Ankle Sprains

All about ankle sprains

An ankle sprain is a stretch or tear of the ligaments that hold the ankle and foot bones together. Your ankle ligaments hold your joint together to limit excessive motion and keep your ankle safe from twists.

Ankle sprains are graded by severity from Grade I to Grade III. With a Grade III sprain you usually cannot bear weight right after the injury and later.

There are three types of ankle sprains:

  • Lateral (outside aspect)
  • Medial (inside aspect)
  • Syndesmosis (between the two lower leg bones)

The most common sprain is the lateral or inversion sprain.

Self-care for your sprain

RICE

Do these for the first week following your ankle sprain:

  • Rest from all painful activity. No sports for three weeks!
  • Ice. Apply an ice pack to your ankle for 15 to 20 minutes. Do this three times per day for at least the first 48 hours and after doing the exercises and stretches described on this page. Place a dry layer of towel between your skin and the ice pack to prevent frostbite. Secure with an elastic bandage or towel.
  • Compression. Wrap your ankle with an elastic bandage.
  • Elevation. Raise your ankle up on pillows, a chair seat, or a sofa when applying ice. To prevent swelling avoid having your ankle hang down for long periods.

Contrast baths

After 48 hours you can use contrast baths. Alternate placing your ankle/foot into a container of warm (100 to 101 degrees F) water for three minutes and then place it into a container of cold water (55 to 65 degrees F) water for one minute. Do this for a total of 20 minutes or 5 times each container. While in the warm water you may move your foot gently to improve range of motion. Keep your foot still while in the cool water.

Exercises/stretches

Toe Pumps: Move all toes together up and down, alternating 10 to 20 times.

Ankle Pumps: Move ankle up and down, alternating 10 to 20 times.

Ankle Circles: Circle ankle clockwise, then counterclockwise, 10 to 20 times each way.

Calf Stretch: Sitting with your legs straight, place a towel around the ball of your foot. Holding each end of the towel, pull your foot and ankle up, placing a stretch on the back of your leg (calf muscle). Hold for 20 to 30 seconds. Repeat three times.

When to seek further medical attention

  • Immediately if your foot or lower leg is bent at an angle.
  • If you experience any of the following:
    • You heard a “pop” at the time of injury.
    • You have moderate to severe pain or severe swelling and bruising.
    • You are unable to walk or put weight on the foot/ankle.
    • You have numbness or tingling that lasts after the initial injury.
    • You have swelling or bruising that lasts longer than two weeks.

Treatment

In some cases, a doctor or nurse might order an X-ray to check for broken bones, but that is not always needed.

You may be given a brace or other supportive device which you will typically use for two weeks unless otherwise instructed. Physical therapy may also be necessary for some injuries. These will enable your ligaments to heal well and will help prevent recurrent ankle sprains.

You should take off your bracing device three times per day (unless given other directions) to do active range of motion and stretching exercises for your foot and ankle to prevent stiffness. These are found in the self-care exercises on this page.

Be sure to follow up with your health care provider as they recommend, or sooner if you have any problems.

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