Overview
An ankle sprain occurs when the ligaments supporting the ankle are overstretched or torn, usually when the foot rolls inward (inversion injury), straining the lateral ligaments. It is one of the most common musculoskeletal injuries. Most sprains heal fully with appropriate management, though inadequate rehabilitation leads to chronic instability.
How common is it?
Ankle sprains are common injuries caused by overstretching or twisting the ligaments, often during sport or everyday activity.
Causes and risk factors
Sudden uncontrolled inversion or eversion of the foot stresses the ankle ligaments beyond their tensile capacity, causing fibres to stretch or tear.
Common risk factors
- Running on uneven terrain
- Landing awkwardly from a jump
- Contact sports: football, basketball, netball
- Previous ankle sprain (single biggest risk factor for recurrence)
- Wearing high heels
- Muscle weakness or fatigue
- Poor proprioception (joint position sense)
Symptoms
- Immediate pain and tenderness over the lateral (outer) or medial (inner) ankle
- Swelling and bruising developing over hours
- Difficulty bearing weight (in moderate to severe sprains)
- Feeling of instability or 'giving way'
- Stiffness and reduced ankle movement
When to see a doctor
Seek urgent assessment for severe or worsening pain or swelling, inability to walk more than a few steps, or lack of improvement. Deformity, numbness, a cold or discoloured foot, or a crack at injury needs emergency care. With diabetes, a new hot, swollen or discoloured foot or ankle needs urgent assessment even without pain; avoid weight-bearing until assessed. A clinician decides whether imaging is needed.
Diagnosis
Clinical examination assessing tenderness location, stability (anterior drawer test), and range of movement. X-ray if Ottawa criteria met. MRI for suspected ligament rupture or osteochondral injury in complex cases.
Treatments
PRICE protocol (first 48 to 72 hours)
For a mild sprain, protect, briefly rest, elevate and use comfortable support. Apply ice wrapped in a towel for up to 20 minutes at a time. Ask for advice before ice or compression if sensation or circulation is reduced; do not self-manage a hot swollen diabetic foot as a sprain.
Early mobilisation and physiotherapy
For an uncomplicated sprain, begin gentle movement and gradually increase weight-bearing as pain allows, following professional advice. Severe sprains may need temporary immobilisation. Suspected fracture or Charcot injury must be assessed before loading.
Functional bracing
A brace may support rehabilitation and return to activity. The type of support and any period of immobilisation depend on severity and assessment.
Surgery
Surgery is uncommon but may be considered for persistent instability or associated injuries despite appropriate rehabilitation. Eligibility is not limited to athletes or complete tears; an orthopaedic assessment guides the decision.
Self-care and lifestyle
- Complete the full rehabilitation course before returning to sport
- A clinician or physiotherapist can advise whether a brace would help during return to sport and how long to use it.
- Balance and proprioception training (wobble board) specifically reduces re-sprain risk
- Replace worn-down sports footwear
Prevention
Sprains cannot always be prevented. Return to activity gradually and follow any rehabilitation advice given for your injury.
Sources for targeted updates
Updated: 24 October 2026. Targeted corrections to urgent-care guidance, treatment, frequency, self-care. This update covers the named sections; a full review of the remaining guide is pending.