Twist and Shout: Everything You Need to Know About Ankle Sprains

by Karli Richards, DPM, FACFAS, CWSP, Lexington Podiatry

Ankle sprains are among the most common injuries among athletes and non-athletes. Whether running, making quick cuts on the field, or simply tripping over a child's toy, an awkward movement can stretch or tear the ligaments surrounding the ankle, resulting in a painful sprain. While these injuries vary in severity, they can keep you sidelined for days, weeks, or even months without proper care and rehabilitation.

Causes and Symptoms of an Ankle Sprain
A sprained ankle occurs when the ligaments that connect the bones in the joint are overstretched or torn due to excessive force. It often happens when the foot twists beyond its normal range of motion, leading to swelling, bruising, pain, and difficulty bearing weight. Mild sprains may cause slight discomfort and swelling, while more severe sprains can result in significant pain, instability, and an inability to walk without support.

Effective Treatment Strategies
The first step in treating an ankle sprain is following the RICE method—Rest, Ice, Compression, and Elevation. Resting the injured ankle and avoiding activities that put stress on the joint help prevent further damage. Applying ice for 15–20 minutes several times daily reduces swelling and inflammation, while a compression wrap or ankle brace provides stability and support. Elevating the foot above heart level minimizes swelling and promotes faster healing.

For pain relief, over-the-counter anti-inflammatory medications like ibuprofen can be effective. However, if the pain is severe or the ankle remains swollen and unstable after a few days, a doctor may perform an X-ray to rule out a fracture. In cases where pain and instability persist, an MRI may be necessary to check for a ligament tear.

More serious ankle sprains may require immobilization with a controlled ankle motion (CAM) boot to prevent excessive movement during healing. Once the acute pain and swelling subside, physical therapy can be beneficial in restoring strength, balance, and mobility. A structured rehabilitation program typically includes gentle range-of-motion exercises and strengthening and stability training to prevent re-injury.

How to Prevent Ankle Sprains
Preventing ankle sprains requires proactive measures to strengthen the joint and reduce the risk of awkward movements. Wearing well-fitted, supportive shoes designed for the specific sport or activity is crucial in maintaining proper foot alignment. Athletes should also avoid playing on uneven or slippery surfaces, as these increase the likelihood of missteps and falls.

A proper warm-up routine is another key component of injury prevention. Dynamic stretches and mobility drills prepare the muscles, tendons, and ligaments for sudden changes in direction and impact forces. Strength training, particularly for the muscles surrounding the ankle, enhances joint stability and helps reduce the risk of future sprains.

Recovery and Return to Play
Recovery time for an ankle sprain varies depending on the severity of the injury. Mild sprains may heal within a few days to a few weeks, while moderate to severe sprains can take weeks or months to recover fully. Rushing back into physical activity too soon increases the risk of re-injury and long-term complications.

Athletes should follow their healthcare provider's guidance on rehabilitation and gradually return to play. Once they regain pain-free mobility and strength, they can incorporate sport-specific drills to test the ankle's stability before full participation.

Ankle sprains, while common, should not be taken lightly. Proper treatment, rehabilitation, and preventative measures are essential in ensuring a full recovery and reducing the risk of recurrence. By investing in supportive footwear, incorporating strength and balance exercises, and following appropriate warm-up routines, athletes can stay on the field and avoid setbacks due to ankle injuries.


Karli Richards, DPM, FACFAS, CWSP, Lexington Podiatry