Ankle Sprains

An ankle sprain is a stretch or tear of the ligaments that hold the ankle stable. The most common pattern is a lateral sprain, where the foot rolls inward and the ligaments on the outer side are overloaded. A high ankle sprain involves the syndesmosis, the band that binds the two leg bones together above the joint, and takes considerably longer to heal. When a sprain does not fully heal or sprains keep recurring, the ankle can become chronically unstable and give way during normal activity. Most ankle sprains heal well with the right care, and many people return to full activity without lasting problems.

Common symptoms include:

• Pain and swelling over the outer ankle, just in front of and below the bony tip
• Bruising within a day or two
• An ankle that feels unstable, with pain putting weight on it early on
• Pain above the joint, between the two leg bones, in a high ankle sprain
• Episodes of the ankle giving way, in chronic instability

Your provider maps where the ankle is tender to tell a lateral sprain from a high sprain and checks whether the ankle is stable under gentle stress. X-rays are taken first to rule out a fracture, weight-bearing views can show whether a high sprain is unstable, and MRI is used when the diagnosis is unclear or surgery is being planned.

Nearly all ankle sprains are treated without surgery:

• Early weight-bearing in a supportive brace rather than a cast
• Physical therapy to rebuild strength and balance, the core of treatment
• An ankle brace during higher-risk activities to reduce giving-way episodes

Surgery is uncommon. It becomes relevant for a high ankle sprain where weight-bearing views show the syndesmosis is unstable, and for chronic instability that a structured rehabilitation program has not controlled.

For a fuller explanation, including anatomy, diagnosis, and the full range of treatment:

• Sprained Ankle — AAOS OrthoInfo