Causes

A sprain occurs when your ankle is forced to move out of its normal position, which can cause one or more of the ankle's ligaments to stretch, partially tear or tear completely.
Causes of a sprained ankle might include:
  • A fall that causes your ankle to twist
  • Landing awkwardly on your foot after jumping or pivoting
  • Walking or exercising on an uneven surface

Risk factors

Factors that increase your risk of a sprained ankle include:
  • Sports participation. Ankle sprains are a common sports injury. Sports that require rolling or twisting your foot, such as basketball, tennis, football, soccer and trail running, can make you vulnerable to spraining your ankle, particularly if you're overweight. Playing sports on an uneven surface also can increase your risk.
  • Prior ankle injury. Once you've sprained your ankle, or had another type of ankle injury, you're more likely to sprain it again.

Complications

A sprained ankle left untreated, engaging in activities too soon after spraining your ankle or spraining your ankle repeatedly might lead to the following complications:
  • Chronic pain
  • Chronic ankle joint instability
  • Early-onset arthritis in that joint

Preparing for your appointment

Many people don't seek medical attention for mild ankle sprains. If your sprain is severe, however, your family doctor may refer you to a doctor who specializes in sports medicine or orthopedic surgery.

What you can do

You may want to write a list that includes:
  • Detailed descriptions of your symptoms
  • Information about medical problems you've had, especially past ankle injuries
  • Information about the medical problems of your parents or siblings
  • All the medications and dietary supplements you take
  • Questions you want to ask the doctor

What to expect from your doctor

Your doctor 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?

Tests and diagnosis

During the physical exam, your doctor will check for points of tenderness. He or she will move the joint in various ways to check your range of motion and to see if a particular position or movement causes pain.
If the injury is severe, your doctor may recommend one or more of the following imaging scans to rule out a broken bone or to better evaluate the soft tissue damage:
  • X-ray. During an X-ray, a small amount of radiation passes through your body to produce images of your internal structures. This test is good for evaluating bones.
  • Magnetic resonance imaging (MRI). MRIs use radio waves and a strong magnetic field to produce detailed images of internal structures, including soft tissue injuries.
  • CT scan. CT scans can reveal more detail about the bones of the joint. CT scans take X-rays from many different angles and combine them to make cross-sectional images of internal structures of your body.

Treatments and drugs

Treatment for a sprained ankle depends on the severity of your injury. Many people simply treat their injuries at home.

Medications

In most cases, over-the-counter pain relievers — such as ibuprofen (Advil, Motrin IB, others), naproxen (Aleve, others) or acetaminophen (Tylenol, others) — are enough to manage the pain of a sprained ankle.

Devices

Because walking with a sprained ankle might be painful, you may need to use crutches until the pain subsides. Your doctor might also recommend that you use a removable plastic device such as a splint.

Therapy

Once the swelling goes down, a physical therapist can help you with exercises to restore your ankle's range of motion, strength, flexibility and balance.
Balance and stability training is especially important to retrain the ankle muscles to work together to support the joint. These exercises may involve various degrees of balance challenge, such as standing on one leg.
If you sprained your ankle while exercising or participating in a sport, talk to your doctor about when you can resume your activity. You may need to wear an ankle brace or wrap your ankle to protect it from re-injury.

Surgical and other procedures

If your ankle joint is unstable, your doctor may refer you to a musculoskeletal specialist for evaluation. You may need a cast or walking boot to immobilize your joint so that it can heal properly. In rare cases of severe ligament tears, particularly in elite athletes, your doctor might recommend surgery to repair the damage.

Lifestyle and home remedies

For immediate self-care of an ankle sprain, try the R.I.C.E. approach:
  • Rest. Avoid activities that cause pain, swelling or discomfort.
  • Ice. Use an ice pack or slush bath immediately for 15 to 20 minutes and repeat every two to three hours while you're awake. If you have vascular disease, diabetes or decreased sensation, talk with your doctor before applying ice.
  • Compression. To help stop swelling, compress the ankle with an elastic bandage until the swelling stops. Don't hinder circulation by wrapping too tightly. Begin wrapping at the end farthest from your heart.
  • Elevation. To reduce swelling, elevate your ankle above the level of your heart, especially at night. Gravity helps reduce swelling by draining excess fluid

Prevention

Here are some things you can do to help prevent a sprained ankle.
  • Warm up before you exercise or play sports.
  • Be careful when walking, running or working on an uneven surface.
  • Wear shoes that fit well and are made for your activity.
  • Don't wear high-heeled shoes.
  • Don't play sports or participate in activities for which you are not conditioned.
  • Maintain good muscle strength and flexibility.
  • Practice stability training, including balance exercises.