Ankle sprains are a real pain — especially if they sideline you from physical activity. Ankle injuries are far too common.
And when you consider that it takes between 3 to 4 weeks to heal a moderate ankle sprain and 3 to 6 months for a more severe injury to heal, finding the right treatment is key.
The good news is you can heal from an ankle sprain and get back to doing the things you enjoy with the proper:
Keep reading to find out about the different types of ankle sprains, the best way to treat them, and how to prevent them from occurring again.
If you’ve been told you have an ankle sprain, you’re probably wondering how severe the sprain is, and how long it will take to heal.
An ankle sprain involves one or more of the ligaments that connect your bones in your leg to your bones in your foot.
Your ankle ligaments keep your bones from moving out of place. When you sprain your ankle, you stretch or tear a ligament(s).
“In general, the more severe the sprain, the longer the recovery,” says Eric Sampsell, a physical therapist at The Centers for Advanced Orthopaedics.
Sampsell says sprains are defined by grades, and are ranked from mild to severe. The approximate healing times correspond with these grades as follows:
|Type of ankle sprain||Approximate healing time|
|first degree or grade 1 (mild)||3 to 5 weeks|
|second degree or grade 2 (moderate)||4 to 6 weeks|
|third degree or grade 3 (severe)||3 to 6 months|
First degree or grade 1 ankle sprain
“A first degree sprain is a mild tear of the ligament, causing mild swelling and pain, and tends to recover quickly,” says Sampsell.
First degree sprains often take 3 weeks to heal. But some people can recover in less time, while some need 4 or 5 weeks.
Second degree or grade 2 ankle sprain
A little more severe is a second degree sprain, which Sampsell says usually involves 50 percent of the ligament tearing and will have more swelling and pain and loss of mobility.
When you’re diagnosed with a second degree sprain, you can anticipate a longer recovery than 4 weeks. In general, a second degree sprain can take 4 to 6 weeks to heal.
Third degree or grade 3 ankle sprain
A third degree sprain is a complete tear, which Sampsell says will take much longer to heal. This sprain will require some patience since you can expect anywhere from 3 to 6 months for recovery.
The best way to treat an ankle sprain begins with a proper diagnosis and treatment plan.
“It’s not uncommon for an ankle sprain to be misdiagnosed, under-treated, or have compounding factors if left to heal on its own,” says Emily Sandow, DPT, OCS, program manager of physical therapy at Harkness Center for Dance Injuries at NYU Langone Health.
But you can avoid many of these complications by following a good physical therapy program.
Step 1: RICE
The first step after an injury is to:
- reduce the swelling
- prevent further injury
The American Academy of Orthopaeidic Surgeons (AAOS) recommends:
- R: rest the ankle
- I: ice for 20 minutes, three to four times a day
- C: apply compression (if needed)
- E: elevate the foot
If surgery is not needed, you’ll move on to the recovery and rehab phase.
Step 2: Recovery
In the first 2 weeks following an injury, Sandow says that there can be a quick decrease of pain and an improvement in your ankle’s movement and function.
“Some people can return to activities within 1 to 3 weeks depending on the demands of their daily life,” she explains.
However, Sandow points out that certain people may continue to experience pain 1 year after an ankle injury.
That’s why early intervention is critical. “Unless otherwise told by your doctor, starting weight-bearing exercises right away, with caution, can be beneficial for the healing process, unless there is a fracture involved,” Sampsell explains.
If an ankle sprain is not taken care of properly through physical therapy and medical care, Sampsell says the ligament may heal slightly stretched, which can lead to future ankle sprains.
“In some cases, the domed bone at the top of the ankle, the talus, can get very stiff, which may limit the mobility of the ankle,” he says.
Additionally, the fibula can move slightly anteriorly. If this happens, Sampsell says a skilled physical therapist can perform mobilization to help restore normal motion and function.
Changes in movement patterns can initially be protective, but Sandow recommends returning to normal walking patterns as early as possible. “Walking unnaturally will perpetuate a limp and cause abnormal loading and stress on the foot and ankle,” she says.
Step 3: Rehabilitation
For a faster return to sports and activity and re-injury prevention, Sandow says a supervised and specific exercise program should be implemented by a physical therapist.
“This will speed up the recovery, increase confidence and strength in the ankle, prevent recurrence of the ankle injury, and allow a confident return to a normal lifestyle,” she explains.
Sandow says a good rehabilitation program includes:
- restoring range of motion
- rebuilding strength
- rebuilding balance and confidence in the ankle
- progressively reintroducing high impact loads
Additionally, Sandow says training specifically in balance and control can:
- accelerate the recovery of an ankle sprain
- prevent the recurrence of an ankle sprain
- prevent the long-term risk of chronic ankle instability
Some people can recall the exact moment a sprain occurred, while others have to really think about what they were doing and how it impacted the ankle.
Common causes of ankle sprain include:
- walking or running on uneven surfaces
- falling down
- sports that require rolling or twisting of the foot or cutting actions
- jumping, then landing hard on your foot
- someone stepping or landing on your foot
These movements and activities involve the foot or lower leg experiencing a sudden twisting force or roll, which forces the ankle joint out of normal position. When this happens, you can sprain a ligament(s) in this area.
Another cause of ankle sprains is a previous sprain. According to the AAOS, once you experience an ankle sprain, it’s more likely to happen again, especially if the ligaments do not heal.
Preventing ankle sprains from happening in the first place or occurring again is ideal, especially if you are an athlete or physically active.
“There is a strong correlation between ankle sprains and weakness through the gluteal muscles or core,” says Sampsell.
Since the muscles on the side of your hip help stabilize your entire leg, he says a weakness could cause the ankle to roll out and a sprain to occur.
The good news, says Sampsell is a 2014 research review showed that balance training, like balancing on one foot, can help prevent ankle sprains.
Following a strength training program that also includes ankle-specific exercises like balancing, band work, and stretching can help prevent future ankle sprains.
The amount of time it takes for an ankle sprain to heal depends on the severity of the injury.
In general, it will take a minimum of 3 to 4 weeks and up to 6 months for an ankle sprain to heal. That’s why getting a proper diagnosis and treatment plan for an ankle sprain is critical.
Working with your physician and a skilled physical therapist on the initial treatment as well as the long-term rehab can ensure that you are moving in the right direction.