If you’ve ever rolled your ankle getting off a curb or playing a pickup game of basketball, you understand how quickly an ankle sprain can bring you to your knees. It’s one of the most frequent injuries around, and it happens to both active and inactive individuals of all ages. But what happens when you sprain your ankle—and how do you heal the fastest and safest way possible?
An ankle sprain occurs when the ligaments—those tough bands of tissue that keep your bones in place and stabilize your joint—become overstretched or ripped. Most often, it’s when your foot rolls inward, stretching the ligaments on the outside of your ankle. Mass General Brigham says that approximately 90% of sprains occur in this manner, termed an inversion sprain. Less commonly, the foot rolls outward, damaging the inner ligaments.
Not all sprains are created equal. Physicians divide them into three grades depending on how bad the injury is. A Grade 1 sprain is mild—it indicates that the ligaments were stretched a little or have small tears. You’ll probably experience some pain, swelling, and soreness, but you can still walk, although it will hurt. Grade 2 is more severe, with tearing in part, more bruising and swelling, and walking is more difficult. Grade 3 is the worst—this refers to the ligament being torn, with significant pain, extensive swelling and bruising, and usually, you can’t bear weight on the ankle. As the Cleveland Clinic says, “The ligament is torn completely. Your ankle has significant swelling, the injury is painful, and walking is difficult.”
So, who is at higher risk of spraining their ankle? Athletes are an obvious choice because of all the jumping, turning, and rapid movements they perform, but anyone can get a sprain, even just walking. If your ankle has been sprained before, that part of your body may still be weakened and more susceptible to another injury. Some of the other dangers are weak ankle muscles, bad balance, not warming up, and improperly fitting or poorly supported shoes. Landing improperly after a jump or running on rough surfaces is also at risk of causing a sprain. The Jackson Clinics Physical Therapy writes, “Previous ankle injuries. May still be weakened, making it easier to re-injure the same area.”
Recognizing a sprain usually isn’t hard. You’ll probably feel pain, especially when trying to put weight on it, along with swelling, tenderness, bruising, and maybe even hear a popping sound when it happens. If it’s a bad sprain, walking might not be possible at all. Swelling can take a few hours to show up, and depending on how bad the injury is, it can stick around for days or even weeks.
When you see a doctor, they’ll give you a physical examination, tongue the range of motion, tenderness, swelling, and bruising, usually comparing it with your other ankle. If the doctor suspects broken bones or more severe problems, they may refer you for an X-ray or MRI.
Treatment begins with reducing the swelling and initiating the healing process. The old standby is RICE: rest, ice, compression, and elevation. That involves not putting weight on the ankle as much as possible, icing it in 20-minute intervals to alleviate pain and swelling, wrapping it with a bandage or support to stabilize it, and keeping it elevated above the heart to assist with fluid drainage. Over-the-counter medications such as ibuprofen can also assist with pain and inflammation relief.
In the more severe instances, you may be required to use crutches, a walking cast, or even a splint to keep pressure off the injury. Physical therapy is also often prescribed, particularly if your sprain is moderate or severe or if you are an athlete. Rehab is essentially about restoring your strength, flexibility, and balance. Early exercises can be merely tracing the alphabet with your big toe or calf muscle stretching. Eventually, strengthening and balance exercises are incorporated to prevent re-injury.
Healing will depend on the severity of the sprain. Mild sprains tend to heal within one to three weeks, moderate sprains will take three to six weeks, and the more severe ones may take months. It’s recommended by The Jackson Clinics Physical Therapy that “Mild (Grade 1) sprains. Heal within 1-3 weeks with proper care, including rest, ice, compression, and elevation (RICE).” You should be consistent with your rehab exercises—if you miss them, your ankle may remain weak and will be easier to reinjure.
Of course, the best thing is to avoid spraining your ankle in the first place. Strengthen the muscles around your ankle, warm up before physical activity, and wear shoes that fit well and support your feet properly. Be cautious on uneven terrain and use good technique when playing sports or exercising. If you’ve sprained your ankle before, it might be smart to wear a brace or tape it for extra support.
If you’re in a lot of pain, can’t walk, or your swelling and bruising aren’t improving after a couple of days, it’s time to visit a healthcare provider. Early treatment can make a big difference in how fast—and how well—you get better. That way, you can get back to doing what you want to do, without the fear of another painful twist.