Ankle Sprain

Most people know what a sprained ankle feels like, but what's causing the pain? It's the ligaments, the flexible tissue that bonds your bones and keeps your joints stable, that are stretched or torn. The injury usually affects one or more ligaments on the outside of the ankle.

Types Of Ankle Sprains

The three types of ankle sprains:

  • Grade 1: Stretched ligaments that will improve with light stretching.
  • Grade 2: Partially torn ligaments that could require a splint or cast.
  • Grade 3: Fully torn ligaments that might require surgery. When it happens, you'll feel severe pain.


Recovery Time

"The recovery timetable depends on the extent of the injury," says Dr. Clifford Rios, a Bone & Joint Institute orthopedic surgeon and board-certified in sports medicine. "Nearly all ankle sprains are managed non-surgically. Mild injuries can often be rehabilitated quickly, with players returning to play the following week. More severe ankle sprains, and those involving the end of the tibia and fibula (high ankle sprain), require a much longer period of rest and rehabilitation."

When Does An Ankle Sprain Turn Black And Blue?

Grades 2 and 3 sprains could include tears in small blood vessels. Blood that then leaks into tissues causes the discoloration, even though it might not show for several days. The blood is usually absorbed from the tissue within two weeks.

Low Ankle Sprain vs. High Ankle Sprain

A low ankle sprain affects the ligaments supporting the subtalar joint, just below the true ankle joint -- a set of of three bones, the tibia (inside part of ankle), fibula (lateral, or outside) and the talus (lower). A high ankle sprain affects the ligaments connecting the tibia and fibula, the lower leg's two bones.  A high ankle sprain hurts whenever you place rotational force on the ankle.

"Cutting puts more stress laterally, which is where the ankle sprain commonly occurs," says Dr. Rios. "A severe high ankle sprain would not tolerate even straight running for up to 8-12 weeks."


A low ankle sprain is usually caused by an inward twisting motion. It's less serious than a high ankle sprain  -- most athletes will return anywhere from a few days to a month. Recovery from a high ankle sprain, often caused in football when a player plants a foot on the ground before an extreme outward twist of the foot, can take 4-6 weeks. 

Severe high ankle sprains can take up to six months and might require surgery. An X-ray, CT scan or MRI can help determine if you have a high ankle sprain or possible fracture.

A cast, splint or brace and physical therapy could part of the recovery plan, depending on the injury's severity.

If you suffer a mild ankle sprain:

  • Apply ice hourly during waking hours, 20 minutes at a time, for the first 24 hours after the injury.
  • After the initial 24-hour period, apply ice for 20 minutes three or four times a day.
  • Warning: Even though pain medications (ibuprofen) can reduce pain and swelling, do not use them for 24 hours after the injury because it could increase the risk of bleeding. 

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