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Ankle sprains: what's normal and what's not?

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AN ORTHO-PINION
Alexandra Page, MD

Alexandra E. Page, MD

Any views or recommendations shared in the Ortho-pinions blog are solely those of the authors and do not necessarily represent those of the American Academy of Orthopaedic Surgeons. 

Ankle sprains are the most common sports injuries, with an estimated 25,000 occurring every day in the US.

Sprains can happen with any sport, including just walking across the yard! Ankle sprains are most common in ball sports such as basketball, soccer, volleyball and others.

What happens? The ankle is designed to have much more motion with the foot turning in, which is how sprains usually happen. The term “sprain” refers to any ligament injury. Ligaments are the tough fibers that connect bones to each other to give the skeleton strength while still allowing joints to move.

The most common ankle sprains involve tearing of the ligaments on the outside of the ankle. The ligament tearing leads to bleeding deep inside, which you see as bruising on the skin.  Fortunately, your body is designed to heal injuries, so these ligaments will almost always heal on their own.

As with any injury, your body quickly sends blood to start the healing process, which leads to the swelling. Remember: your heart is the pump and it is a long way to pump the blood back up from the ankle. For many people, some swelling will continue long after the sprain has “healed” and you are back to activities. This is, again, due to the distance from the ankle to the heart. At night, the swelling gets better but, with activity during the day, the fluid from normal blood flow leads to gradual swelling.

Rest, ice, compression, elevation, known as RICE, is a good way to treat an ankle sprain. This decreases the swelling, lessens your pain, and allows your body to heal the injury. Studies have shown that the sooner you return to activity, the better and typically the faster you will recover.

 If pain allows, start moving the ankle early.

When to seek care: If it hurts too much to put any weight on the ankle and you can’t walk, seek treatment immediately. Depending on the amount of injury to the ligaments, it may be days, weeks, or even months to return to high-intensity sports. Sometimes recovery may be slow but, if it gets better day by day or week by week, you are on the right path.

If the ankle seems to stop improving and you just can’t get back to your activities then your orthopaedic surgeon can help.

Prevention: It is always better to avoid the sprain in first place! Remember to stretch before sports to prevent ankle and other injuries to all your bones and joints. Some studies show that taping or an ankle brace can help avoid repeat sprains if you have had sprains in the past.

Don’t let fear of an ankle sprain keep you from your sport. Your orthopaedic surgeon wants you to stay in motion to stay healthy!

Learn more about Sprained Ankle.

This Ortho-pinion was originally written for A Nation in Motion, the AAOS's award-winning public awareness campaign dedicated to sharing the stories of people whose lives were improved by orthopaedic surgery.

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Last Reviewed

March 2019

Contributed and/or Updated by

Alexandra E. Page, MD

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.