Patient Basics: Ankle Sprain

An ankle sprain happens when you roll, twist or turn your ankle hard enough to stretch or tear its ligaments, the tough bands that hold the bones together. It’s one of the most common injuries, in sports and in everyday life. Most sprained ankles heal well with a few days of protection, followed by early walking and exercises.

Key points

• Most are low ankle sprains: the foot rolls inward and injures ligaments on the outer side of the ankle.
• Sprains are graded from 1 (mild stretch) to 3 (full tear).
• For the first few days, protect the ankle, use cold packs, wrap it and keep it raised.
• You need an X-ray only if you can’t walk on it or certain spots on the bones are tender.
• Balance and strength exercises speed healing and lower the chance of another sprain.

Types of ankle sprain

• Low ankle sprain. This is the usual “rolled ankle.” The sole turns inward and the ligaments on the outside of the ankle stretch or tear. The ligament at the front of the outer ankle bone is hurt most often.
• Inner ankle sprain. The foot rolls outward and injures the strong ligament on the inner side. This type is less common.
• High ankle sprain. The ligaments that hold the two lower leg bones together, just above the ankle, are injured. It often comes from the foot twisting outward, as in football or skiing. High ankle sprains take longer to heal, and some need surgery.

Other ankle injuries can feel like a sprain, including a broken bone, a torn Achilles tendon, or an injured tendon behind the outer ankle bone.

Grades of ankle sprain

• Grade 1 (mild): the ligament is stretched. Mild pain and swelling, and you can walk with little trouble.
• Grade 2 (moderate): the ligament is partly torn. More swelling and bruising, and walking hurts.
• Grade 3 (severe): the ligament is torn through. Heavy swelling and bruising, you may not be able to stand on it, and the ankle may feel wobbly.

Symptoms

• Pain, often right away, sometimes with a pop
• Swelling and tenderness around the ankle
• Bruising, which may spread down to the heel and toes over a few days
• Stiffness and pain when you put weight on the foot
• A loose or unstable feeling in a severe sprain

How it’s diagnosed

A doctor will ask how you hurt it, then press on different spots and move the ankle gently. Doctors use a checklist called the Ottawa ankle rules to decide who needs an X-ray. You likely need one if you couldn’t take four steps right after the injury and still can’t, or if the back edge or tip of either ankle bone, or certain bones in the middle of the foot, are tender. An MRI is rarely needed, mostly for an injury that isn’t healing or a possible high ankle sprain.

How to treat an ankle sprain

The first two or three days

• Protect it. Use a brace or wrap, and crutches if walking hurts too much.
• Cold packs. Hold ice wrapped in a thin towel on the ankle for 15 to 20 minutes every 2 to 3 hours while you’re awake. This eases pain.
• Compression. An elastic bandage or compression sleeve helps limit swelling.
• Raise it. Prop your ankle above the level of your heart as much as you can.
• Pain relief. Acetaminophen, ibuprofen or naproxen, or diclofenac gel rubbed on the skin, can help for a few days, if they’re right for you.

Getting moving

Start putting weight on the ankle as soon as the pain allows, often within a few days. A lace-up or stirrup-style brace gives more support than a bandage. A severe sprain may need a walking boot for a short time. Casts are rarely needed.

Once walking is comfortable, add exercises:

1. Range of motion: trace the alphabet in the air with your toes, and stretch your calf.
2. Strength: push your foot against a stretchy exercise band in each direction.
3. Balance: stand on the injured leg for 30 seconds, then try it with your eyes closed or on a pillow.
4. Sports drills: jogging, hopping and side-to-side moves, once the first three feel easy.

A physical therapist can guide you, especially after a moderate or severe sprain. Surgery is rare. It’s mainly for a high ankle sprain with separated bones, a fracture, or an ankle that keeps giving way after months of rehab.

How to wrap a sprained ankle

1. Start at the ball of the foot and wrap around it twice.
2. Bring the bandage across the top of the foot, behind the ankle and back across the top, making a figure 8.
3. Keep making figure 8s, overlapping each layer by about half, until you’re a few inches above the ankle bones.
4. Make it snug but not tight. Loosen it if your toes turn pale, blue or cold, or feel numb or tingly.

A wrap mostly helps with swelling. For walking and sports, a brace gives better support.

Recovery

A mild sprain often feels much better in 1 to 3 weeks. A moderate sprain takes about 3 to 6 weeks. A severe sprain or a high ankle sprain can take 3 months or more. Return to sports when you can run, hop and change direction without pain or limping. Wearing a brace or tape for sports for several months afterward lowers the chance of hurting it again. Some people who skip rehab end up with a weak ankle that rolls easily.

Lowering your risk

• Do balance exercises regularly, especially after any sprain.
• Warm up before sports.
• Wear shoes that fit well and suit the activity. Avoid high heels on uneven ground.
• Take extra care on trails, curbs and stairs, and in poor light.

When to see a doctor

• You can’t take four steps on the injured foot
• Pain is over the ankle bones or the middle of the foot
• Swelling and pain are severe, or aren’t improving after 5 to 7 days
• The ankle keeps giving way

Get emergency care if the ankle looks deformed, a bone is showing, or your foot turns cold, pale or numb.

Common questions about ankle sprains

Can a sprained ankle heal overnight?

No. Ligaments need at least one to several weeks to heal, depending on how badly they were hurt. You can ease pain and swelling quickly with a cold pack, a wrap, raising the ankle and a pain reliever, then gentle movement. Pain often fades before the ligament has fully healed, so keep up the exercises.

Should I walk on a sprained ankle?

Yes, once you can do it without severe pain, usually within a few days. Early walking in a brace helps ligaments heal stronger than weeks of rest. If you can’t take four steps, see a doctor first to make sure the ankle isn’t broken.

Is a bad sprain worse than a broken ankle?

A severe sprain can hurt as much as a break and take just as long to heal. Many simple ankle fractures heal in about six weeks, while a full ligament tear or high ankle sprain can take three months or more. An X-ray is the way to tell them apart.

Should I use heat or ice on a sprained ankle?

Use cold packs in the first two or three days to ease pain. After that, some people find warmth helps stiffness before exercises. Avoid heat while the ankle is still very swollen. Never put ice or a heating pad straight on the skin.

Questions to ask your doctor

• How bad is my sprain, and is it a high or low ankle sprain?
• Do I need an X-ray?
• What kind of brace should I wear, and for how long?
• Should I see a physical therapist?
• When can I go back to running or sports?

Learn more

• Sprains and strains (MedlinePlus, U.S. National Library of Medicine)
• Sprains and strains (NHS)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.