What is a sprained ankle?

A sprained ankle happens when you 'roll your ankle' and overstretch or tear one or more of the ligaments in your ankle. Ligaments are bands that hold your ankle together. It is a common injury, especially among athletes.

Proper treatment can help recovery and reduce chances of complications. Most ankle sprains can take 4 to 6 weeks to heal. Some people continue to feel discomfort in their ankle up to 12 months after their injury.

What are the symptoms of a sprained ankle?

Spraining your ankle can be painful. Other symptoms include:

• swelling
• bruising
• difficulty moving your ankle as you normally do
• difficulty putting weight on your ankle

If your symptoms are severe, it might mean that you can't walk or do other everyday activities.

What causes a sprained ankle?

Your ankle can become sprained when you 'roll' it into an abnormal position that stretches and damages the ligaments. Most commonly, this happens when your foot points downwards and then twists inwards.

This can happen when you are:

• walking and unexpectedly step into a hole in the ground
• running and quickly change your direction

You are more likely to sprain your ankle if you:

• play sport, for example tennis, rugby or volleyball
• have previously sprained your ankle
• wear shoes that are not appropriate for the activity you are doing

When should I see my doctor?

You should see your doctor if:

• you cannot put weight on your ankle
• your ankle looks deformed
• you have been treating your sprained ankle, but pain, swelling or stiffness are not getting better, or are getting worse

After you see your doctor, they may suggest you return a few days later to check how your ankle is healing.

Read about how to get the most out of your doctor's appointment.

How is a sprained ankle diagnosed?

Your doctor can diagnose a sprained ankle by:

• asking you questions — what happened, what symptoms you have, if you have previously sprained your ankle, and about your medical history
• examining your ankle — they will look at your ankle, gently touch it and move it in certain directions, check if you can weight bear and how your ankle feels
• referring you for imaging — an x-ray may rule out broken bones

How is a sprained ankle treated?

Your treatment will include self-care, medicines, physiotherapy and possibly other treatments. It will depend on how severe your injury is.

Self-care at home

During the first 2 days after you have sprained your ankle, follow the 'RICE' recommendations:

• Rest — avoid activities that cause pain.
• Ice — apply ice packs for 10 minutes every 1 to 2 hours. This reduces pain and swelling.
• Compression — use compression bandages to reduce swelling.
• Elevation — raise your ankle to reduce swelling, for as long and as often as you need.

You can do gentle exercises, walk or weight bear on your sprained ankle. Try to walk as normally as you can. If you cannot put weight on your leg comfortably, ask your doctor or physiotherapist if they recommend crutches.

During this time, also follow 'NO HARM' recommendations:

• No Heat.
• No Alcohol.
• No Running or similar activity.
• No Massage.

Medicines

If you are in pain, you can take:

• paracetamol
• nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen — you should only take NSAIDs during the first 48 hours after your injury.

Ask your doctor or pharmacist before you take any medicines, to check if they are right for you. This is especially important before starting a new medicine for pain relief.

Physiotherapy

Your doctor may refer you to a physiotherapist after your injury. Physiotherapy can help you recover more quickly.

Your physiotherapist will work on the muscles and ligaments in your ankle.

As you start to recover, your physiotherapist will create a program with stretches and exercises. These may include balance, strengthening and functional exercises to help:

• strengthen the muscles around your ankle
• restore your ankle's range of motion
• your proprioception (your sense of knowing where your ankle is in space)
• your balance and stability

Functional exercises are exercises that are adapted to your regular activities. For example, if you play basketball, your physiotherapist may recommend you jump as a functional exercise.

Other treatments

Depending on how severe your sprain is, you may need to wear an ankle brace for 4 to 6 weeks.

Usually, you will not need surgery. If you have a chronic injury or if your ligament was completely torn, your doctor may refer you to a surgeon for an assessment.

There is not enough research to confidently say that acupuncture is effective in treating a sprained ankle.

You can return to physical activity or sport when you can do regular daily movements without being in pain. There is no rule to say how long it will take. The worse your injury, the longer it will take.

What are the complications of a sprained ankle?

Complications of a sprained ankle may include:

• chronic ankle instability (CAI) — your ankle joint becomes unstable. It will feel weak or continue to give out. This can interfere with your regular activity and is common among athletes.
• posttraumatic osteoarthritis — osteoarthritis that develops after you have injured your joint.

Can a sprained ankle be prevented?

You can prevent spraining your ankle by:

• doing warm-ups before playing sports including stretching, strengthening and balance exercises
• wearing an ankle brace or tape, especially if you are an athlete or you have recently sprained your ankle
• wearing supportive shoes

Resources and support

• Visit the Australian Physiotherapy Association to learn more about ankle sprains.
• St John Ambulance Australia have a sprain and strain first aid fact sheet.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

Do you prefer to read in languages other than English?

• Visit the Emergency Care Institute for resources about ankle sprains in a range of community languages.