Sprained Ankle: Symptoms, Grades and Treatment

A sprained ankle can happen in an instant, whether you land awkwardly after a jump, roll your foot while running, step on an uneven surface or twist the ankle during sports.

An ankle sprain occurs when one or more of the ligaments that stabilize the ankle are stretched beyond their normal range or torn. Symptoms can include pain, swelling, bruising, reduced motion and difficulty putting weight on the foot.

Elite Sports Medicine evaluates the severity of the injury, ankle stability, mobility and ability to bear weight before recommending treatment. Depending on the sprain, care may include protection, activity modification, manual therapy, progressive exercise and rehabilitation to help restore strength, balance and function.

What Is a Sprained Ankle?

A sprain is an injury to a ligament, which is a strong band of tissue that connects one bone to another and helps stabilize a joint.

An ankle sprain occurs when the ankle rolls, twists or turns beyond its normal range of motion, stretching or tearing one or more ligaments. Most ankle sprains involve ligaments on the outside of the ankle.

A sprain is different from a strain, which involves a muscle or tendon rather than a ligament.

What Does a Sprained Ankle Feel Like?

Symptoms vary depending on the severity of the injury.

Common signs include:

• Ankle pain
• Swelling
• Bruising
• Tenderness
• Reduced range of motion
• Pain when standing or walking
• A feeling that the ankle is unstable or may give way
• A popping sensation or sound at the time of injury

Mayo Clinic notes that symptoms can range considerably depending on how severely the ligament has been injured.

What Causes an Ankle Sprain?

Common mechanisms include:

Landing awkwardly: A jump or step can force the ankle into an excessive position.

Running or walking on uneven ground: A sudden change in the surface can cause the ankle to roll.

Sports involving cutting or pivoting: Basketball, soccer, tennis and similar activities place significant demands on ankle stability.

Falls: A fall can twist the ankle beneath the body.

Contact injuries: Another person may land on or step on the foot during sports.

These are among the common causes identified by Mayo Clinic.

What Is a Lateral Ankle Sprain?

A lateral ankle sprain affects the ligaments on the outside of the ankle and is the most common type.

It typically happens when the foot rolls inward, placing excessive stress on the outer ankle ligaments.

The anterior talofibular ligament, or ATFL, is commonly involved, but other lateral ligaments may also be injured depending on the severity of the sprain.

What Is a High Ankle Sprain?

A high ankle sprain affects the ligaments that connect the tibia and fibula above the ankle joint.

These injuries typically occur with a forceful twisting mechanism and are different from the more common lateral ankle sprain.

High ankle sprains may require a longer recovery period and should be evaluated carefully, particularly when pain is located above the ankle rather than primarily along its outer edge.

What Are the Grades of Ankle Sprains?

Ankle sprains are often described by severity.

Grade 1: Mild ligament stretching or microscopic tearing with relatively little instability.

Grade 2: Partial ligament tearing with greater pain, swelling and some instability.

Grade 3: Complete ligament tearing with substantial instability.

The grade of an ankle sprain can help guide treatment, but symptoms, ability to bear weight and functional stability also matter.

How Do I Know If My Ankle Is Sprained or Broken?

Sprains and fractures can cause similar symptoms, including pain, swelling and difficulty walking.

A fracture is more likely when there is significant bone tenderness, inability to bear weight, deformity or severe pain after trauma.

Mayo Clinic recommends evaluation when a person cannot move or bear weight on the joint, has pain directly over a bone or experiences numbness.

X-rays may be used when a fracture is suspected.

Should You Walk on a Sprained Ankle?

It depends on the severity of the injury.

Some mild ankle sprains can tolerate gradual weight-bearing fairly early, while more severe injuries may temporarily require crutches, a brace or a walking boot.

Walking through substantial pain is not the goal.

Mayo Clinic notes that support devices such as crutches, elastic bandages, braces or a walking boot may be recommended depending on severity.

Should You Use Ice for a Sprained Ankle?

Ice may help manage pain and swelling during the early stage of an ankle sprain.

Mayo Clinic still recommends the familiar R.I.C.E. approach during the first two or three days:

• Rest from activities that worsen symptoms
• Ice
• Compression
• Elevation

The goal is to control symptoms while protecting the ankle, not to remain completely inactive for an extended period.

Can a Chiropractor Help with a Sprained Ankle?

Chiropractic care may be one part of conservative treatment for an ankle sprain once serious injury has been ruled out.

A useful evaluation should focus on more than whether the ankle is “out of alignment.”

It may include:

• Location of tenderness
• Swelling
• Range of motion
• Ability to bear weight
• Joint stability
• Strength
• Balance
• Previous ankle injuries
• Walking or running mechanics
• Sport or work demands

When appropriate, care can include manual therapy, mobility work and rehabilitation rather than attempting to “reposition” the ankle bones.

How Does Elite Sports Medicine Treat a Sprained Ankle?

Treatment depends on the severity and stage of the injury.

It may include:

Protection and activity modification: Painful activities may temporarily need to be reduced while the injured ligament begins to heal.

Bracing or support when appropriate: Some patients may benefit from external support while walking or returning to activity.

Mobility treatment: Gentle mobility work may be introduced as pain and swelling improve.

Therapeutic exercise: Strengthening helps restore the muscles that support the ankle.

Balance and proprioception training: Single-leg balance and similar exercises help retrain ankle control and stability.

Progressive return to activity: Rehabilitation should gradually prepare the patient to walk, run, jump, cut or participate in sport again.

Mayo Clinic specifically emphasizes restoring motion, strength, flexibility and stability after an ankle sprain.

Why Are Balance Exercises Important After an Ankle Sprain?

After an ankle sprain, the joint can feel unstable or less responsive during quick changes in direction.

Balance and proprioception exercises help retrain the body’s ability to sense ankle position and respond to movement.

Mayo Clinic specifically recommends balance training as part of ankle rehabilitation and notes that strengthening and balance exercises may help reduce the risk of future sprains.

This is why rehabilitation should extend beyond simply waiting for swelling to disappear.

Why Is Strengthening Important After an Ankle Sprain?

The muscles surrounding the lower leg and ankle help support and stabilize the joint.

A rehabilitation program may include strengthening for:

• Calf muscles
• Ankle evertors and invertors
• Dorsiflexors and plantar flexors
• Foot and lower-leg muscles

AAOS recommends strengthening and flexibility work after foot and ankle injuries to restore joint stability and support return to daily and recreational activity.

Patients who need a structured rehabilitation program may also benefit from physical therapy at Elite Sports Medicine.

Can Soft Tissue Therapy Help After an Ankle Sprain?

It may be incorporated at appropriate stages of rehabilitation when surrounding muscles or soft tissues are painful or restricted.

Soft tissue therapy should not replace ligament healing, strengthening or balance training, but it may be used as an adjunct when it helps the patient move more comfortably.

This is a good example of why ankle rehabilitation is usually more effective as a combination of approaches rather than one isolated treatment.

Can Foot Problems Affect Recovery from an Ankle Sprain?

The ankle and foot function together during standing, walking, running and jumping.

Lingering stiffness, altered walking mechanics or weakness after an ankle injury may sometimes contribute to discomfort elsewhere in the foot.

Patients whose symptoms extend beyond the ankle may also have another condition contributing to foot pain.

The goal is to evaluate the whole lower-extremity movement pattern without assuming every foot or ankle problem comes from a single alignment issue.

How Long Does a Sprained Ankle Take to Heal?

Recovery varies depending on the severity of the sprain.

A mild sprain may improve relatively quickly, while a more significant ligament tear can take substantially longer.

Rather than focusing only on a calendar date, return to activity should consider:

• Pain
• Swelling
• Range of motion
• Strength
• Balance
• Ankle stability
• Ability to perform sport or work-specific movements

The ankle should be functionally ready for the demands being placed on it.

When Can You Run Again After a Sprained Ankle?

Running should usually return gradually.

Before progressing back to running, the ankle should have enough strength and stability to tolerate walking, single-leg loading and progressively more demanding movement without significant symptoms.

Mayo Clinic recommends movement testing before resuming sports to make sure the ankle has recovered sufficient strength and stability.

For athletes, rehabilitation may eventually progress from walking to jogging, running, hopping, cutting and sport-specific activity.

Can You Sprain the Same Ankle Again?

Yes.

A previous ankle sprain can increase the likelihood of another sprain, particularly when strength, balance or stability has not been fully restored.

That is one reason rehabilitation should not stop simply because the ankle no longer hurts.

Mayo Clinic lists repeat sprains and ongoing ankle instability among possible complications and emphasizes balance and strengthening exercises as part of prevention.

Does a Sprained Ankle Need Surgery?

Most ankle sprains do not require surgery.

Mayo Clinic notes that surgery is rare and is generally considered when a ligament fails to heal or the ankle remains unstable after extensive rehabilitation.

When an injury appears severe or instability persists, Elite Sports Medicine can coordinate additional orthopedic evaluation when appropriate.

When Should a Sprained Ankle Be Evaluated?

Evaluation is especially important when:

• You cannot bear weight
• Pain is severe
• There is substantial swelling or bruising
• Pain is directly over a bone
• The ankle appears deformed
• You experience numbness
• The ankle repeatedly gives way
• Symptoms are not improving
• The injury occurred with a significant impact or twisting force

These findings can indicate a more severe ligament injury, fracture or another problem that should not be treated as a routine mild sprain.

Why Choose Elite Sports Medicine for Sprained Ankle Treatment?

A sprained ankle is more than a swollen joint. Recovery requires restoring the ankle’s mobility, strength, balance and ability to tolerate normal activity.

Elite Sports Medicine evaluates the severity of the injury, ankle stability, mobility and functional limitations before developing an individualized treatment plan.

When conservative care is appropriate, treatment may combine chiropractic care, manual therapy, therapeutic exercise and rehabilitation. Elite’s multidisciplinary approach also provides access to physical therapy and orthopedic evaluation when more extensive care is needed.

Elite Sports Medicine provides sprained ankle treatment in Woodland Hills, Los Angeles (LAX), Montebello, West LA, Orange, and South Central LA.

Schedule a Sprained Ankle Evaluation

If an ankle injury is making it difficult to walk, exercise or return to normal activity, an evaluation can help determine the severity of the sprain and the appropriate next steps.

Request an appointment with Elite Sports Medicine in Woodland Hills, Los Angeles (LAX), Montebello, West LA, Orange, and South Central LA.