An ankle sprain is a partial or complete tear of the ligaments that support the ankle. Ligaments are strong bands of tissue that cross joints and connect bones to each other.
Copyright © Nucleus Medical Media, Inc.
Ankle sprains may be caused by: Falling
Sudden twisting of the ankle, such as:
Stepping on an uneven surface or in a holeTaking an awkward step when running, jumping, or stepping up or downHaving your ankle roll over when playing sports or exercising—called inversion of the foot
Factors that increase your chance of getting an ankle sprain include: Playing sports, especially with the wrong type of shoeWalking on uneven surfacesWeak ankles from a previous sprain
Poor coordinationPoor balancePoor muscle strength and tight ligamentsLoose jointsCertain footwear, such as high heels
Symptoms of an ankle sprain may include: Pain, swelling, and bruising around the ankleWorsening of pain when walking, standing, pressing on the sore area, or moving the ankle inwardAn inability to move the ankle joint without painA popping or tearing sound at the time of the injury
An ankle sprain may not require a visit to the doctor. However, you should call your doctor if you have any of the following: Inability to move the ankle without significant painInability to put any weight on that footSignificant swelling or bruisingPain over a bony part of your foot or anklePain that interferes significantly with walkingPain not relieved by ice, pain relief medication, and elevationNumbness in the leg, foot, or anklePain that does not improve in 5-7 daysUncertainty about the severity of the injuryUncertainty about how to care for this injury
You will be asked about your symptoms and how your injury occurred. An examination of your ankle will be done to assess the injury.
Images may be taken of your ankle. This can be done with
x-rays. If additional details are needed, other images may be done, such as a CT scan or an MRI scan.
Ankle sprains are graded according to the damage to the ligaments. The more ligaments involved, the more severe the injury.
Some minor tearing of ligament tissueAnkle remains stable
Partial tearing of ligament tissueMild instability of the jointUsually involves damage to 2 ankle ligaments
Complete tearing of 2 or 3 of the ligamentsSignificant instability of the joint
The ankle will need time to heal. Supportive care may include: Rest—Activities may need to be restricted. Normal activities will be gradually reintroduced as the injury heals. Ice—Ice therapy may help relieve swelling. Compression—Compression bandages can provide gentle pressure to help move fluids out of the area. Elevation—Keeping the ankle elevated can help fluids drain out or prevent fluids from building up. Protection—A brace or walking boot may be advised to prevent the ankle from moving as it heals. A short leg cast may be advised in severe cases, but this is rare.
Over-the-counter medications may be advised to reduce pain.
A physical therapist will assess the ankle. An exercise program will be created to help recovery and to strengthen the muscles around the ankle.
Surgery is rarely needed to repair an ankle sprain. However, it may be necessary to repair a third degree sprain in which all 3 ligaments are torn.
Many ankle sprains cannot be prevented. However, you can reduce your risk of spraining an ankle: Take a break from sports or exercise when you feel tired.Do exercises that improve your balance and strengthen leg and foot muscles.Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, ligaments, and tendons, including those around your ankle.If you have injured your ankle before, you are more likely to injure it again. You may reduce your risk of repeated sprains by wearing an ankle brace.Wear appropriate footwear when playing sports to avoid injury.
Ankle sprain. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated January 30, 2015. Accessed March 3, 2015.
Kemler E, van de Port I, et al. A systematic review on the
treatment of acute ankle sprain: brace versus other functional treatment types.
Sports Med. 2011;41(3):185-197.
Kerkhoffs GM, Handoll HH, et al. Surgical versus
conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults.
Cochrane Database Syst Rev. 2007 Apr 18;(2):CD000380.
Sprained ankle. American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00150. Updated September 2012. Accessed March 3, 2015.
Sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at:
Published July 2012. Accessed March 3, 2015.
10/26/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults.
Cochrane Database Syst Rev.
11/19/2010 DynaMed's Systematic Literature Surveillance
: van Rijn RM, van Ochten J, Luijsterburg PA, van Middelkoop M, Koes BW, Bierma-Zeinstra SM.
Effectiveness of additional supervised exercises compared with conventional treatment alone in patients with acute lateral ankle sprains: systematic review.
9/10/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Mosher TJ, Kransdorf MJ, et al. ACR Appropriateness Criteria acute trauma to the ankle online publication]. Reston (VA): American College of Radiology (ACR);2014. 10 p. Available at: http://www.guideline.gov/content.aspx?id=48284#Section420. Accessed March 3, 2015.
Last reviewed March 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.