Ankle · condition guide
Ankle sprain
A sprained ankle is a stretched or torn ligament, usually on the outer side when the foot rolls inward. Most sprains heal well without surgery, in a couple of weeks for a mild one and up to a few months for a bad one. The balance and strength exercises matter: skipping them is the main reason ankles keep giving way.
- Usual cause
- The foot rolling inward
- Mild sprain
- About 2 weeks
- Severe sprain
- 6 to 12 weeks or more
For patients of Dr. Mandar Deb, orthopaedic surgeon, Kolkata. Based on AAOS OrthoInfo and NHS guidance. Sources
The injury
What is an ankle sprain?
Ligaments are strong bands that hold the ankle bones together. In most sprains the foot rolls inward and the ligaments on the outer side of the ankle stretch or tear. Less often the foot turns outward and the inner ligament is hurt.
A sprain can be mild (grade 1, a stretch), moderate (grade 2, a partial tear) or severe (grade 3, a complete tear). Even complete tears usually heal without an operation when the ankle is protected and then rehabilitated properly.
Signs
Is it sprained or broken?
A sprain causes pain, swelling and bruising, tenderness, and difficulty putting weight on the foot. A bad sprain can look and feel like a fracture, so these signs mean it should be examined and X-rayed:
- You couldn’t take four steps on it right after the injury, or can’t now
- The back edge or tip of either ankle bone is tender when pressed
- The bone on the outer edge of the mid-foot, or the bump on its inner side, is tender
Doctors use these checks, the Ottawa ankle rules, to decide when an X-ray is needed. Take the 3-question ankle check
First aid
What should I do in the first days?
- Protect: a support bandage or firm shoes; crutches if walking hurts a lot.
- Rest from sport and long walks.
- Ice wrapped in a cloth, up to 20 minutes every two to three hours. Never directly on the skin.
- Compression: a bandage during the day for support and swelling.
- Raise it on a pillow as much as you can.
For the first two to three days, avoid heat (hot baths, heat packs), alcohol and massage, which can increase swelling. Then start walking as pain allows: long rest slows recovery.
Recovery
How long does a sprained ankle take to heal?
About two weeks for a mild sprain and six to twelve weeks for a severe one, sometimes longer. Rehabilitation runs in phases; finishing them is what stops the ankle giving way again.
- ProtectThe first days: protect, ice, compress and raise. A brace or boot for a bad sprain.
- MoveWalk as pain allows and get the ankle moving fully again.
- StrengthenStrength and balance exercises, such as standing on one leg.
- ReturnStraight-line running first, then turning and jumping sports. Keep up the balance work.
Treatment
Does an ankle sprain ever need surgery?
Rarely. Nearly all sprains, including complete tears, heal with protection and rehabilitation. Physiotherapy helps most with balance training, because poor balance is what leads to repeat sprains.
Surgery is considered when the ankle keeps giving way after months of proper rehabilitation, or when the sprain came with other damage, such as to the cartilage, a tendon or the joint between the two leg bones (a high ankle sprain). The torn ligament is then repaired or rebuilt, sometimes by keyhole surgery.
Incomplete rehabilitation is the most common cause of a weak, unstable ankle. Repeated sprains can lead to long-term pain, instability and arthritis.
See an orthopaedic doctor if…
- You can’t take four steps on it, or the ankle bones are tender to press
- It isn’t getting better after a week
- It keeps giving way, or you keep spraining the same ankle
- Pain or swelling lasts beyond four to six weeks
Emergency: bone through the skin, an ankle that looks deformed, or a foot that is numb, cold, pale or blue. Go to the nearest emergency department now.
Questions
Ankle sprain FAQs.
What patients ask most after rolling an ankle.
How long does a sprained ankle take to heal?
About two weeks for a mild sprain and six to twelve weeks for a severe one, sometimes longer. Avoid strenuous sport until the ankle is strong and steady again.
Should I walk on a sprained ankle?
After the first two to three days, yes, as pain allows. Early, gentle walking helps it heal; long rest slows recovery. If you can’t take four steps on it, have it checked for a fracture first.
Do I need an X-ray for a sprained ankle?
Only if you couldn’t take four steps on it, or the ankle bones or the bones of the mid-foot are tender to press. Otherwise a sprain is diagnosed by examination.
Ice or heat for a sprained ankle?
Ice, wrapped in a cloth, for up to 20 minutes every two to three hours in the first days. Avoid heat, alcohol and massage for the first two to three days, as they can increase swelling.
Why does my ankle keep giving way?
Usually because the ligaments healed loose and the balance and strength work was stopped too early. Physiotherapy focused on balance often fixes it; surgery is considered only if the ankle still gives way after months of proper rehabilitation.
Where can I see Dr. Mandar Deb for an ankle injury?
At his weekly OPDs in Newtown, Rajarhat, Dum Dum and South Kolkata, and in Basirhat twice a month. Book by calling the clinic; days, times and numbers are on the Clinics page.
References
Sources
This guide follows patient information from these organisations. It is general information; Dr. Deb’s advice for your own ankle comes first.
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01
OrthoInfo, American Academy of Orthopaedic Surgeons (AAOS)
Patient information written and reviewed by orthopaedic surgeons.
Sprained Ankle -
02
NHS, the UK’s National Health Service
Public health guidance from the NHS website.
Sprains and strains