Sprained ankle
Also called: rolled ankle, twisted ankle, ankle ligament injury, ankle sprain. Clinical name: Lateral ankle ligament sprain (usually the anterior talofibular ligament).
Most mild ankle sprains settle in 1–3 weeks and moderate sprains in 3–8 weeks. Complete ligament tears can take 3 months. If you cannot take four steps on it, get it checked for a fracture.
What it actually is
A sprained ankle is an injury to the ligaments that hold the joint together, and in the vast majority of cases it is the ligaments on the outside of the ankle, hurt by the foot rolling inwards: off a kerb, on a landing, in a tackle. It is probably the most common sports injury there is, which is exactly why it is the most under-treated. Familiarity breeds neglect.
Severity runs from a stretch to a complete tear, and the first week tells you a lot. A mild sprain is sore but walkable and settles in a couple of weeks. The classic moderate sprain swells, bruises down the side of the foot, and grumbles for a month or two. A severe tear struggles to take weight at all early on and needs proper assessment. The four-step test matters here: if you cannot take four steps, that is the standard trigger for an X-ray to rule out a fracture.
The trap with ankles is not the healing, it is the half-finished recovery. Pain goes early; balance and reactive strength come back late. The ligament also carries the nerve endings that tell your brain where your foot is, and until that sense is retrained with balance work, the ankle stays quietly slower to catch a roll. That is why one sprain so often becomes three, and why the boring single-leg balance exercises are the most valuable part of the whole plan.
How bad is it?
Injuries like this are usually described in grades. The grade is what shapes your timeline and what you can safely do while it settles.
Ligament fibres stretched, mild swelling and tenderness on the outside of the ankle. You can walk, gingerly, and sport is usually possible again within a couple of weeks.
A partial ligament tear. Real swelling and bruising, walking is painful for days, and the ankle feels wobbly on uneven ground. Most rolled ankles that bruise fall here.
A complete ligament tear. Marked swelling and bruising, difficulty bearing weight at all early on, and a genuinely unstable joint. Needs a clinician, sometimes a boot and, rarely, surgery.
How long will it take?
Recovery moves in phases. This is the typical shape of it — yours may run faster or slower, and the numbers below are general ranges, not a forecast for your specific injury.
When to get it looked at
Most cases settle with time and sensible loading. Get it assessed by a professional if any of these apply — they can point to something that needs hands-on care:
- Unable to take four steps immediately after the injury or in the hours afterwards
- Bone tenderness when pressing on the ankle knobs (malleoli), the base of the little-toe side of the foot, or the inside of the midfoot
- A foot or ankle that looks deformed
- Numbness, coldness or colour change in the foot
- Pain and swelling getting worse after the first few days rather than better, or new calf pain and swelling well above the ankle
This is a list of warning signs, not a diagnosis. If you are worried, or the pain is severe, see a GP, physiotherapist or urgent care.
What to track while you recover
Ankle sprains improve fast at the start and then plateau exactly when people stop paying attention, which is when the re-sprains happen. A short daily log keeps the last, unglamorous half of the recovery visible.
- Pain score, 0–10, walking on the flat and on stairs
- Swelling compared with the other ankle (a quick look each evening is enough)
- How long you can balance on the injured leg with eyes open, a genuinely useful daily test
- The most the ankle did today: walking, jogging, uneven ground, sport drills
- Any moments it felt like giving way, and what you were doing at the time
This is exactly what InjuryLog does.
Log each of these in seconds, watch the trend build day by day, and keep every scan and receipt tied to this one injury. Free on iOS, Android soon.
Wondering how long yours will take? Try the free recovery time estimator for a typical, phased timeline by injury and severity.
What to tell your physio
Physios grade ankle sprains from the mechanism and the first-week story, so bring the details of the day it happened, not just how it feels now.
- How it happened (the classic is rolling inwards on a step, landing or tackle) and whether you heard a crack or pop
- Whether you could walk on it straight away, and when the bruising and swelling appeared
- Whether this ankle has been sprained before, and how many times; repeat sprains change the plan
- Your current problems in order: pain, swelling, stiffness, instability, or fear of it going again
- The surface and sport you are returning to, and any giving-way moments so far
Walk in with the whole picture.
InjuryLog turns your daily logs into a clean Physio Visit Pack, a one-page summary your physio can actually read, so the first appointment starts with facts, not guesswork.
The questions people actually ask
How long does a sprained ankle take to heal?
Mild sprains, where the ligament is stretched rather than torn, usually settle in one to three weeks. Moderate partial tears, the classic swollen, bruised rolled ankle, take more like three to eight weeks to be sport-ready. Complete tears can take three months or more. Pain improves well before strength and balance do, which is why so many people feel healed at three weeks and roll the same ankle again at five.
How do I know if my ankle is broken or just sprained?
You cannot always tell from pain alone, but clinicians use a simple screen: if you could not take four steps right after the injury and still cannot, or if pressing directly on the bony knobs of the ankle or specific spots on the midfoot is exquisitely tender, an X-ray is warranted. Massive immediate swelling, deformity, or a crack at the moment of injury also point towards a fracture. When in doubt, get it looked at; walking on a missed fracture makes everything worse.
Should I walk on a sprained ankle?
Yes, as soon and as much as pain sensibly allows. The old advice of strict rest has been replaced by early movement: weight-bearing within comfort helps ankle sprains recover faster and stiffen less. In the first day or two you may need to keep it short and use support. What you should not do is push through sharp pain, or tackle uneven ground while the ankle still wobbles; progression is the point, not toughness.
Why is my sprained ankle still swollen after weeks?
Lingering swelling is common after ankle sprains and can persist for weeks, especially by the evening after a day on your feet. It usually reflects the slow tail of healing rather than new damage, and elevation, movement and compression help it along. Swelling that is getting worse rather than slowly better, or that comes with increasing pain, redness or heat, is a different pattern and deserves a clinician's look.
Do I need physio for a sprained ankle?
For a mild first-time sprain, a sensible self-managed plan of movement, strength and balance work often does the job. Physio earns its money for moderate and severe sprains, repeat sprains, or any ankle that keeps giving way, because the missing ingredient is usually retrained balance and strength rather than more rest. If you are still limping at two weeks, or this is your third sprain on the same side, book the appointment.
Why do I keep spraining the same ankle?
Each sprain stretches the ligaments and, more importantly, dulls the ankle's position sense, its ability to notice and correct a roll before it happens. If the balance and strengthening phase of rehab gets skipped, the ankle stays subtly slower to react, and the next uneven kerb finishes the job. This is fixable: single-leg balance work, calf and outer-ankle strengthening, and a brace or taping during sport while you rebuild give most people a stable ankle again.
Sources
- Sprains and strains — NHS
- Sprained Ankle — AAOS OrthoInfo