Diagnosis
Diagnosing a sprained ankle typically involves a physical exam of the injured area. Your healthcare professional examines your ankle, foot and lower leg by:
- Pressing on the skin around the injury to find tender areas.
- Moving your foot to test range of motion and see what positions cause pain.
Tests
If the injury is severe, you may need imaging tests to check for broken bones or ligament damage. These tests may include:
- X-ray. During an X-ray, a small amount of radiation passes through your body to produce images of the bones of the ankle. This test is good for ruling out bone fractures.
- Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce detailed cross-sectional or 3D images of soft internal structures of the ankle, including ligaments.
- CT scan. CT scans can reveal more detail about the bones of the joint. CT scans take X-rays from many different angles and combine them to make cross-sectional or 3D images.
- Ultrasound. An ultrasound uses radio waves to produce real-time images. These images help your healthcare professional judge the condition of a ligament or tendon when the foot is in different positions.
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Treatment
The right treatment depends on how serious the sprain is. The main goals are to reduce pain and swelling, help the ligament heal, and restore ankle movement, strength and stability.
For severe injuries, your healthcare professional may refer you to a specialist in musculoskeletal injuries, such as an orthopedic surgeon or a doctor specializing in physical medicine and rehabilitation.
Medicines
For most people, pain relievers you can buy without a prescription are enough to manage the pain of a sprained ankle. You can take ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others) to manage pain.
Devices
Walking on a sprained ankle can be painful. You may need crutches until the pain improves. Depending on the severity of the sprain, your healthcare professional may recommend using an elastic bandage, sports tape or an ankle support brace to stabilize the ankle. For a severe sprain, a cast or walking boot may be needed to keep the ankle still while it heals.
Therapy
Once your pain and swelling improve, your healthcare professional recommends exercises to help restore your ankle's movement, strength, flexibility and stability. Your healthcare professional or a physical therapist will guide you on how to progress through these exercises safely.
Strengthening your ankle muscles is key to supporting the joint and preventing future sprains. Balance exercises, such as standing on one leg, help retrain the muscles to work together and improve stability.
If you sprained your ankle while playing sports or exercising, talk with your healthcare professional before resuming activity. Your healthcare professional or physical therapist may have you do specific movement tests to make sure your ankle is strong and stable enough for the sports you play.
Surgery
In rare cases, surgery is needed when the injury doesn't heal or the ankle is still noy stable after a long period of physical therapy and rehabilitation exercises. Surgery may be done to:
- Repair a ligament that won't heal.
- Reconstruct a ligament with tissue from a nearby ligament or tendon.
Self-care
For self-care of an ankle sprain, use the R.I.C.E. approach for the first two or three days:
- Rest. Avoid activities that cause pain, swelling or discomfort.
- Ice. Use an ice pack or ice slush bath for 15 to 20 minutes and repeat every 2 to 3 hours while you're awake. Always put a thin towel between the ice pack and your skin. If you have vascular disease, diabetes or reduced feeling in your skin, talk with your healthcare professional before using ice.
- Compression. To help stop swelling, compress the ankle with an elastic bandage until the swelling stops. Don't block circulation by wrapping too tightly. Begin wrapping at the end farthest from your heart.
- Elevation. To reduce swelling, elevate your ankle above the level of your heart, especially at night. Gravity helps reduce swelling by draining excess fluid.
Preparing for your appointment
Schedule an appointment with a healthcare professional or get emergency medical care if your sprained ankle doesn't improve with self-care or continues to cause pain or instability. If your sprain is severe, you may be referred to a doctor who specializes in sports medicine or orthopedic surgery.
What you can do
You may want to write a list that includes the following:
- Detailed descriptions of your symptoms.
- Information about medical issues you've had, especially past ankle injuries.
- All the medicines and dietary supplements you take.
- Questions you want to ask the healthcare professional.
What to expect from your doctor
Your healthcare professional may ask some of the following questions:
- How did the injury occur?
- Which direction did your foot turn when you injured it?
- Can you bear weight on that foot?
- What self-care treatments have you used?
- What effect did the treatments have?
- Have you injured your ankle before?
- How was that injury treated?