There’s a good chance you—or someone you know—has had a sprained ankle. This very common condition comprises about 30 percent of injuries seen at sports medicine clinics. And not just athletes are affected, more than 23,000 people each day seek care for a sprained ankle and half of all sprains seen in the emergency room are unrelated to sports.
Mariam Zakhary, DO, Assistant Professor, Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, and Attending Physician at Mount Sinai-Union Square, explains how to treat this common injury and what to do if you have chronic ankle instability.
What happens when you sprain an ankle?
Ankle sprains happen when you turn, twist, or roll the joint in a way that causes you to stretch or tear one or more of the three thick bands of tissue (called ligaments) that keep our ankles stable. Sprains occur when we misstep and put pressure on the ankle while it is out of its normal position. Often, we sprain our ankle when we walk on an uneven surface, such as a city street, or when we’re running and changing direction. Most sprains affect the ligaments on the outer side of the ankle.
Doctors typically put sprained ankles into one of three categories:
- Grade one: You have stretched at least one of your ligaments but there is no tear.
- Grade two: You have stretched at least one of your ligaments and have a partial tear in another.
- Grade three: You have a full tear in one or more ligaments. You’ve probably also stretched your ligaments. Your ankle will most likely feel unstable with this injury, and will require immobilization with a boot.
What should I do if I sprain my ankle?
It depends on the severity of the sprain. If you can put weight on your ankle, you should be able to do some self-care at home and walk it off. But if it hurts to stand on your ankle, you should be checked out by a doctor as this might indicate that you have done serious damage to your ligaments and ankle, or even broken a bone.
What kind of self-care can I do?
If you have a minor, grade one sprain, there are a few things you can do to heal at home. Try these for a day or two and, if your ankle does not improve by the third day, you should probably see a doctor.
- Rest your ankle. The rule of thumb is: if it hurts, don’t do it.
- Elevate it. Raise your ankle above your heart, especially at night. This allows you to enlist the help of gravity to drain any excess fluid.
- Apply ice. I recommend icing for 20 minutes, every two or three hours for at least the first 48 hours. Then, continue to ice for pain relief as needed.
- Use a brace. If your ankle feels unstable, use a brace to hold it in place.
- Try compression. Wrap your ankle with an elastic bandage. The wrapping should be snug but not so tight that it hinders circulation.
- Take a pain reliever. Use an over-the-counter anti-inflammatory, such as ibuprofen.
How long do I need to stay off my injured foot?
It depends on how bad a sprain you’ve got. As soon as your ankle can bear weight with minimal pain, you can walk on it. But respect the pain; it is your body’s way of communicating with you. If it hurts to walk, don’t. You may find you need to use a walking boot, crutches, or even a wheelchair for a while. If you find it hard to walk after a day or two, make an appointment with a doctor.
How long will it take to fully recover from an ankle sprain?
While a minor sprain can take about two weeks to heal, a severe sprain can take as long as three months. Listen to your body. If you try a new activity and it increases pain, that is your body’s way of telling you that you might be making the condition worse.
When should I see a doctor about my injury?
It’s never a bad idea to see a doctor about a sprained ankle—and the sooner you see one, the better. If you have a minor sprain, a doctor can tell you how to treat it and cope with the pain. If your pain is more severe, the doctor may order an X-ray to get a better idea of what is going on and see if you’ve fractured your ankle or done other damage.
I keep injuring my ankle. What can I do?
When you sprain your ankle, you stretch the ligaments, and these bands of tissue don’t recover their pre-injury tightness even after your ankle has healed. This may lead to chronic ankle instability—a tendency to turn, twist, or roll your ankle with the slightest provocation. Each time you re-sprain your ankle, you stretch the ligaments just a little more. Unfortunately, you can’t strengthen your ligaments, but you can strengthen your secondary stabilizers, which are the muscles around the ankle such as your lower leg and calf muscles.
Also, because repeated sprains may cause even more sprains, it’s not a bad idea to use an elastic bandage, tape, or an ankle brace to keep the joint stable. Many athletes with chronic ankle instability wear braces or use medical or therapeutic tape for increased stability, but the best treatment is to work on the muscles around the ankle.
How do I strengthen the muscles around the ankle?
The key is to strengthen the muscles both on the outside and inside of the ankle. Some of these muscles go all the way up to the knee. You’ll also want to strengthen the muscles in your feet.
One easy thing to do at home is to spell the alphabet out with your foot while seated. This activates the muscles in the ankle and works on conditioning them. When the ankle is more stable, you can start doing single leg exercises. An example of this is standing on one foot and hinging forward to touch an object out in front of you, close to the ground. This forces your ankle to use the surrounding muscles to remain stable. You can also do this single leg exercise as a preventative.
However, the best way to learn the right exercises is to work with a physical therapist.