Sprained ankle
Your health expert: Alice Parsons, Physiotherapist
Content editor review by Rachael Mayfield-Blake, Freelance Health Editor, April 2023
Next review due April 2026
A sprained ankle is a common type of ankle injury that can happen if you twist or turn your foot beyond its normal range of movement. This can stretch or tear the ligaments that support your joint. A sprained ankle can be very painful, but most ankle sprains heal well.
About sprained ankle
There are different ways that you can sprain your ankle. It’s most likely to happen if you suddenly twist your foot too far inwards (an inversion sprain). This can make the ligaments on the outside of your ankle stretch past their normal range and sometimes tear. Ligaments are bands of fibrous tissue that connect one bone to another, and support your joint. Sometimes more than one ankle ligament is affected. Occasionally, a sprain can affect the bones around your ankle joint too.
Sprained ankle grades
Sprained ankles can be graded to describe how bad the injury is.
- Grade 1. A mild sprain, which happens when you overstretch a ligament. You may have mild swelling, bruising, and pain around your ankle, but you should be able to put some weight on your foot.
- Grade 2. A moderate sprain, which happens when you overstretch and partially tear a ligament. You may have quite a lot of swelling, bruising and pain around your ankle, and you may find it difficult to put weight on your foot.
- Grade 3. A severe sprain, which happens when you completely tear a ligament. The swelling, bruising, and pain around your ankle are usually very bad. Your ankle may feel quite wobbly (unstable) and you won’t be able to put any weight on your foot without a lot of pain.
What causes a sprained ankle?
You may sprain your ankle when doing sports, especially those that involve sudden changes in direction or where you may jump and land awkwardly. These include football, basketball, volleyball, and climbing. But ankle sprains aren’t always linked to sport – you can sprain your ankle doing everyday activities too.
If you’ve sprained your ankle before, you’re more likely to do it again because your ankle ligaments may be weaker, even after they’ve healed.
Some other things can increase your risk of spraining your ankle, such as:
- if you’re new to a sport or haven’t trained properly and your technique is poor
- not warming up or cooling down after you exercise
- wearing unsuitable footwear, which may make you more likely to go over on your ankle
- not exercising regularly, which means your muscles and joints may be weaker and more prone to injury
- If you have poor co-ordination or balance
- if you’re overweight or underweight
Symptoms of a sprained ankle
Sprained ankle symptoms will depend on how bad your injury is and may include:
- pain
- swelling
- bruising
- restricted movement
- difficulty putting weight on your foot or more pain when you do
- your ankle feeling unstable and wobbly when you try to stand on it
When should I seek medical help?
You don’t always need to seek medical help for a sprained ankle. You can usually treat a mild ankle sprain by following some self-care measures at home (see our section on self-help). But if your sprain is very bad, you may need medical attention. It’s possible you may have damaged other parts of your ankle such as the bones or tendons. And it can be difficult to know if you have a very bad sprain or a broken bone (fracture) without an X-ray.
Seek medical attention straight away if your ankle is too painful to stand on, seems deformed, or your skin is broken. You can usually go to an urgent treatment centre or minor injury unit for injuries like these, but phone NHS 111 if you’re not sure. You should also see a physiotherapist if the pain and swelling don’t improve within a week, or they get worse after a few days.
If you keep spraining your ankle or it feels unstable, make an appointment to see a GP or a physiotherapist.
Diagnosis of a sprained ankle
A doctor or physiotherapist will usually be able to diagnose a sprained ankle by asking about your symptoms and examining you. They’ll ask exactly how you hurt your ankle and if you could stand and walk afterwards. When they examine you, they’ll check for pain, swelling, and bruising around your ankle. They may also check how much you can move your ankle and if you can put any weight on your foot.
If your injury is particularly bad, your doctor or physiotherapist may recommend you have an X-ray to check whether or not your ankle is broken. Although not used as much, they may also arrange an ultrasound or
Self-help for a sprained ankle
If you have a sprained ankle, there’s a lot you can do yourself at home to ease your symptoms in the first few days.
The following steps, known as the ‘POLICE principles’ are things you can do to reduce your pain and help you to recover.
- P – Protect. You’ll need to rest your ankle straight after the injury and protect it from further damage – possibly using an ankle support or splint.
- OL – Optimal Loading. You should start moving your ankle and putting weight on it as soon as you can. Do this gradually and be guided by what feels right for you.
- I – Ice. Placing a cold compress on your sprained ankle, such as a bag of ice or frozen peas wrapped in a towel, may help with swelling. Do this for 20 minutes every couple of hours for the first two or three days.
- C – Compression. Use a bandage to compress the injured ankle and reduce swelling.
- E – Elevate. You should raise your ankle above the level of your heart. Try resting your leg up on a chair or cushion.
Infographic: POLICE principles
Bupa's POLICE infographic (PDF, 0.5 MB), illustrates the ‘POLICE principles’ to reduce your pain and help you to recover. Click on the POLICE image below to download the PDF.
Ask a physiotherapist or pharmacist for the best type of support or splint to use, and use crutches if you need to.
You can also use the word HARM to remind yourself of things you should avoid doing in the first three days after your injury.
- H – Heat. Don’t have hot baths, showers or saunas, and avoid heat packs and rubs.
- A – Alcohol. Drinking alcohol can slow down your recovery and mask your symptoms – increasing the risk that you’ll injure yourself again.
- R – Running. Don’t run or do any other form of moderate exercise. This can delay your ankle healing.
- M – Massage. Massaging the affected areas can cause more swelling and damage, so avoid this for the first day or two.
Infographic: HARM principle
Bupa's HARM infographic (PDF, 0.6 MB), illustrates the ‘HARM principle' of things you should avoid doing in the first three days after your injury. Click on the HARM image below to download the PDF.
Treatment of a sprained ankle
Sprained ankle treatment aims to:
- reduce pain
- reduce swelling
- get your ankle back to its usual range of movement as soon as possible
- improve your muscle strength
- improve the way your muscles and nerves work together (to help with things like your balance)
Medicines for a sprained ankle
You can take over-the-counter painkillers such as paracetamol or ibuprofen to help ease your ankle pain. You can get ibuprofen gels that you put on the skin over your ankle. If over-the-counter painkillers don’t help, your doctor may offer you a prescription for stronger pain relief. Always read the patient information that comes with your medicine. If you have questions, ask a pharmacist or doctor for advice.
Exercise and movement for a sprained ankle
You may need to briefly rest your ankle after you injure it, usually for two to three days. But it’s usually best to start moving it again and do some gentle exercises as soon as you can. This will help your ankle to get back to normal more quickly than if you keep it still (unless you have a severe sprain). Your doctor or physiotherapist may give you something to protect your ankle while you move it, like a brace or splint.
If you have a particularly bad sprain, your doctor or physiotherapist may advise you to wear a cast, splint, or brace to stop your ankle from moving (immobilise it) for a few days. This may help to reduce any pain and swelling around your ankle. They’ll advise you when to start moving and exercising your ankle again.
If you’re at all worried about doing exercises or feel any pain, stop and speak to a doctor, nurse, or physiotherapist before you continue. If you’re not sure when and how to start exercising your ankle, check with a doctor or physiotherapist.
Physiotherapy for a sprained ankle
You don’t always need physiotherapy for a sprained ankle. But if your sprain is very bad or isn’t getting better after a week or so, it may help. You may be able to book an appointment with a physiotherapist directly, without needing to see your GP (self-referral). Ask at your GP surgery to see whether or not this is available in your area.
A physiotherapist can develop an exercise programme for you. This will include exercises to improve your range of movement, strength, balance, and neuromuscular (muscle and nerve) control. The programme will involve co-ordination exercises and balance training. It will aim to build your strength and mobility while getting back the full range of movement in your ankle.
If you have strong ankle muscles and joints, it may mean you’re less likely to sprain your ankle again. It’s important to stick to your physiotherapist’s exercise plan. This will help to make sure your ankle is back to full strength before you return to any sports or high impact activities.
Surgery for a sprained ankle
It’s unlikely you’ll need to have surgery for a sprained ankle. But if your ankle is badly sprained or isn’t getting any better, your GP may refer you to see an orthopaedic surgeon. They’ll advise you whether or not surgery may be helpful. You’re more likely to need surgery if you’re an athlete at a professional level.
Recovering from a sprained ankle
Sprained ankle recovery time will depend on how bad your sprain is. The most common sprains affect the ligaments on the outside of your ankle (lateral ankle sprains). The average time it takes people to return to sport after a lateral ankle sprain is 16 to 24 days. But it can vary a lot between people.
Mild-to-moderate sprains should heal enough to walk on within a few weeks. But it may take up to two or three months to get back to normal and play sports. If you have a very bad ankle sprain, it may take several months to recover, especially if you need surgery. There’s a risk of injuring your ankle again, especially in the first four to six weeks.
Wait until you have full range of motion and have rebuilt the strength in your ankle before you go back to your normal activities and sports. Even if the pain in your ankle has eased, if you start too soon, you may hurt your ankle again, which may lead to long-term problems. Ask your doctor or physiotherapist when you can safely take up sports or your normal activities again.
Prevention of a sprained ankle
There are things you can do to reduce your chances of spraining an ankle or injuring it again after you’ve recovered. This includes keeping the muscles around your ankle as strong and as flexible as possible.
Other things you can do include the following.
- Wear shoes that are suitable for the activity you’re doing and are in good condition.
- Try to do some exercises that incorporate strength and flexibility training, as well as cardiovascular fitness. And make sure you have days off from doing intense exercise.
- Take care when you walk or run on uneven surfaces – exercise on even surfaces if you can, or wear supportive footwear.
- Warm up and stretch your muscles before you play sport, and cool down afterwards.
- During certain activities it may help to wear an ankle brace or ankle tape, especially if you’ve had a previous injury.
- Stay a healthy weight for your height – sprains are more likely if you’re very overweight or underweight.
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You don’t usually need to go to hospital for a sprained ankle. In fact, you can usually treat a mild ankle sprain at home, but if your sprain is very bad, you may need medical attention. If your ankle is too painful to stand on, seems deformed, or your skin is broken, go to an urgent treatment centre or minor injury unit. Call NHS 111 if you need advice.
For more information, see our section: When should I seek medical help?
Whether or not you can walk on a sprained ankle depends on how severe your injury is. Most people are able to walk on a sprained within a week or two. You should be able to get back to normal activities after about 6 to 8 weeks, and return to sports after 8 to 12 weeks. But if you’ve a bad sprain you may need to wait longer.
For more information, see our section: Recovering from sprained ankle.
What’s best to do for a sprained ankle will depend on your injury. There are lots of treatments to treat a sprained ankle. These include applying ibuprofen gel on your ankle and using a brace or splint while you recover. Physiotherapy for a sprained ankle may help too. Speak to your doctor or physiotherapist for more advice on the best treatment for you.
For more information, see our section: Treatment of sprained ankle.
A grade 1 ankle sprain is a mild sprain and it happens when you overstretch a ligament. You may have mild swelling, bruising, and pain around your ankle, but you should be able to put some weight on your foot.
For more information, see our section: About sprained ankle.
A high ankle sprain is when you damage one of the ligaments just above your ankle (called the syndesmotic ligaments). It often happens if your lower leg and foot twist too far outwards. You may sprain other ligaments or fracture one of the bones in your lower leg at the same time. You may feel pain at the front of your lower leg and when you move your foot outwards, and the area may be tender to touch.
How long a sprained ankle takes to heal will depend on how severe your injury is. If you only have a mild or moderate sprain, it should heal within a few weeks. If your injury is severe, it may take months to heal fully. But recovery times can vary a lot between people.
For more information, see our section: Recovering from sprained ankle.
Fractures
A fracture is a broken or cracked bone.
Over-the-counter painkillers
Physiotherapy
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