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That last step down, something was off. Your ankle rolled, twisting on its side. Now it’s swollen and painful, and you’re wondering what the best course of action is.
Ankle injuries are among the most common cause of emergency room visits, and sprained ankles account for a good portion of them (Maughan, 2021).
Your joints have ligaments, which are sort of fibrous bands that connect your bones to each other. Those ligaments in your ankle are typically nice and tight to keep your feet stable while you walk and run. While some people (like athletes and dancers) have more flexibility in their ligaments, “rolling” your ankle can stretch the ligament beyond its normal capacity. A sprained ankle happens when one of the ligaments that hold the ankle joint in place is stretched or partially or completely torn.
There are different degrees of injury, and some heal quickly on their own, while others can lead to long-term instability in the ankle joint, increasing the chance that they’ll happen again (Melanson, 2021).
Here are some signs you may have a sprained ankle––and how to treat it when it happens.
Symptoms of a sprained ankle
If you’ve hurt your ankle and you want to know if it’s a broken bone or a sprained, an X-ray may be in order. Healthcare providers can use it to see if there’s a fracture or an injury that may require more significant treatment or if you have a sprain that can be treated at home. It’s also possible to have a fracture at the same time as a sprain
Here are some symptoms you can look for at home before making a trip to the doctor (Melanson, 2021):
- Not being able to walk on the ankle for more than four steps
- Not being able to bear weight on the ankle immediately after the injury
- Tenderness on the sides or front of the ankle
How to treat a sprained ankle
Regardless of how bad the injury is, you’ll need to treat your ankle for the sprain itself, as well as protect it from recurring injury.
Healthcare providers typically recommend the use of something known as the PRICE protocol (protection, rest, ice, elevate) for a few days after the injury happens. You can treat any pain with over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
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Here’s a breakdown of the PRICE protocol (Melanson, 2021; Strudwick, 2018):
- Protection: Wear an elastic bandage for extra support. Studies have shown walking with the support of an elastic bandage or splint, which helps immobilize the ankle, speeds up how long it takes to get back to normal. It also keeps persistent swelling down.
- Rest: Keep off your ankle for the first three days to give it a chance to heal. You can use crutches if that makes it easier. Once you’re mobile, use a splint or bandage for extra protection.
- Ice: Icing helps reduce swelling and pain. Even if you need to move around, you can strap an ice pack to your ankle and still use your crutches at the same time.
- Elevate: Try to lay down and elevate your ankle above the level of your heart as much as possible during the first two days after injury. That’s because it will keep blood from pooling around your ankle and reduce swelling.
If symptoms persist after 15 days, schedule a follow-up appointment to make sure nothing else is going on behind the scenes. As many as 40% of people who sprain their ankle have long-lasting instability in their ankles, making them prone to recurring injury there. That’s because once a ligament is stretched out, it can have trouble going back to its original tension (kind of like the elastic in sweatpants). That makes the ankle joint less stable and increases the risk of another injury. Treatment may then require further care from a specialist.
You may be referred to a physical therapist, sports medicine specialist, or orthopedic doctor who can work with you on strengthening exercises. Physical therapy like this can help restore your range of motion and improve ankle stability, especially in the case of a severe sprain (Melanson, 2021).
How to prevent a sprain
Even if you don’t have a long-lasting ankle injury, it’s important to be mindful about preventing future ones. If you sprain your ankle once, you’re unfortunately more likely to do it again.
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If you work on your feet, be sure to stretch before and during your shift to avoid reinjury. It should go without saying that this is also super important for athletes, as is wearing proper shoes, and making sure to always warm-up before working out. You can also wear an ankle brace or tape for extra protection against sprains (Melanson, 2021).
- Maughan, K. L. (2021). Ankle Sprain. [Updated Nov 16, 2021]. UpToDate. Retrieved from https://www.uptodate.com/contents/ankle-sprain#H29
- Melanson, S. W. & Shuman, V. L. (2021). Acute Ankle Sprains. [Updated Jul 29, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459212/
- Strudwick, K., McPhee, M., Bell, A., Martin-Khan, M., & Russell, T. (2017). Review article: Best practice management of common ankle and foot injuries in the emergency department (Part 2 of the musculoskeletal injuries rapid review series). Emergency Medicine Australasia, 30(2), 152-180. doi: 10.1111/1742-6723.12904. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.12904
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.