What should I do if I sprain my ankle?

Ankle sprains are very common injuries — some 25,000 people do it every day.​​​ Sometimes, it is an awkward moment when you lose your balance, but the pain quickly fades away and you go on your way. But the sprain could be more severe; your ankle might swell and it might hurt too much to stand on it. If it's a severe sprain, you might have felt a "pop" when the injury happened.

A sprained ankle is an injury or tear of one or more ligaments on the outer side of your ankle​. If a sprain is not treated properly, you could h​ave long-term problems. A sprain can be difficult to differentiate from a broken bone without an X-ray. If you are unable to put weight on your foot after this type of injury, or if there is significant swelling, bruising, or deformity, you should seek medical treatment from a doctor (MD or DO). This may be your primary care physician or pediatrician, an emergency department, or a foot and ankle orthopaedic surgeon​, depending on the severity of the injury.

Tell your doctor what you were doing when you sprained your ankle. He or she will examine it and may want an X-ray to make sure no bones are broken. Most ankle sprains do not require surgery, and minor sprains are best treated with a rehabilitation program similar to your sporting activities. Depending on how many ligaments are injured, your sprain will be classified as Grade 1 (mild), 2 (moderate), or 3 (severe).

Treating Your Sprained Ankle

Treating your sprained ankle properly may prevent chronic pain and looseness. For a Grade 1 (mild) sprain, follow the R.I.C.E. guidelines:

Rest your ankle by not walking on it. Limit weight bearing and use crutches if necessary. If there is no broken bone you are safe to put some weight on the leg. An ankle brace often helps control swelling and adds stability while the ligaments are healing.

Ice it to keep down the swelling. Don't put ice directly on the skin (use a thin piece of cloth such as a pillowcase between the ice bag and the skin) and don't ice more than 20 minutes at a time to avoid frostbite.

Compression can help control swelling as well as immobilize and support your injury.

Elevate the foot by reclining and propping it up above the waist or heart as needed.

Swelling usually goes down in a few days.

For a Grade 2 (moderate) sprain, follow the R.I.C.E. guidelines and allow more time for healing. A doctor may immobilize or splint your sprained ankle.

A Grade 3 (severe) sprain puts you at risk for permanent ankle looseness (instability). On rare occasions, surgery may be needed to repair the damage, especially in competitive athletes. For severe ankle sprains, your doctor may also consider treating you with a short leg cast for 2-3 weeks or a walking boot. People who sprain their ankle repeatedly may also need surgical repair to tighten their ligaments.

Rehabilitating Your Sprained Ankle

Every ligament injury needs rehabilitation. Otherwise, your sprained ankle might not heal completely and you might re-injure it. All ankle sprains, from mild to severe, require three phases of recovery:

Phase 1 includes resting, protecting, and reducing swelling of your injured ankle.

Phase 2 includes restoring your ankle's flexibility, range of motion , and strength .

Phase 3 includes gradually returning to straight-ahead activity and doing maintenance exercises, followed later by more cutting sports such as tennis, basketball, or football.

Once you can stand on your ankle again, your doctor will prescribe exercise routines to strengthen your muscles and ligaments and increase your flexibility, balance, and coordination. Later, you may walk, jog, and run figure eights with your ankle taped or in a supportive ankle brace.

It's important to complete the rehabilitation program because it makes it less likely that you'll hurt the same ankle again. If you don't complete rehabilitation, you could suffer chronic pain, looseness, and arthritis in your ankle. If your ankle still hurts, it could mean that the sprained ligament has not healed right, or that some other injury occurred.

To prevent future sprained ankles, pay attention to your body's warning signs to slow down when you feel pain or fatigue, and stay in shape with good muscle balance, flexibility, and strength.