Exams and Tests

Your doctor will ask you when and how the ankle sprain occurred and ask about any prior injuries.

Next, your doctor will examine your foot, ankle, and lower leg and even your knee to see if any other injury occurred. He or she may ask you to move your foot up and down and to take a few steps if possible. Your doctor will then carefully try moving your foot and ankle to see if the ligaments are intact and what movements cause pain.

If your sprain is mild, an X-ray may not be taken. If your sprain is more severe, you will need X-rays to evaluate the ankle. X-rays can help your doctor find out whether you have any ligament tears, broken bones, or bones that have moved out of their normal positions.

X-rays are usually taken for children because of potential injury to the bone's growth plate and possible disruption of normal growth. Doctors may take X-rays of both ankles so they can compare the injured ankle with the one that is healthy.

Treatment Overview

Initial treatment for an ankle sprain is summarized as the PRINCE approach:

• Protection. Use a protective brace, such as a brace with a built-in air cushion or other form of ankle support, along with a compression wrap, such as an elastic ACE bandage, for the first 24 to 36 hours.
• Rest. You may need to use crutches until walking is not painful without them.
• Ice. For the first 48 to 72 hours or until swelling goes down, apply an ice pack for 10 to 20 minutes every 1 to 2 hours during the day. After 48 hours, you can continue with ice or try contrast baths. There is not good scientific evidence that ice or contrast baths help, but they are often used.
• NSAIDs or acetaminophen. Examples of nonsteroidal anti-inflammatory drugs (NSAIDS) include ibuprofen (such as Advil or Motrin) and naproxen (such as Naprosyn). A common type of acetaminophen is Tylenol.
• Compression. An elastic compression wrap will help decrease swelling and should be worn for the first 24 to 36 hours. A protective brace should also be worn if you try to bear weight on your injured ankle. Don't apply the wrap too tightly. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling in the area below the bandage. See instructions on how to wrap an ankle with an elastic bandage. Compression wraps do not offer protection, except by reminding you to be careful of your ankle.
• Elevation. Raise your ankle above the level of your heart for 2 to 3 hours a day if possible to decrease swelling and bruising.

Also, it can help to wear hiking boots or other high-top, lace-up shoes for support.¹ But use caution. Don't force your foot into a boot if you feel a lot of pain or discomfort.

Your doctor may suggest that you keep some or all of your weight off your ankle as it heals. If this happens, learn to use your crutches or walker properly and safely.

• Using crutches
• Using a walker

Almost all ankle sprains heal on their own with proper treatment and rehabilitation (rehab) exercises. For more information, see the Home Treatment section of this topic.

Surgery to repair torn ligaments is usually only considered when there is a severe ligament tear (or tears) or if the ankle remains unstable after rehab. Surgery is also a consideration if you have broken a bone.

For more information on the correct way to wrap a sprained ankle, see:

Sprained Ankle: Using a Compression Wrap.