Ever landed awkwardly on your ankle playing sport or rolled your ankle while walking? A sprained ankle can be painful. A mild sprain means you’ve overstretched your ligaments – the strong but stretchy bands that hold your bones in place and keep your joint stable. A severe sprain can cause the ligaments to tear.
It can be difficult to know whether you’ve strained, sprained or broken your ankle. Here’s how to tell what type of injury you might have and how to get the best treatment for the fastest possible recovery.
First aid tips for an ankle sprain
Even if you don’t know whether it’s a sprain or break, if you twist or jolt your ankle painfully, follow these first steps to prevent further injury and to help with healing in the long-run:
- Avoid putting weight on it if it’s very painful and make sure you rest your ankle
- Sit in a comfortable position with your ankle elevated
- Use a crutch or friend for support
- Place ice or a cold compress on the ankle as soon as you can. It helps if this is done regularly throughout the first few days
- Keep your ankle elevated as much as you can
- Seek medical help if the pain and swelling is severe
How do I know if I have a sprained ankle?
A sprained ankle will feel painful but it may also start to look swollen and bruised. Your symptoms will depend on how bad your injury is, the initial symptoms might be:
- Pain
- Swelling
- Bruising
- Restricted movement of the ankle
- Difficulty putting weight on your foot or more pain when you do
- Feeling wobbly or unstable when you try to stand on it
Sprained ankle vs broken ankle – what’s the difference?
A sprain happens when you damage the ligaments in your ankle – either stretching them beyond their limit or tearing them completely. An ankle fracture or break happens when at least one of the bones in your ankle breaks.
There are some key ways to help you identify which your injury might be:
- Noise – a sprain may be silent or in severe cases cause a popping sound. With a fracture, you’ll likely hear a loud crack.
- Shape – swelling can happen with both injuries, but if your ankle looks out of shape or off its usual position, this means it’s most likely broken.
- Feeling – with a sprain, you’ll usually feel pain. If you have numbness or tingling, your ankle is more likely broken.
- Pain placement – if the pain is in the soft part of your ankle, it’s more likely a sprain. If your ankle hurts directly above the ankle bone, you probably have a fracture.
Still not sure? Speak to a doctor. They can properly examine your ankle and identify which injury you have so you can get the best ankle sprain or break treatment. If it’s a bad injury then they may suggest that you have an X-ray to look at the bones in your ankle.
When should I seek medical help?
You don’t always need medical help for a sprained ankle. You can usually follow some self-care steps at home to aid the healing process, including RICE – Rest, Ice, Compress, Elevate.
If your sprain is very bad, the skin is broken, if your ankle is too painful to stand on or you think the bone might be fractured, seek medical attention as soon as possible. It may be best to go to an urgent treatment centre or minor injury unit where they will help to determine the injury type. You can phone NHS 111 if you’re not sure.
You should also seek medical help if your ankle is still painful or the swelling doesn’t improve after a few days. If you keep spraining your ankle or it feels unstable when you walk on it, make an appointment to see a doctor or physiotherapist, and they can help find you the right support.
The best self-help steps for a mild sprained ankle
Most minor ankle sprains will get better on their own.
Try the RICE method for the first 2-3 days:
- Rest - try not to put weight on your ankle as much as possible
- Ice - place an ice pack (or a bag of frozen peas wrapped in a towel) on the ankle joint for about 20 minutes every 2-3 hours
- Compression - use a bandage or ankle support, but be careful not to wrap too tightly
- Elevation - keep your ankle above your heart as much as you can, try propping it up with pillows
You can also try the following:
- Take an anti-inflammatory drug to ease the pain if you’re able to do so
- Try physiotherapy for a moderate sprain or introduce your own exercises to increase the range of motion once the pain and swelling go down.
The best sprained ankle treatments if the sprain is severe
If your sprain is severe, it’s best to seek medical help as soon as you can. To diagnose the injury, a healthcare professional will likely do an imaging scan to rule out a fracture or to look in more detail at your ligament damage. They may do one of the following:
- X-ray
- MRI
- CT scan
- Ultrasound
You then might need any of the following treatments or methods for a severe ankle sprain:
- Medication – pain relievers and anti-inflammatories recommended by a doctor can help to ease the pain
- Crutches or a support brace – these can help to stabilise the ankle while it heals
- Physiotherapy – once the swelling and pain has reduced, a doctor or physical therapist will be able to recommend exercises to help you build stabilisation and balance
- Surgery - on rare occasions when the injury doesn’t heal or the ankle remains unstable, you may need surgery
How long does a sprained ankle take to heal?
Most sprained ankles are minor, but your injury – and recovery time – depends on the severity of damage to your ligaments.
Grade 1 sprain – one or more ligaments in your ankle is overstretched but not torn. You’ll likely see normal range in your foot after a few days, and this type of sprain usually heals within 2 weeks.
Grade 2 sprain – your ligament is partially torn and a doctor may be able to feel the instability when they move your ankle. This can take 6-8 weeks for the swelling to go down and for the injury to heal properly.
Grade 3 sprain – your ligament is completely torn. This can take 3-6 months or longer for you to regain full strength and movement in the foot.
This article has been medically reviewed by Dr Bryony Henderson, Lead Livi GP.
