening techniques: Resistance band exercises, toe raises and gentle weight-bearing.
- Balance training: Single-leg stands, wobble board exercises to restore proprioception.
- Return to activity guidelines: Progress to sport-specific drills and full activity only when pain-free and stable.
Understanding Risk and Prevention
Ankle sprains can happen to anyone, but some people may be more vulnerable than others. By understanding what increases your risk and learning how to prevent injuries, you can take steps to protect your ankles.
Previous Ankle Injuries
If you’ve sprained your ankle before, you’re more likely to experience another sprain in the future. This is because a past injury can weaken the ligaments and reduce the stability of the joint, making it more susceptible to further damage.
Balance, Muscle Strength and Warm Up
People with poor balance or weak muscles around the ankle are at a higher risk of sprains. This is because their joints are less able to respond to sudden movements or uneven surfaces. An additional risk factor is skipping a proper warm up before physical activity, which leaves the muscles and ligaments less prepared to handle stress and increases the chances of injury.
Preventing a Sprained Ankle
Regular balance training and strengthening exercises help improve joint stability and muscle coordination, reducing the risk of future sprains. Wearing supportive footwear that fits well and gives the right ankle support is also essential, especially during sports or activities on uneven ground. Taking these preventive steps can help protect your ankles and keep you active.
Ready to Get Back on Your Feet?
Don’t let an ankle sprain slow you down. Trust our specialists at Foot & Ankle Surgical Associates for personalized care and proven treatment options. Call 360-754-3338 or fill out our easy online contact form to start your healing journey today!
