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Rady Children's Specialists

Ankle Sprain

An ankle sprain is an injury to the ligaments that connect the two leg bones (tibia and fibula) to the ankle bone (talus) and heel bone (calcaneous). There are multiple ligaments that interconnect these four bones.  An ankle sprain is caused by a twisting injury to the ankle, or by “rolling over” the ankle either to the outside or towards the inside, or a combination of motions.


Symptoms of an ankle sprain include:

  • Pain.
  • Swelling and bruising.
  • Limited ankle motion.
  • Difficulty walking.


A physical exam and how the injury occurred will help diagnosis the injury. An X-ray is very important to rule out a fracture.  The younger you are, the more likely that you may sustain a fracture though one of the growth plates, rather than just an injury to the ligaments. An MRI is only necessary if you have chronic or recurrent ankle instability.


Treatment depends on the severity of the injury. For a mild injury (grade I), a short period of rest, ice, compression, elevation and anti-inflammatory medications are needed.  Return to sport can be within a couple weeks. For a moderate injury (grade II), a short course of immobilization may be necessary, as well as a course of physical therapy to help prevent recurrent ankle sprains. Return to sports can occur in four to six weeks. For severe injuries (grade III), immobilization in a cast or walking boot is often needed for a four-week period, followed by physical therapy for an additional six weeks. Return to sports can be expected between two and four months. Surgery is rarely indicated for a first-time ankle sprain.