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Ankle Sprain

What is an ankle sprain?
An ankle sprain is an injury that causes a stretch or tear of one or more ligaments in the ankle joint. Ligaments are strong bands of tissue that connect bones at the joint.

Sprains may be graded I, II, or III depending on their severity:
  • Grade I sprain: pain with minimal damage to the ligaments.
  • Grade II sprain: more ligament damage and mild looseness of the joint.
  • Grade III sprain: complete tearing of the ligament and the joint is very loose or unstable.
Sometimes sprains are just classified as mild or severe, depending on the amount of ligament damage. Most sprains occur on the outside part of the ankle, but they can occur on the inside as well.


How does it occur?
A sprain is caused by twisting your ankle. Your foot usually turns in or under but may turn to the outside.


What are the symptoms?
Symptoms of a sprained ankle include:
  • mild aching to sudden pain
  • swelling
  • discoloration
  • inability to move the ankle properly
  • pain with or without weight bearing

How is it diagnosed?
To diagnose a sprained ankle, it is necessary to examine your child’s ankle. The mechanism of the injury (how the injury happened) and the severity of your child’s symptoms will determine what treatment is necessary.


Are X-rays necessary?
Most ankle sprains are not associated with bone fractures. X-rays are only necessary if a fracture of the bones of the lower leg (which make up part of the ankle joint) is suspected. Pain above the ankle with or without inability to weight bear, is more suggestive of a fracture.


Treatment may include:
  • Applying ice packs to your ankle for 20 to 30 minutes every 3 to 4 hours for the first 2 to 3 days or until the pain goes away. Thereafter, ice your ankle at least once a day until the other symptoms are gone.
  • Elevating your ankle by placing a pillow underneath your foot. Try to keep your ankle above the level of your heart.
  • Wrapping an elastic ace bandage around your ankle to keep the swelling from getting worse. Wrap the ace bandage in a figure of 8, leaving the heel and toes open.
  • Wearing a lace-up brace or ankle stirrup (an Aircast or Gelcast).
  • Using crutches until you can walk without pain.
  • Using Ibuprofen (Motrin/Advil) every 6-8 hours for up to 10 days.
  • Doing ankle exercises to improve your ankle strength and range of motion. The exercises will help you return to your normal activity or sports.
Rarely, severe ankle sprains with complete tearing of the ligaments (grade III) need surgery. After surgery your ankle will be in a cast for 4 to 8 weeks.


How long does it take for an ankle sprain to heal?
The length of recovery depends on many factors: age, health, severity of injury and previous injuries to that joint.


When can I return to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your ankle recovers, not by how many days or weeks it has been since your injury occurred.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:
  • You have full range of motion in the injured ankle compared to the uninjured ankle.
  • You have full strength of the injured ankle compared to the uninjured ankle.
  • You can jog straight ahead without pain or limping.
  • You can sprint straight ahead without pain or limping.
  • You can do 45-degree cuts, first at half-speed, then at full-speed.
  • You can do 20-yard figure eights, first at half-speed, then at full-speed.
  • You can do 90-degree cuts, first at half-speed, then at full-speed.
  • You can do 10-yard figure eights, first at half-speed, then at full-speed.
  • You can jump on both legs without pain

How can I help prevent an ankle sprain?
To help prevent an ankle sprain, follow these guidelines:
  • Wear proper, well-fitting shoes when you exercise.
  • Stretch gently and adequately before and after athletic or recreational activities.
  • Avoid sharp turns and quick changes in direction and movement.
  • Consider taping the ankle or wearing a brace for strenuous sports, especially if you have a previous injury.

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