What Is an Ankle Sprain?
An ankle sprain occurs when the ligaments supporting the ankle stretch beyond their normal range or tear. This can happen when the foot twists awkwardly on uneven ground, during sport or after a simple misstep.
Common symptoms include pain, swelling, bruising, tenderness and difficulty walking. Some people may also experience ankle instability or a feeling that the joint is giving way.
Ankle sprains are commonly classified into three grades:
Grade I Ankle Sprain
A Grade I sprain involves mild stretching or microscopic damage to the ligament. Symptoms may include mild pain, swelling and tenderness, but the ankle is usually relatively stable.
Grade II Ankle Sprain
A Grade II sprain involves a partial ligament tear. It may cause greater pain, swelling, bruising and difficulty bearing weight, with some looseness or instability in the ankle, requiring medical evaluation.
Grade III Ankle Sprain
A Grade III sprain involves a complete ligament tear. It may cause swelling, bruising, difficulty walking and instability. A medical assessment may be needed to check for injuries.
How Are Ankle Sprains Treated?
The appropriate ankle sprain treatment depends on the severity of the injury, examination findings, symptoms and whether there are associated injuries.
Protection and Activity Modification
Early treatment may involve protecting the ankle, limiting activities that worsen symptoms and gradually returning to movement as pain and swelling improve.
Bracing or Immobilisation
A brace, splint or walking boot may be recommended for some moderate or severe sprains. These supports can help protect the injured ligament while allowing a gradual return to weight-bearing.
Physiotherapy and Rehabilitation
Physiotherapy may help restore ankle movement, strength, balance and coordination. Rehabilitation can also support a gradual return to work, exercise and sport.
When May Surgery Be Considered?
Most ankle sprains are managed without surgery. Surgical treatment may be considered when significant instability, pain or functional limitation continues despite appropriate non-surgical treatment, or when the injury pattern requires surgical management.
What Happens During Ankle Sprain Assessment and Treatment?
Assessment and Diagnosis
Your orthopaedic surgeon will assess the ankle for tenderness, swelling, restricted movement and instability. They may also examine your foot and lower leg for associated injuries.
Imaging
X-rays may be recommended when a fracture is suspected, particularly if there is significant tenderness over the ankle bones or difficulty taking weight-bearing steps. MRI or ultrasound may be considered to assess ligament, tendon or other soft-tissue injuries.
Treatment Planning
Your treatment plan may include protection, bracing, pain-management measures, activity modification and physiotherapy. More serious or persistent injuries may require additional specialist treatment.
Follow-Up Care
Follow-up appointments may be recommended to monitor healing, assess stability and guide your return to weight-bearing and normal activities.
Recovery After Ankle Sprain Treatment
Recovery depends on the severity of the sprain and the treatment required. Mild sprains may improve over several weeks with protection, controlled movement and gradual rehabilitation.
More significant injuries may require a staged recovery programme. This may begin with swelling control and range-of-motion exercises, followed by balance, strength and activity-specific training.
If surgery is required, recovery may include a period of immobilisation, gradual weight-bearing and guided physiotherapy. Your surgeon or physiotherapy team will advise you based on your specific injury and progress.
Who May Need Ankle Sprain Treatment?
Not every ankle sprain requires specialist treatment. However, persistent or worsening symptoms should be assessed to check for ligament damage, fracture or another associated injury.
You should consider an ankle assessment if you have:
- Pain, swelling or bruising after twisting your ankle.
- Difficulty bearing weight or walking normally.
- Significant tenderness over the ankle bones.
- A visible deformity.
- Numbness or unusual changes in sensation.
- Symptoms that do not improve with rest and home care.
- Recurrent ankle sprains or repeated ankle instability.
- Ongoing pain or swelling after the initial injury.
About Your Orthopaedic Specialist
Dr. Gowreeson Thevendran
MBChB (Bristol) · MRCS.Ed · Dip. Sports Med.Ed · FRCS.Ed (Trauma & Ortho.) · FAMS (Singapore)
Dr Gowreeson Thevendran is an orthopaedic surgeon in Singapore who specialises in lower limb orthopaedic conditions, trauma and fracture surgery of upper and lower limbs. He received his medical education from the University of Bristol and completed his surgical training in the UK and Canada.
Before establishing his private practice, he served as Chief of Foot & Ankle Surgery in the Department of Orthopaedics at Tan Tock Seng Hospital, Singapore.
Questions patients ask
FAQs
What Are the Common Symptoms of an Ankle Sprain?
Common symptoms include ankle pain, swelling, bruising, tenderness, difficulty walking and a feeling of instability. A popping sensation at the time of injury may indicate a more significant ligament injury.
How Is an Ankle Sprain Diagnosed?
Diagnosis usually involves a physical examination of the ankle and foot. X-rays, MRI or ultrasound may be recommended when a fracture, significant ligament injury or another soft-tissue problem is suspected.
Are Non-Surgical Treatments Available?
Yes. Many ankle sprains are managed with protection, bracing, activity modification, pain management and physiotherapy rather than surgery.
When May Surgery Be Considered?
Surgery may be considered when persistent instability, pain or functional limitation continues despite appropriate non-surgical treatment, or when the injury pattern requires surgical management.
What Are the Risks and Recovery Requirements?
Risks vary according to the treatment provided. Surgical treatment may involve infection, nerve irritation, stiffness, blood clots and anaesthesia-related complications. Recovery may involve protection, restricted weight-bearing and structured rehabilitation.
Can I Return to Work, Exercise or Sport?
Many people return to their usual activities after appropriate ankle sprain treatment. The timeline depends on the severity of the injury, treatment provided and progress during rehabilitation.
Does Insurance or MediSave Cover Ankle Sprain Treatment?
Coverage depends on the treatment, medical indication, patient eligibility, insurance policy and applicable regulations. Confirm your eligibility and expected out-of-pocket costs with the clinic, hospital and insurer.
Is Your Ankle Sprain Affecting Your Daily Life?
If your ankle pain, swelling or instability has not improved, an orthopaedic assessment can help identify the cause and determine the most appropriate treatment.