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Ankle sprains are common injuries. They occur when the foot twists or turns beyond its normal range of motion, causing the ankle ligaments to overstretch or tear. Ankle sprains happen frequently, both in athletes and in the general population. In the United States, ankle sprains make up 15% of all sports injuries. Athletes who participate in “cutting” and pivoting sports, such as football or soccer, are the most often affected. Younger athletes, those in the military, and anyone who frequently runs, jumps, and changes direction quickly are at an increased risk for spraining an ankle. Physical therapists help people with ankle sprains reduce their pain; regain strength, motion, and balance; and return to normal activities. They also help people avoid reinjury.

Physical therapists are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.

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What Is an Ankle Sprain?

Sprains are injuries to ligaments (bands of tissue that hold joints together). Ankle sprains occur when the foot twists or turns beyond its normal range of motion. This causes the ligaments connecting the bones of the leg, ankle, and foot to overstretch or tear.

The ligaments on the outer side of the ankle are most commonly injured. Ligaments on the inner side of the ankle, or above the ankle bone, also can be sprained, but this is less common.

Health care professionals grade ankle sprain severity from 1 to 3:

  • Grade 1. Mild injury. The ligament is overstretched. This condition usually takes two weeks to two months to heal. The ankle will feel better after a few weeks, and full strength can be restored in a few months.
  • Grade 2. Moderate injury. The ligament is overstretched or partially torn. It can take six to 12 weeks to heal.
  • Grade 3. Severe injury. The ligament is completely torn. This can take nine months to one year to heal fully.

Recurring ankle sprains are common. Once an ankle ligament is sprained, it is more prone to reinjury. This is true especially if muscle strength and balance are not fully restored to, or improved beyond, preinjury levels.

Ankle sprains can affect any person, no matter their activity level. However, active people or athletes have a higher likelihood of injury.

Illustration of ankle sprains

How Does It Feel?

Right after an ankle sprain, you may experience:

  • Pain in the affected area.
  • Swelling.
  • Inability to stand or walk on the affected foot.
  • Throbbing.
  • Stiffness.
  • Weakness.
  • A feeling of instability in the ankle joint.

After most sprains, you feel pain right away at the site of the ligament stretch or tear. Often, the ankle starts to swell immediately and may bruise. The ankle area usually is tender to the touch. When you move the ankle, it hurts. In more severe sprains, you may hear or feel something tear, along with a "pop" or "snap." It can be difficult or painful to walk immediately after an ankle sprain.

How Is It Diagnosed?

Your physical therapist will examine your ankle, take your health history, and ask questions such as:

  • How did you get injured?
  • Did you hear or feel a pop, snap, or tear?
  • What activities are you having trouble doing?
  • What activities do you want to get back to doing?

Your physical therapist will gently press around your ankle to see if it is painful to the touch. They may use additional tests to determine if other parts of your foot are injured.

Your physical therapist also will test your strength and flexibility, observe how you can move your foot and leg, and watch how you walk.

They also will test and screen for other, more serious conditions that could be causing your pain and swelling. They may team with an orthopedic doctor or other health care provider who may order an X-ray or MRI to confirm the diagnosis and to rule out other damage (such as a bone fracture).

How Can a Physical Therapist Help?

Physical therapists help people with ankle sprains recover more quickly than they would without treatment. Your physical therapist will work with you to design a specific treatment program that meets your needs and goals.

During the first 24 to 48 hours after your diagnosis, your physical therapist may advise you to:

  • Rest the area by avoiding any activity that causes pain.
  • Apply ice packs to the area under their guidance.
  • Consult with a physician for further services, such as diagnostic tests.
  • Walk on the affected foot as soon, and as much, as you are able, under their guidance.
  • Use crutches or other walking aids to help alleviate pain and support your balance.
  • Wrap your ankle or use an ankle brace for support and to prevent swelling.

These guided treatments will allow you to be as active as possible with the least amount of pain. They also will help speed healing. Your physical therapist will design the right treatment program for you based on your condition and goals.

Your physical therapist will work with you to:

Reduce pain and swelling. You will learn how to avoid or modify your daily and sports activities to allow healing. Your physical therapist may use different types of treatments and technologies to control and reduce your pain and swelling, including:

  • Ice and heat.
  • Electrical stimulation.
  • Taping.
  • Specific exercises.
  • Hands-on therapy, such as specialized massage.

Improve motion. Your physical therapist will choose specific activities and treatments to help restore normal movement of your ankle. These might begin with passive motions that the physical therapist performs for you to gently move your ankle and foot. They will progress to active exercises and stretches that you do yourself.

Improve flexibility. Your physical therapist will determine if any foot, ankle, or lower leg muscles are tight. They will begin to stretch them for you, and teach you exercises to stretch them on your own.

Improve strength. Ankle sprains may be related to weak, injured, or uncoordinated leg muscles. This can include muscles near the ankle, but also may consist of knee and hip muscles. Certain exercises will aid healing at each stage of recovery. Your physical therapist will teach you the correct exercises and equipment to use to steadily and safely restore your strength. This will be based on your age, condition, and goals. Devices used may include cuff weights, stretch bands, and weightlifting equipment.

Improve endurance. Regaining your muscular endurance in the ankle and leg is important after an injury. Your physical therapist will teach you the right exercises to improve endurance, so you can return to your normal activities. They may have you use cardio exercise equipment, such as treadmills or stationary bicycles.

Improve balance. Regaining your sense of balance is important after an injury. Your physical therapist will teach you exercises to improve your balance.

Restore agility. Speed and accuracy of leg movement is important in sports and in many daily activities. Your physical therapist will help you regain these skills to help prepare you for a return to sports and your daily routine.

Learn a home program. Your physical therapist will teach you strengthening and stretching exercises to do at home. These exercises will be specific for your needs. If you do them as prescribed, you can speed your recovery.

Return to activities. Your physical therapist will discuss activity goals with you and use them to set your work, sport, and home-life recovery goals. Your treatment program will help you reach your goals in the safest, fastest, and most effective way possible. Your physical therapist will teach you exercises, work retraining activities, and sport-specific techniques and drills to help you achieve your goals.

Speed recovery time. Your physical therapist is an expert in choosing the best treatments and exercises to help you safely heal. Following your prescribed exercise program will help you return to your normal lifestyle and reach your goals faster than you are likely to do on your own.

If Surgery Is Necessary

Surgery is not common for ankle sprains. If surgery is needed, you will follow a recovery program over several weeks, guided by your physical therapist. Your physical therapist will help you minimize pain, regain motion and strength, and return to normal activities in the safest and speediest manner possible.

Can This Injury or Condition Be Prevented?

Your physical therapist can recommend a home exercise program to help prevent ankle sprains. It may include strength, flexibility, and balance exercises. If you have sprained your ankle once, it is at greater risk for reinjury in the future. If the ligaments did not heal properly or if your ankle never returned to its normal strength, it has a higher risk for reinjury. And if you return to sports or other activities too soon, you might have persistent pain or more easily or frequently reinjure your ankle.

Other factors that may increase someone’s risk of spraining an ankle include:

  • Excess body weight.
  • Female gender.
  • Muscle weakness.
  • Balance problems.
  • Foot/ankle problems.
  • Previous history of ankle sprain.

To help prevent an ankle sprain or a reinjury, your physical therapist may recommend that you:

  • Warm up effectively before athletic activities.
  • Use the right footwear for specific activities.
  • Use ankle wraps or braces as directed.
  • Do specific balance and strength exercises several times per week, for up to a year.
  • Maintain a healthy body weight.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat various conditions, such as ankle sprains. You may want to consider:

  • A physical therapist who is experienced in treating people with musculoskeletal injuries. Some physical therapists have a practice with an orthopedic focus.
  • A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic or sports physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.

You can search for physical therapists in your area who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association.

General tips when you're looking for a physical therapist (or any other health care provider):

  • Get recommendations from family, friends, or other health care providers.
  • Ask about the physical therapist's experience in helping people with ankle sprain.
  • Be prepared to describe how your injury occurred and your symptoms in as much detail as possible.

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The American Physical Therapy Association believes that consumers should have access to information that can:

  • Help them make health care decisions.
  • Prepare them for a visit with their health care provider.

The following articles provide some of the best scientific evidence for the treatment of ankle sprains. The articles report recent research and give an overview of the standards of practice both in the United States and internationally. The article link either to a PubMed* abstract of the article or to the free full text, so that you can read it or print copy to bring to your health care provider.

Martin RL, Davenport TE, Fraser JJ, et al. Ankle stability and movement coordination impairments: lateral ankle ligament sprains revision 2021. J Orthop Sports Phys Ther. 2021;51(4)4:CPG1–CPG80. Article Summary in PubMed.

Herzog MM, Kerr ZY, Marshall SW, Wikstrom EA. Epidemiology of ankle sprains and chronic ankle instability. J Athl Train. 2019;54(6):603–610. Article Summary in PubMed.

Miklovic TM, Donovan L, Protzuk OA, et al. Acute lateral ankle sprain to chronic ankle instability: a pathway of dysfunction. Phys Sportsmed. 2018;46(1):116–122. Article Summary in PubMed.

Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018;52(15):956–956. Article Summary in PubMed.

Hung YJ. Neuromuscular control and rehabilitation of the unstable ankle. World J Orthop. 2015;6(5):434–438. Article Summary in PubMed.

McCriskin BJ, Cameron KL, Orr JD, Waterman BR. Management and prevention of acute and chronic lateral ankle instability in athletic patient populations. World J Orthop. 2015;6(2):161–171. Article Summary in PubMed.

*PubMed is a free online resource developed by the National Center for Biotechnology Information. PubMed contains millions of citations to biomedical literature, including citations in the National Library of Medicine's MEDLINE database.

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