Patient information from BMJ

Ankle sprain

Last published:Feb 20, 2025

A sprained ankle can be painful and swollen. You may find it hard to walk. But most people make a good recovery within a few weeks or months.

What is an ankle sprain?

When you sprain your ankle you damage the bands of tissue (called ligaments) that connect your bones together at the ankle joint. This can happen if you accidentally roll or twist your ankle, or injure it playing sports. The ligaments become over-stretched, which causes problems at the joint.

It’s also possible to get an injury known as a strain. This is different to a sprain. An ankle strain happens when you stretch or pull a muscle rather than a ligament.

What are the symptoms of an ankle sprain?

If you sprain your ankle, it will usually be painful, swollen, and bruised. It may also feel warm to touch. You might find it hard to move your foot, walk, or even to stand. If you are able to move, you may still feel your ankle is weak and gives out easily.

You might have felt a pop or tear when you twisted your ankle. This could mean you've completely torn the ligaments. This type of sprain is the most serious. Hearing this sound could also mean that you’ve fractured the bone.

You should see a doctor if your ankle is very swollen and you find it hard to move. Your doctor will want to do a physical examination of your ankle and see if you can walk on it. This is to decide if you need an x-ray to check for any bone fractures. If your doctor thinks you’ve completely torn your ligament, you’ll need an MRI scan too. But less serious sprains won’t need any scans.

What are the treatment options for an ankle sprain?

RICE

Treatment for an ankle sprain depends on how severe it is. In less serious cases, sprains can just be treated with something called RICE. This stands for:

• Rest

• Ice

• Compression

• Elevation.

RICE works by helping to bring down the swelling of your ankle and reduce pain. It's a very common method used to treat all kinds of sprains and strains.

• Rest: try not to walk too much for a day or two. Avoid putting weight on the injured ankle as much as possible, until the worst of the pain and swelling has passed.

• Ice: use ice to reduce swelling soon after a sprain. You can either put the injured foot in ice water for up to 10 minutes, or hold an ice pack (e.g., a bag of frozen peas), onto the injured ankle for up to 30 minutes. Avoid using ice for too long on the skin, or using it without wrapping it in a cloth, as you could get an ice 'burn'. You can use ice on the sprain every few hours for the first two days.

• Compression: put a fairly tight bandage, for example, an elastic bandage, around the injured ankle. The bandage should be comfortable, and not so tight that you restrict the blood moving in your foot.

• Elevation: rest your injured foot on a footstool or table when you sit down. Ideally, your foot should be at a level above your heart.

RICE can help in the first 1-2 days after a sprain. But when the worst of the pain and swelling have gone you should start moving again and trying to get back to your regular activities. Ideally, this should be after 2-3 days of rest.

​To move about more easily you may still need to support your ankle with an elastic bandage. Getting moving early should reduce swelling and help you get back to normal faster. Moving early can also help to protect your ankle from giving way again in future.

Pain relief

You might need to take painkillers to help reduce the pain. Paracetamol is usually recommended for minor injuries, but ibuprofen is also another option.

Ibuprofen works by helping to reduce inflammation (swelling) as well as pain, but it can sometimes irritate your stomach or cause stomach ulcers if taken regularly. Your doctor might recommend taking extra medicines to protect your stomach if you are taking ibuprofen.

Physiotherapy

Physiotherapy is recommended for severe sprains (with complete tear of the ligament), and in some cases of minor sprains too. This usually starts 48 hours after injury and can last up to 6 weeks. Activities normally start with helping you get back to normal movement and strength, before focusing on endurance training (exercises that strengthen your muscles and improve your heart health).

Surgery

Most people with a sprained ankle won't need surgery. Even people with severe sprains are unlikely to need surgery unless they routinely put a lot of pressure on their ankle, for example, if they play a lot of sport. Research has also shown that surgery isn’t much better than regular treatments for ankle sprains. If your doctor thinks that you might need surgery, they will discuss the benefits and risks with you.

What happens next?

It's important to rest your ankle for the first few days after a sprain. This may mean you have to take a few days off work, or ask friends or family to help run your errands.

Most people make a good recovery from ankle sprains, but more serious sprains need longer to heal.

Severe tears may not heal completely, and can lead to longer-term pain and loss of stability. If you’re worried about your recovery from an ankle sprain, speak to your doctor or physiotherapist.