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Ankle Sprains


The Manual's Editorial Staff

Last full review/revision Nov 2020| Content last modified Nov 2020
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What is an ankle sprain?

An ankle sprain is a tear in or painful stretch of one or more of the ligaments that hold your ankle in place. Ligaments are short, tough bands of tissue that hold your bones together at a joint.

Ligaments: Holding the Ankle Together

Ligaments: Holding the Ankle Together

Your ankle has several ligaments. Sometimes more than one is sprained. With a bad sprain, you may also have a broken bone in your ankle.

Ankle sprains:

  • Usually happen when you twist your foot

  • Can be mild, moderate, or severe depending on whether the ligament is stretched, partly torn, or fully torn

  • Cause pain and swelling

  • Don't show up on x-rays, but doctors may do x-rays to look for a nearby broken bone

  • Are treated by Protecting the area, Rest, Ice, Compression, and Elevation ("PRICE")

  • Sometimes require a splint or cast

  • Usually heal on their own

  • May require surgery if the ligament is completely torn

See a doctor if you're unable to stand or walk.

What's a high ankle sprain?

Sometimes when you sprain your ankle, you also injure a ligament above the ankle. This is the ligament that connects your 2 lower leg bones together. Since this ligament is above your ankle, it's called a high ankle sprain.

What causes ankle sprains?

Ankle sprains usually happen when your ankle is twisted, stretched, or bent too far. This can happen when you walk or run on uneven ground, especially if you step on a rock or step off the edge of a curb.

You may be more likely to get an ankle sprain if you:

  • Had an ankle sprain before

  • Have weak leg muscles or nerve damage in your legs

  • Wear unstable shoes such as high heels

What are the symptoms of an ankle sprain?

Symptoms include:

  • Swollen ankle

  • Pain that's worse when you try to walk

The torn ankle ligament can bleed under your skin. You may have a bruise a day or so after you sprain your ankle.

How can doctors tell if I have an ankle sprain?

Doctors can usually tell if you have an ankle sprain by examining you.

If doctors suspect a bone is broken or out of place, they’ll do an:

If doctors need to see how badly a ligament is injured, they may do an MRI.

How do doctors treat ankle sprains?

Mild ankle sprains don’t need special treatment. In the first 24 hours after a sprain, doctors have you do a treatment called PRICE, which stands for:

  • Protect your ankle with a bandage or splint

  • Rest your ankle by not walking on it and using a crutch

  • Ice your ankle with an ice pack wrapped in a towel

  • Compress (wrap) your ankle with an elastic bandage to keep it from swelling

  • Elevate your ankle as high as your heart, or higher, to keep it from swelling

To lessen pain, you can take acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen.

Your ankle could heal within a few days. Your doctor will recommend walking and doing other activities only if you wear shoes that support your ankle and are careful not to put too much weight on your injured foot. As your ankle sprain heals, you'll slowly be able to walk more and do other activities.

A moderate ankle sprain is also treated with PRICE. You may need to wear a splint or boot to aid healing. You'll probably need physical therapy to strengthen your ankle.

A severe ankle sprain needs treatment from a doctor. Your doctor will:

  • Put your ankle in a removable cast or boot

  • Sometimes, do surgery

  • Have you do physical therapy

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