Sprained Ankle: Symptoms, Causes, Treatment & Complete Guide
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 17, 2026
Quick Answer
A sprained ankle is an injury in which rolling, twisting or turning the ankle awkwardly stretches or tears the ligaments holding the ankle bones together, usually on the outer side. Many sprains respond to self-care and pain relievers, while severe ones may need a brace, cast, boot or rarely surgery. Strengthening and balance exercises aid healing and prevention.
What the research says
Supervised exercise and ankle braces are guideline-backed. An updated evidence-based clinical guideline for lateral ankle sprains prefers supervised exercise-based programs over passive treatments, reserves surgery for cases that do not respond to thorough exercise-based treatment, and considers ankle braces an efficacious option for preventing recurrent sprains; it also advises caution with anti-inflammatory medicines (NSAIDs), which can reduce pain and swelling but may suppress natural healing. (Vuurberg et al., Br J Sports Med, 2018) [3]
Bracing and exercise are the best-supported ways to prevent another sprain. An overview of 46 systematic reviews found strong evidence for bracing and moderate evidence for neuromuscular training in preventing recurrence; for acute sprains, there was strong evidence for NSAIDs and early mobilisation, moderate evidence for exercise and manual therapy, and insufficient evidence for ultrasound. (Doherty et al., Br J Sports Med, 2017) [4]
Rehabilitation lowers the odds of re-injury. A meta-analysis of 14 randomized trials (2,182 participants) found that exercise-based rehabilitation reduced re-injury at 12 months compared with usual care (odds ratio 0.60; 95% CI 0.36 to 0.99); there was not enough data to say which exercise program works best. (Wagemans et al., PLoS One, 2022) [5]
Sprained Ankle at a Glance
Aspect | Summary |
What it is | A stretch or tear of the ankle's ligaments — the tough bands that hold ankle bones together |
Most affected area | The three ligaments on the outer side of the ankle |
Most common mechanism | Rolling, twisting, or turning the ankle in an awkward way |
First-line self-care | R.I.C.E. for the first 2–3 days |
Pain relief | OTC pain relievers: ibuprofen, naproxen sodium, or acetaminophen |
Severe sprains | Crutches, brace, or cast/walking boot; rarely surgery |
Why rehab matters | Strengthening and balance exercises help healing and prevent repeat sprains |
If untreated | Repeat sprains, ongoing pain, unstable ankles, arthritis in the ankle joint |
What Is a Sprained Ankle?
A sprained ankle happens when you roll, twist, or turn your ankle in an awkward way. This can stretch or tear the tough bands of tissue that help hold your ankle bones together. These tough bands of tissue are called ligaments.
Ligaments do an important job: they stabilize joints and prevent harmful movement. A sprained ankle occurs when the ligaments are stretched too far or tear. Most sprained ankles affect the three ligaments on the outer side of the ankle.
A sprain can range in severity — the ankle being forced out of its typical position can cause one or more ligaments to stretch, partially tear, or fully tear — and the right treatment depends on how serious the sprain is.
What are the seven signs of a sprained ankle?
Symptoms of a sprained ankle depend on how serious the injury is. They may include:
Sign | What It Looks or Feels Like |
Pain | Especially when putting weight on the affected foot |
Tenderness | Pain when touching the ankle |
Swelling | The ankle puffs up around the injury |
Bruising | Discoloration around the ankle |
Limited movement | Reduced range of motion in the ankle |
Instability | Feeling unstable or like the ankle might give out |
A pop | A popping feeling or sound at the moment of injury |
When should you see a doctor for a sprained ankle?
If you have pain and swelling in your ankle and you think you may have a sprain, contact your healthcare professional. While self-care may be all you need, it's best to check whether a medical exam is needed.
Here is why that check matters: depending on your symptoms, you may have a torn ligament or a broken bone in your ankle or lower leg.
A sprain and a fracture can feel remarkably similar — and as our guide to broken ankles explains, you can even walk on some fractures. Pain, swelling, and instability after a twist or roll deserve a professional assessment rather than a self-diagnosis.
What causes a sprained ankle?
A sprain happens when the ankle is forced out of its typical position, causing one or more of the ligaments to stretch, partially tear, or fully tear. The common causes include:
Cause | How It Happens |
Twisting during a fall | Especially rolling the ankle inwards |
Awkward landings | Landing awkwardly after jumping or pivoting |
Uneven surfaces | Walking or exercising on an uneven surface |
Impact from others | Someone stepping or landing on your foot — often during sports |
What are the risk factors for a sprained ankle?
Certain things can increase the likelihood of spraining an ankle:
Risk Factor | Why It Raises Risk |
Playing sports | Sports involving jumping, quick direction changes, or twisting motions carry higher risk — examples include basketball, soccer, football, tennis, pickleball, and trail running |
Uneven surfaces | Walking or running on uneven ground or playing on poor field conditions |
Previous ankle injuries | If you've sprained your ankle before or had other ankle injuries, you're more likely to injure your ankle again |
Weak ankles | Poor strength or flexibility in the ankle may increase sprain risk, especially during physical activity |
Improper footwear | High heels, shoes that don't fit properly, or the wrong shoes for an activity make your ankles less stable |
What happens when a sprained ankle is ignored?
Ignoring a sprained ankle, returning to activity too soon or spraining it repeatedly can lead to four complications that proper follow-up care helps prevent.
Complication | What to Expect |
Repeat sprains | Previously injured ankles sprain more easily |
Ongoing ankle pain | Pain that lingers long after the injury |
Unstable ankles | Weak ankles that give out easily |
Arthritis | Arthritis can develop in the ankle joint |
This is the strongest argument for taking every sprain seriously from day one: the R.I.C.E. steps and follow-up care described below are exactly what keep these four complications from becoming your future.
How Is a Sprained Ankle Diagnosed?
Diagnosing a sprained ankle typically involves a physical exam of the injured area. Your healthcare professional examines your ankle, foot, and lower leg by pressing on the skin around the injury to find tender areas and moving your foot to test range of motion and see what positions cause pain.
If the injury is severe, you may need imaging tests to check for broken bones or ligament damage:
Test | What It Shows |
X-ray | A small amount of radiation produces images of the bones of the ankle — good for ruling out bone fractures |
MRI | Radio waves and a strong magnetic field produce detailed cross-sectional or 3D images of soft internal structures, including ligaments |
CT scan | X-rays from many different angles combine into cross-sectional or 3D images that reveal more detail about the bones of the joint |
Ultrasound | Radio waves produce real-time images that help the provider judge the condition of a ligament or tendon when the foot is in different positions |
How is a sprained ankle treated, from ice packs to surgery?
The right treatment depends on how serious the sprain is. The main goals are to reduce pain and swelling, help the ligament heal, and restore ankle movement, strength, and stability. For severe injuries, your provider may refer you to a musculoskeletal specialist such as an orthopedic surgeon or a doctor specializing in physical medicine and rehabilitation.
Medicines
For most people, over-the-counter pain relievers are enough to manage the pain. You can take:
Ibuprofen (Advil, Motrin IB, others)
Naproxen sodium (Aleve)
Acetaminophen (Tylenol, others)
Devices: Support While It Heals
Walking on a sprained ankle can be painful — you may need crutches until the pain improves. Depending on the severity of the sprain, your provider may recommend an elastic bandage, sports tape, or an ankle support brace to stabilize the ankle. For a severe sprain, a cast or walking boot may be needed to keep the ankle still while it heals.
Therapy: The Key to Full Recovery
Once your pain and swelling improve, your provider recommends exercises to restore your ankle's movement, strength, flexibility, and stability, guided by a healthcare professional or physical therapist. Two points matter most:
Strengthening your ankle muscles is key to supporting the joint and preventing future sprains.
Balance exercises — such as standing on one leg — retrain the muscles to work together and improve stability.
If you sprained your ankle while playing sports or exercising, talk with your healthcare professional before resuming activity. You may be given specific movement tests to make sure your ankle is strong and stable enough for your sport.
Surgery: Rare but Sometimes Necessary
In rare cases, surgery is needed when the injury doesn't heal or the ankle is still not stable after a long period of physical therapy and rehabilitation exercises. Surgery may be done to:
Repair a ligament that won't heal
Reconstruct a ligament with tissue from a nearby ligament or tendon
Treatment Summary
Step | What It Involves |
Medicines | OTC pain relievers: ibuprofen, naproxen sodium, or acetaminophen |
Devices | Crutches until pain improves; elastic bandage, sports tape, or ankle brace; cast or walking boot for severe sprains |
Therapy | Exercises to restore movement, strength, flexibility, and stability; balance training like standing on one leg; movement tests before returning to sport |
Surgery (rare) | Repair or reconstruction of a ligament that won't heal, after prolonged therapy fails |
How do you use the R.I.C.E. approach for a sprained ankle?
For self-care of an ankle sprain, use the R.I.C.E. approach for the first two or three days:
Step | How to Do It |
R — Rest | Avoid activities that cause pain, swelling, or discomfort |
I — Ice | Use an ice pack or ice slush bath for 15 to 20 minutes, repeating every 2 to 3 hours while awake. Always put a thin towel between the ice pack and your skin. If you have vascular disease, diabetes, or reduced feeling in your skin, talk with your provider before using ice |
C — Compression | Compress the ankle with an elastic bandage until the swelling stops. Don't block circulation by wrapping too tightly. Begin wrapping at the end farthest from your heart |
E — Elevation | Elevate your ankle above the level of your heart, especially at night — gravity helps reduce swelling by draining excess fluid |
What eight guidelines help prevent a sprained ankle?
Following eight simple guidelines can reduce the risk of a sprained ankle or another ankle injury.
Prevention Step | Practical Detail |
Practice balance exercises | Improves stability and ankle strength |
Warm up before exercising or playing sports | Prepares muscles and joints for activity |
Be careful on uneven surfaces | When walking, running, or working |
Use ankle support if vulnerable | A brace or tape if you have a weak or previously injured ankle |
Wear well-fitting shoes | Made for your activity |
Limit high heels | Reduces ankle strain |
Match activity to conditioning | Only play sports or do activities your body is conditioned for |
Keep muscles strong and flexible | Through regular exercise |
How should you prepare for a sprained ankle appointment?
Schedule an appointment with a healthcare professional — or get emergency medical care — if your sprained ankle doesn't improve with self-care or continues to cause pain or instability. If your sprain is severe, you may be referred to a doctor who specializes in sports medicine or orthopedic surgery.
What You Can Do
Write a list that includes detailed descriptions of your symptoms, information about medical issues you've had — especially past ankle injuries — all the medicines and dietary supplements you take, and the questions you want to ask the healthcare professional.
What to Expect from Your Doctor
Your healthcare professional may ask some of the following questions:
How did the injury occur?
Which direction did your foot turn when you injured it?
Can you bear weight on that foot?
What self-care treatments have you used?
What effect did the treatments have?
Have you injured your ankle before?
How was that injury treated?
Frequently Asked Questions
What is a sprained ankle?
A sprained ankle happens when you roll, twist, or turn your ankle in an awkward way, stretching or tearing the ligaments — the tough bands of tissue that hold the ankle bones together. Most sprained ankles affect the three ligaments on the outer side of the ankle.
How do I know if my ankle is sprained or broken?
You can't reliably tell on your own. Symptoms depend on how serious the injury is, and a sprain can share signs with a torn ligament or a broken bone in the ankle or lower leg. Contact a healthcare professional, who may order an X-ray to rule out a fracture.
What is R.I.C.E. for a sprained ankle?
R.I.C.E. is the self-care approach for the first two to three days: Rest by avoiding activities that cause pain; Ice for 15 to 20 minutes every 2 to 3 hours with a towel between the ice and your skin; Compression with an elastic bandage (never too tight, starting at the end farthest from your heart); and Elevation of the ankle above heart level, especially at night.
How long does a sprained ankle take to heal?
It depends on how serious the sprain is. Many sprains respond to self-care and over-the-counter pain relievers, while severe sprains may need a brace, cast, or walking boot. Therapy exercises restore movement, strength, flexibility, and stability as the ligament heals.
Should I keep walking on a sprained ankle?
Walking on a sprained ankle can be painful, and you may need crutches until the pain improves. Avoid activities that cause pain, swelling, or discomfort, and follow your provider's guidance on weight-bearing and movement.
What happens if a sprained ankle is not treated?
Not treating a sprain properly, returning to activities too soon, or repeatedly spraining the ankle can lead to repeat sprains, ongoing ankle pain, weak or unstable ankles that give out easily, and arthritis in the ankle joint.
Can surgery fix a sprained ankle?
In rare cases, yes. Surgery is considered when the injury doesn't heal or the ankle remains unstable after a long period of physical therapy and rehabilitation exercises. It may repair a ligament that won't heal or reconstruct it with tissue from a nearby ligament or tendon.
Conclusion
The three lessons to carry away from this guide:
Treat every sprain seriously: a sprain can mask a torn ligament or a broken bone, so pain and swelling after an injury deserve a professional check — not a self-diagnosis.
R.I.C.E. first, then rebuild: rest, ice, compression, and elevation for the first two to three days manage the acute phase, while exercises that strengthen the ankle muscles and improve balance do the real work of healing and protecting the joint from repeat sprains.
Prevention is a habit, not a one-time fix: balance training, proper footwear, warm-ups, and matching your activities to your conditioning keep the three outer ligaments of your ankle from facing the same awkward roll twice.
This guide has walked you through what a sprain is, the seven signs, the four common ways it happens, who is at risk, the four imaging tests that check for hidden damage, the full treatment ladder from pain relievers to surgery, the R.I.C.E. method, and eight prevention habits.
For more injury and recovery guides, explore our guides to broken ankles and Achilles tendinitis for related lower-body injury care.
Disclaimer: This article is for general informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment of any health condition. Never disregard professional medical advice or delay seeking it because of something you have read here.
Related Reading
Ankle Arthroscopy: Procedure, Risks and Recovery explains ankle arthroscopy and recovery.
References
Mayo Clinic Staff. Sprained ankle - Symptoms and causes. Mayo Clinic. June 19, 2026. https://www.mayoclinic.org/diseases-conditions/sprained-ankle/symptoms-causes/syc-20353225
Mayo Clinic Staff. Sprained ankle - Diagnosis and treatment. Mayo Clinic. June 19, 2026. https://www.mayoclinic.org/diseases-conditions/sprained-ankle/diagnosis-treatment/drc-20353231
Vuurberg G, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018;52(15):956. PMID 29514819. https://doi.org/10.1136/bjsports-2017-098106
Doherty C, et al. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med. 2017;51(2):113-125. PMID 28053200. https://doi.org/10.1136/bjsports-2016-096178
Wagemans J, et al. Exercise-based rehabilitation reduces reinjury following acute lateral ankle sprain: A systematic review update with meta-analysis. PLoS One. 2022;17(2):e0262023. PMID 35134061. https://doi.org/10.1371/journal.pone.0262023
Comments