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Ankle Sprain

Ankle sprains are among the most common musculoskeletal injuries and often occur when the ankle suddenly rolls or twists during sports, exercise, or everyday activities. Most involve the ligaments on the outside of the ankle and can range from a mild stretch to a more significant ligament injury. 

Dr. Michael Hoiles has created this page as a resource to help you better understand ankle sprains, including common symptoms, diagnosis, treatment options, exercises, recovery timelines, and when it may be appropriate to seek an assessment. 

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Quick Facts 

✔ Most ankle sprains involve the ligaments on the outside of the ankle. 

✔ Pain, swelling, bruising, and difficulty walking are common early symptoms. 

✔ Most ankle sprains recover well without surgery. 

✔ Early, comfortable movement and progressive loading are usually encouraged. 

✔ Balance and strengthening exercises can help restore ankle function. 

✔ Proper rehabilitation may reduce the risk of recurring ankle sprains. 

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Ankle Anatomy 

The ankle is supported by several ligaments that help provide stability while allowing the foot and ankle to move. 

Most ankle sprains occur when the foot rolls inward, placing stress on the lateral ankle ligaments. The anterior talofibular ligament (ATFL) is the ligament most commonly injured, although other ligaments (mainly the calcaneofibular ligament and the posterior talofibular ligament) may also be involved in more significant sprains. 

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What Are Ankle Sprains? 

An ankle sprain occurs when one or more of the ligaments supporting the ankle are stretched or torn beyond their normal capacity. 

The most common type is a lateral ankle sprain, which typically occurs when the foot suddenly rolls inward. Less commonly, the ligaments on the inside of the ankle or the ligaments above the ankle can be injured. 

Ankle sprains vary considerably in severity. Some cause only mild discomfort, while more significant injuries can result in substantial swelling, bruising, and difficulty bearing weight. 

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Common Causes & Risk Factors 

Ankle sprains commonly occur during: 

  • Running or changing direction quickly 

  • Landing awkwardly from a jump 

  • Stepping on an uneven surface 

  • Court and field sports 

  • Hiking or trail running 

  • Missing a step or curb 

  • Previous ankle sprains 

  • Activities requiring rapid cutting or pivoting 

A previous ankle sprain is an important risk factor for another sprain, particularly if strength, balance, and ankle control have not been fully restored. 

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Common Symptoms:

  • Pain around the ankle 

  • Swelling 

  • Bruising 

  • Tenderness around the injured ligaments 

  • Difficulty walking or bearing weight 

  • Reduced ankle movement 

  • Pain when turning or twisting the ankle 

  • A feeling of weakness or instability 

Symptoms can develop immediately or become more noticeable during the first several hours after injury. 

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How Is an Ankle Sprain Diagnosed? 

Diagnosis usually begins with understanding how the injury occurred and examining the ankle for swelling, tenderness, movement, strength, and stability. 

Most ankle sprains do not require imaging. However, an X-ray may be recommended when a fracture is suspected based on the injury, location of tenderness, or difficulty bearing weight. 

More advanced imaging may occasionally be appropriate when symptoms are unusually severe, recovery is not progressing as expected, or another injury is suspected. 

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Could My Pain Be Coming From Somewhere Else? 

Not every ankle injury is a simple ankle sprain. 

Other possibilities include: 

  • Ankle fracture 

  • High ankle sprain 

  • Peroneal tendon injury 

  • Osteochondral injury 

  • Other ligament injuries 

An assessment can help determine the likely injury and whether imaging or further medical evaluation is appropriate.

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What Helps? 

Early treatment usually focuses on protecting the injured ankle while maintaining comfortable movement. 

Helpful strategies may include: 

  • Temporarily modifying aggravating activities 

  • Compression to help manage swelling 

  • Elevation when the ankle is swollen 

  • Comfortable ankle movement 

  • Gradually restoring weight-bearing 

  • Progressive strengthening 

  • Balance and proprioception exercises 

  • Gradual return to running and sport 

  • An ankle brace or taping when appropriate 

Ice may provide short-term pain relief if it feels helpful, but rehabilitation should ultimately focus on restoring movement, strength, balance, and confidence in the ankle. 

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How Chiropractic Can Help 

Chiropractic care for an ankle sprain may include: 

  • Assessing the ankle and determining the likely severity of the injury 

  • Screening for signs that imaging or medical referral may be appropriate 

  • Restoring ankle and foot mobility 

  • Soft tissue treatment when appropriate 

  • Progressive strengthening 

  • Balance and proprioception exercises 

  • Guidance on bracing or taping when appropriate 

  • Developing a gradual return-to-running or return-to-sport plan following ankle and other sports injuries

The goal is not simply to reduce pain but to restore ankle function and reduce the likelihood of recurring injuries. 

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Recovery Timeline 

Recovery depends on the severity of the sprain. 

  • Mild sprains: often improve considerably within 1–3 weeks. 

  • Moderate sprains: may require approximately 3–6 weeks. 

  • More significant sprains: may take 6–12 weeks or longer before full return to demanding sports. 

Pain often improves before strength, balance, and stability have completely recovered, so rehabilitation may need to continue even after everyday activities feel comfortable. 

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Can I Still Exercise With an Ankle Sprain? 

Usually, yes, although activity may need to be modified initially. 

Exercises that do not significantly aggravate the ankle can often be continued. As walking becomes comfortable and ankle movement improves, strengthening and balance exercises can gradually become more challenging. 

Running, jumping, cutting, and sport-specific activities should be progressively reintroduced as the ankle becomes ready to tolerate them. 

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Exercises Commonly Recommended 

Exercise selection should depend on the severity and stage of the injury. 

Phase 1 – Restore Movement & Comfortable Loading 

  • Ankle pumps 

  • Ankle circles 

  • Gentle ankle range-of-motion exercises 

  • Supported calf raises 

  • Comfortable walking 

Phase 2 – Build Strength & Balance 

  • Standing calf raises 

  • Resistance-band ankle exercises 

  • Single-leg balance 

  • Step-ups 

  • Supported single-leg strengthening 

Phase 3 – Return to Running & Sport 

  • Single-leg calf raises 

  • Single-leg balance progressions 

  • Hopping and landing drills 

  • Lateral movement drills 

  • Running and change-of-direction progressions 

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Common Mistakes That Slow Recovery of an Ankle Sprain

  • Returning to sport as soon as the pain disappears 

  • Avoiding movement for too long 

  • Ignoring persistent swelling or instability 

  • Skipping balance exercises 

  • Not rebuilding ankle and calf strength 

  • Returning immediately to full training intensity 

  • Repeatedly spraining the ankle without addressing the underlying deficits 

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When Should You Seek an Assessment? 

  • You are having difficulty walking or bearing weight 

  • Swelling or bruising is significant 

  • Pain is not steadily improving 

  • You are unsure whether the ankle may be fractured 

  • The ankle repeatedly gives way or feels unstable 

  • You have experienced multiple ankle sprains 

  • You need guidance returning to running or sport 

 

When Should I Worry? 

Seek prompt medical assessment following a significant ankle injury if you cannot bear weight, have substantial tenderness directly over the bones of the ankle or foot, notice an obvious deformity, develop significant numbness or loss of sensation, or experience rapidly worsening pain or swelling. 

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Frequently Asked Questions 

Should I get an X-ray for an ankle sprain? 
Not every ankle sprain requires an X-ray, but imaging may be appropriate when a fracture is suspected based on your symptoms and examination. 

 

Should I walk on a sprained ankle? 
Gradual weight-bearing is often encouraged as tolerated, although more significant injuries may initially require additional protection. 

 

Should I ice a sprained ankle? 
Ice can be used for short-term pain relief if helpful, but restoring comfortable movement and gradually loading the ankle are important parts of recovery. 

 

Should I wear an ankle brace? 
A brace may provide additional support during the early stages of recovery or when returning to higher-risk activities. 

 

How long does an ankle sprain take to heal? 
Mild sprains may improve within a few weeks, while moderate or severe injuries can require several weeks to a few months. 

 

Why do I keep spraining the same ankle? 
Previous ankle sprains can leave lingering deficits in strength, balance, or stability, which may increase the risk of another injury. 

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Summary 

✔ Ankle sprains are common injuries involving the ligaments that stabilize the ankle. 

✔ Most involve the ligaments on the outside of the ankle. 

✔ Most ankle sprains recover well with conservative care and rehabilitation. 

✔ Early comfortable movement and progressive loading are usually important. 

✔ Strength and balance exercises can help restore ankle function. 

✔ Persistent pain, instability, or difficulty bearing weight should be assessed. 

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Ready to Get Back to Moving Comfortably? 

If an ankle injury is preventing you from walking, running, exercising, or participating in the activities you enjoy, an assessment can help determine the severity of the injury and the most appropriate next steps. 

Dr. Michael Hoiles is a Calgary chiropractor who provides evidence-informed care combining hands-on treatment, exercise-based rehabilitation, and practical advice to help people recover from injury, move better, and stay active. 

Book an appointment today to start your recovery and get back to doing what you enjoy. 

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