Overview

An ankle sprain is a stretch or tear of ligament tissue around the ankle. The common “rolled ankle” mechanism turns the foot inward and most often affects the ATFL, sometimes with the CFL. It can happen during sport, a misstep off a curb or uneven ground.

Typical Pattern

Pain and swelling on the outside of the ankle
Tenderness in front of or just below the outer ankle bone
Bruising that may appear over the following days
Pain with walking, turning or pushing off
A feeling of weakness or giving way later in recovery

What To Do First

Protect the ankle from another roll, but avoid treating it as completely fragile for longer than necessary. Relative rest, comfortable movement, compression or elevation for comfort, and gradual return to walking are reasonable early steps. Ice can reduce pain for some people but is optional; it does not “repair” the ligament.

Recovery Focus

Recovery should progress from walking comfortably, to ankle motion and calf strength, to balance and finally hopping/cutting demands when relevant. A return to sport based only on time or the disappearance of swelling can leave the ankle underprepared.

Get Assessed Urgently If

You cannot take four steps after the injury
There is marked bony tenderness, deformity, numbness, a cold foot or rapidly increasing pain
Pain is high above the ankle, on the inner ankle, or at the base of the fifth metatarsal
The ankle repeatedly gives way or does not regain function as expected

Imaging decisions are based on the examination; the Ottawa Ankle Rules are commonly used to decide when an X-ray is appropriate after acute trauma.

References

Martin RL, et al. Lateral Ankle Ligament Sprains: Clinical Practice Guideline. J Orthop Sports Phys Ther. 2021.
American College of Radiology. Acute Trauma to the Ankle. https://acsearch.acr.org/docs/69436/Narrative/

This information is for education only and is not a medical diagnosis.

Ankle Sprain