Ankle Strains and Sprains

Complete Guide to Ankle Strains and Sprains

What is an Ankle Strain vs an Ankle Sprain?

An ankle strain or sprain is an injury to the soft tissues around your ankle joint that occurs when these tissues are stretched or torn beyond their normal range of motion. While the two terms are often used interchangeably, they refer to different types of injury:

• An ankle strain is when there is an injury to a muscle or tendon. It occurs when the tissues around the joint are overstretched or partially torn, often during activities that involve sudden acceleration, jumping, or changes in direction.
• Ankle sprain involves an injury to a ligament (these are the bands of tissue that connect bones and stabilise joints). Sprains occur when the ankle rolls or is forced into an awkward position.

Strains and sprains cause pain, swelling, bruising, and reduced movement. However, the location of tenderness and the specific tissues affected differ, which is why accurate diagnosis is essential for effective treatment.

It is important to note that a significant sprain or strain can be as serious as a fracture in terms of recovery time frames. 

What are the Types of Ankle Strains and Sprains?

Ankle injuries can vary in severity. Health professionals commonly classify them into grades based on the extent of tissue damage:

• Grade 1 (Mild)
  • Sprain: Slight stretching and microscopic tears of ligament fibres.
  • Strain: Minor overstretching of muscle or tendon fibres.
  • Symptoms are mild with minimal swelling, and the ankle usually feels stable.
• Grade 2 (Moderate)
  • Sprain: Partial tear of a ligament.
  • Strain: Partial tear of a muscle or tendon.
  • May cause moderate pain, swelling, bruising, and some difficulty walking.
• Grade 3 (Severe)
  • Sprain: Complete/total tear or rupture of a ligament.
  • Strain: Complete/total tear of a muscle or tendon.
  • Severe pain, significant swelling, bruising, and marked loss of function. The ankle may feel unstable, and weight-bearing is often impossible.

Sprains can also be described by their location:

• Lateral ankle sprain – the most common type, affecting the ligaments on the outside of the ankle.
• Medial ankle sprain – affects the ligaments on the inside of the ankle.
• High ankle sprain – involves the syndesmotic ligaments that lie between the tibia and fibula above the ankle joint.

How Common are Ankle Strains and Sprains?

Ankle sprains and strains are among the most frequent musculoskeletal injuries in Australia, particularly in sports and active populations. Research indicates:

• Ankle sprains account for around 10–15% of all sports injuries in Australia.
• They are most common in activities involving running, jumping, and where there are sudden changes in direction, such as basketball, netball, soccer, and rugby.
• Emergency department data suggest that ankle sprains represent over 3% of all injury-related presentations.
• Adolescents and young adults have a greater risk, but these injuries can occur at any age.

Given their frequency, prompt diagnosis and appropriate management are important to reduce recovery time and prevent long-term ankle instability. Access Ortho fracture clinics in Brisbane and Ipswich are highly skilled at diagnosing and treating ankle sprains and strains.  

SYMPTOMS AND CAUSES

What Causes Ankle Strains and Sprains?

Ankle strains and sprains usually occur when the joint is pushed outside its normal range of motion, causing the soft tissues to overstretch or tear.

 Common causes include:

• Rolling or twisting the ankle during sports or walking on uneven surfaces.
• Sudden changes in direction that may occur while running or jumping.
• Landing awkwardly from a jump.
• Direct impact or collision in contact sports.
• Overuse or repetitive strain, especially in activities involving repetitive ankle movements.

Sprains most often occur when the foot turns inward (inversion), stretching the ligaments on the outside of the ankle. Strains result from over-stretching or sudden contraction of the muscles and tendons supporting the joint.

What are Ankle Strain and Sprain Risk Factors?

The following factors can increase the likelihood of sustaining an ankle strain or sprain:

• Sports participation – especially basketball, netball, soccer, rugby, dance, and gymnastics.
• Previous ankle injuries – past sprains or strains can weaken tissues and make re-injury more likely.
• Poor balance or coordination – reduces the body’s ability to recover from a sudden loss of stability.
• Inadequate footwear – shoes without proper support or grip increase instability.
• Weak or tight muscles – especially in the lower leg and foot, which can reduce ankle stability.
• Uneven or slippery surfaces – these increase the risk of awkward foot placement.
• Fatigue – tired muscles provide less protection to joints.

What are the Symptoms of Ankle Strains and Sprains?

Symptoms will vary depending on the injury; however, common signs include:

• Pain – may be sharp at the time of injury, followed by a dull ache. Pain location varies:
  • Sprain: usually around the ligaments (outer or inner ankle).
  • Strain: often in the muscle belly or tendon.
• Swelling – caused by inflammation and bleeding into surrounding tissues.
• Bruising – discolouration may appear within hours or the next day.
• Tenderness – pain when touching or pressing the injured area.
• Reduced range of motion – stiffness or difficulty moving the ankle normally.
• Weakness – especially with strains, due to muscle or tendon involvement.
• Instability – ankle may feel like it could “give way,” particularly after a significant sprain.
• Difficulty bearing weight – more common in moderate to severe injuries.

What are the Complications of Ankle Strains and Sprains?

If not treated properly, ankle strains and sprains can lead to ongoing problems, including:

• Chronic ankle instability – repeated “giving way” due to weakened ligaments or poor muscle control.
• Persistent pain and swelling – from incomplete healing or scar tissue formation.
• Reduced mobility – decreased range of motion or stiffness that affects walking, running, and sport.
• Early-onset arthritis – due to cartilage damage within the joint.
• Recurrent injuries – weakened tissues are more prone to further sprains or strains.

Prompt diagnosis, appropriate treatment, and guided rehabilitation are important to prevent these long-term issues and restore full function.

Diagnosis and Tests

How Are Ankle Strains and Sprains Diagnosed?

At Access Ortho, your diagnosis begins with a comprehensive clinical examination. Our providers will:

• Discuss your symptoms – including how and when the injury occurred, any popping or tearing sensations, and whether you could walk afterwards.
• Review your medical and injury history to check for previous ankle injuries, chronic instability, or underlying conditions that may affect healing.
• Inspect your ankle for swelling, bruising, deformity, or skin changes.
• Palpate (feel) the area – to identify areas of tenderness, warmth, or structural irregularities.
• Assess range of motion – checking how far your ankle can move without pain.
• Perform stability tests – gently moving the ankle in specific directions to test ligament integrity (e.g., anterior drawer test for the ATFL).
• Check muscle strength – assessing the surrounding muscles for weakness after a strain.

These steps help us determine whether your injury is more likely a sprain (ligament injury), a strain (muscle or tendon injury), or a combination of both. They also provide information on the chance of a fracture. 

Which Tests Do Providers Like Access Ortho Use to Diagnose Ankle Injuries?

If a fracture, severe injury, or complex damage is suspected, we may recommend diagnostic imaging to confirm the diagnosis and guide treatment:

• X-rays – Used to rule out fractures or bone avulsions.
• MRI – Provides detailed images of ligaments, tendons, muscles, cartilage, and bone marrow to assess the extent of soft tissue injury.
• Ultrasound – Useful for dynamic assessment of tendons and ligaments during movement and detecting fluid build-up or small tears.
• CT scans – Occasionally used for complex bone injuries or when more detail is needed than an X-ray can provide.

Ankle Injury Grading System

Sprain Grades (Ligament Injuries)

• Grade 1 (Mild) – Slight stretching or microscopic tearing of ligament fibres. Mild swelling and tenderness; usually able to walk with little difficulty.
• Grade 2 (Moderate) – Involves a partial tear of the ligament: moderate swelling, bruising, and pain. Walking is painful, and joint stability may be reduced.
• Grade 3 (Severe) – Complete ligament tear. Significant swelling, bruising, and instability; often unable to bear weight without severe pain.

Strain Grades (Muscle or Tendon Injuries)

• Grade 1 (Mild) – Small number of muscle or tendon fibres overstretched or slightly torn; mild discomfort and minimal loss of function.
• Grade 2 (Moderate) – Partial tear of muscle or tendon fibres; moderate pain, swelling, and weakness.
• Grade 3 (Severe) – Complete/total rupture of the muscle or tendon; severe pain at the time of injury, possible visible deformity, and loss of function.

When to Seek Urgent Medical Attention for Ankle Injuries

Red Flags – Call Emergency Services or Visit a Hospital Immediately If You Have:

• Inability to bear any weight immediately after injury.
• Obvious deformity or bones visible through the skin.
• Severe swelling with numbness or loss of sensation in the foot.
• Signs of compromised blood flow (cold, pale, or blue foot).
• Open wounds or heavy bleeding.

Appropriate for Access Ortho:

• Moderate to severe sprains or strains that do not improve within 24–48 hours.
• Persistent pain, swelling, or bruising after an ankle injury.
• Recurrent ankle injuries or ongoing instability.
• Suspected ligament tears, tendon injuries, or undiagnosed ankle pain after sport or activity.

Not Appropriate for Access Ortho:

• Life-threatening injuries.
• Major open wounds or uncontrolled bleeding.
• Suspected fractures where the ankle is grossly deformed and cannot be moved safely.
• In these cases, attend your nearest emergency department first. Once stabilised, you may be referred to us for follow-up care.

Management and Treatment

How Are Ankle Strains and Sprains Treated?

At Access Ortho, we take a comprehensive treatment approach to restore ankle strength, stability, and function while minimising re-injury risk.

For initial care, we recommend the RICE protocol:

• Rest – Limit activities that cause pain or stress to the ankle.
• Ice – Apply ice to the ankle joint for approximately 15–20 minutes every 2–3 hours to reduce swelling.
• Compression – Use elastic bandages or ankle supports to limit swelling and provide stability.
• Elevation – Keep the injured ankle raised above heart level as much as possible.

Taking these steps immediately after an injury will assist with recovery by decreasing swelling, bruising, and pain.

Non-Surgical Treatment Options for Ankle Injuries

Most ankle injuries can be managed with conservative (non-surgical) care, which may include:

• Immobilisation – Using a brace, walking boot, or taping to protect the injured area during early healing.
• Physiotherapy – Tailored exercises to improve range of motion, rebuild strength, and restore balance.
• Activity modification – Avoiding high-impact activities until healing is sufficient.
• Gradual return to sport – Progressively increasing load and intensity under professional guidance.

Surgical Treatment for Severe Ankle Strains and Sprains

Surgery is rarely required, but may be considered when:

• Ligaments are completely torn, and instability persists despite rehabilitation.
• Tendons are fully ruptured or significantly displaced.
• There are associated fractures requiring fixation.

Surgical procedures may involve:

• Ligament repair or reconstruction – Reattaching or replacing damaged ligaments.
• Tendon repair – Reattaching torn tendons to restore strength and function.
• Arthroscopic surgery – This is a minimally invasive operation to repair joint structures and remove damaged tissue.

Ankle Injury Rehabilitation and Physiotherapy

Rehabilitation plays a key role in preventing long-term ankle instability.

 A typical program may include:

• Early phase (0–2 weeks) – Gentle range-of-motion exercises (e.g., ankle circles, alphabet exercises) and isometric strengthening.
• Mid phase (2–6 weeks) – Resistance band strengthening, balance training on a wobble board, and light functional activities.
• Late phase (6–12 weeks) – Plyometric drills, sport-specific movement training, and agility exercises to prepare for return to sport.

Progress is tailored to the injury grade and individual healing rate.

Most mild sprains recover in 2–4 weeks, moderate injuries in 4–8 weeks, and severe cases may take 3–6 months.

Pain Management for Ankle Strains and Sprains

Pain relief strategies may include:

• Over-the-counter medications – Such as paracetamol for pain or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to reduce pain and swelling.
• Topical treatments – Anti-inflammatory gels or creams.
• Cold or Heat therapy – Discuss with your medical team which is best for you.
• Supportive footwear or orthotics – To reduce strain on the healing tissues.

Pain control is always tailored to the patient’s needs, medical history, and injury severity.

Role of Access Ortho in Treating Ankle Strains and Sprains

At Access Ortho, we specialise in the rapid assessment and management of acute and sports-related ankle injuries.

 Our team provides:

• Same-day or next-day appointments for prompt diagnosis and treatment.
• Rapid referral for imaging (X-ray, ultrasound) for fast and accurate injury assessment.
• Customised treatment plans designed to get you moving safely and quickly.
• Close coordination with physiotherapists to optimise rehabilitation and prevent re-injury.
• Expert orthopaedic care for all ages and activity levels.

Whether your injury is mild or severe, we aim to help you fully recover, regain confidence, and return to your activities as soon as possible.

Education and Prevention

How Can I Prevent Ankle Strains and Sprains?

Preventing ankle injuries starts with keeping your joints strong, stable, and supported. Key strategies include:

• Wear supportive footwear—shoes that fit well, provide adequate ankle support, and are appropriate for your activity.
• Warm up before activity – Include dynamic stretches and light movement before sport or exercise.
• Strengthen ankle muscles – Calf raises, resistance band exercises, and single-leg balance drills help stabilise the ankle joint.
• Improve balance and proprioception – Use wobble boards or balance pads to train your ankle’s ability to react to uneven surfaces.
• Avoid uneven or slippery surfaces – Take extra care when walking or running on unstable ground.

Ankle Injury Prevention for Athletes

Athletes are at higher risk due to sudden changes in direction, jumping, and high-impact movements.

 Sports-specific prevention may include:

• Ankle taping or bracing for high-risk sports like basketball, netball, or rugby.
• Plyometric and agility drills to train quick directional changes while maintaining ankle stability.
• Sport-specific conditioning is used to strengthen the muscles used in your chosen sport.
• Gradual load progression when returning to training after a break or previous injury.

Workplace Ankle Injury Prevention

Occupational ankle injuries often occur in jobs involving heavy lifting, ladder use, or uneven work surfaces.

 Prevention tips include:

• Wear appropriate work boots with ankle support and slip-resistant soles.
• Keep work areas clear of trip hazards.
• Use correct lifting techniques to maintain balance and reduce strain.
• Take regular breaks to reduce fatigue, which can increase the risk of injury.

Outlook / Prognosis

What Can I Expect following an Ankle Strain or Sprain?

Most ankle strains and sprains heal well with proper treatment and rehabilitation.

Early intervention, appropriate protection, and guided recovery help prevent complications such as chronic instability or recurrent injuries.

What is the Recovery Time from Ankle Strains and Sprains?

Recovery time depends on the severity (grade) of the injury:

• Grade 1 (Mild) – 1–3 weeks.
• Grade 2 (Moderate) – 4–6 weeks.
• Grade 3 (Severe) – 3–6 months, sometimes longer if surgery is required.

Returning to sport too early may increase the risk of re-injury, so following your treatment plan is important.

Return to Activity After Ankle Injury

• Low-impact activities such as swimming or indoor cycling can often be resumed earlier.
• Running and sport-specific drills should only be reintroduced once you regain strength, stability, and pain-free movement.
• Contact or high-impact sports should be avoided until cleared by your healthcare provider.

Long-term Outlook for Ankle Strain and Sprain Recovery

With correct treatment and rehabilitation, most people make a full recovery and return to their usual activities.

 However, repeated injuries or inadequate rehabilitation can lead to:

• Chronic ankle instability
• Reduced athletic performance
• Increased risk of arthritis in the joint

At Access Ortho, we focus on complete rehabilitation and individualised prevention plans to keep you active, confident, and injury-free.

When Should I Go to a Fracture Clinic?

You should attend a fracture clinic when:

• You have a confirmed or suspected fracture (broken bone).
• Your GP, hospital, or emergency department has advised specialist non-surgical follow-up.
• You have a severe sprain or strain that is not improving with initial treatment.
• There is ongoing swelling, pain, or instability after an injury.
• You have a suspected ligament or tendon tear requiring specialist assessment.

Why choose Access Ortho?

• Rapid appointments – same-day or next-day availability for urgent cases.
• Expert assessment from orthopaedic-trained clinicians.
• Fast imaging turnaround – we refer you to local radiology practices for X-rays, MRI, or ultrasound, with results received promptly.
• Comprehensive management – from diagnosis to rehabilitation, all in one care plan.

What is a Fracture Clinic?

A fracture clinic is a specialist service for the assessment, treatment, and follow-up of bone, joint, and soft tissue injuries.

 At Access Ortho, our fracture clinic services include:

• Specialist orthopaedic assessment for fractures, sprains, strains, and sports injuries.
• Interpretation of imaging results from local radiology providers.
• Application and management of immobilisation devices (casts, splints, walking boots).
• Rehabilitation guidance is needed to ensure a safe and timely return to activity.
• Monitoring of healing progress and adjusting treatment as needed.

You don’t have to wait weeks for hospital outpatient appointments. At Access Ortho, we provide fast, accessible, affordable and expert care close to home.

Ankle Strain and Sprain Treatment in Australia

In Australia, mild ankle sprains and strains are often poorly managed, resulting in extended recovery times. A specialised fracture clinic such as Access Ortho will ensure a correct diagnosis and offer a rapidly established treatment plan, ensuring a smoother recovery. At Access Ortho, we provide:

• Rapid injury assessment without the long wait times of public hospital clinics or the high costs of private emergency departments and urgent care centres.
• Referral to local radiology practices for X-rays, MRI, or ultrasound, with fast result turnaround.
• Complete care with an orthopaedic team from diagnosis to recovery. 
• Evidence-based treatment plans, including immobilisation, bracing, and targeted rehabilitation.
• Close coordination with physiotherapists to ensure complete recovery and reduce re-injury risk.
• Care for all ages and all occupations, from workplace injuries to athletes. 

If you’ve had an ankle injury and want prompt, expert treatment, Access Ortho is your local choice for private fracture care in Brisbane and Ipswich.

Frequently Asked Questions About Ankle Strains and Sprains

How long does it take for an ankle sprain to heal?

Healing time following an ankle injury depends on the injury’s severity:

• Grade 1 (mild) – 1–3 weeks.
• Grade 2 (moderate) – 4–6 weeks.
• Grade 3 (severe) – 3–6 months (longer if surgery is required).
• A proper rehabilitation program can shorten recovery time and reduce the risk of re-injury.

What’s the difference between a sprained ankle and a broken ankle?

A sprained ankle involves a ligament injury; symptoms include swelling, bruising, pain, and limited motion, but the bone remains intact.

A broken ankle (fracture) involves a bone injury. It may cause severe pain, an inability to bear weight, deformity, and sometimes visible bone movement under the skin.

An X-ray (arranged via local radiology) is the best way to confirm or rule out a fracture.

Often, an injury will involve both a ligament and a bony injury.

Should I go to the emergency room for an ankle sprain?

You should attend the emergency department rapidly if you have:

• Significant deformity or suspected fracture.
• Severe swelling with numbness or colour change in the foot.
• Open wounds or heavy bleeding.

 Otherwise, you can attend Access Ortho for urgent assessment and treatment. You could also try a virtual Ankle Sprain consultation

Can I walk on a sprained ankle?

For mild ankle sprains, gentle weight-bearing is often safe once pain allows. You may need crutches, a walking boot, or bracing to protect the joint during healing for moderate or severe sprains. Always follow medical advice to avoid further injury.

What is the RICE method for ankle sprains?

The best thing to do immediately following an ankle injury is to follow the RICE method:

• Rest – Avoid activities that cause pain.
• Ice – Apply ice to the joint for approximately 15–20 minutes every 2–3 hours in the first 48 hours.
• Compression – Use a firm compression bandage or ankle support to reduce swelling.
• Elevation – Keep the ankle above heart level as much as possible.

Elevating your foot helps reduce swelling, bruising and pain. 

When should I see a doctor for an ankle injury?

If you have any of the following, you should seek professional care:

• Persistent swelling or pain beyond 48 hours.
• Inability to walk or stand on the ankle.
• If you suspect a fracture or significant ligament damage.
• If you experience repeated ankle injuries or instability.

How do I know if my ankle sprain is severe?

Medical professionals grade ankle injuries. The more severe injuries are grade 2 and 3 sprains, which often involve:

• Significant swelling and bruising.
• Severe pain at rest and with movement.
• Inability to walk without limping.
• Feeling of the ankle “giving way” or instability.

What happens if I don’t treat an ankle sprain properly?

If you don’t treat an ankle sprain properly, you may develop

• Chronic ankle instability, 
• Persistent pain and swelling.
• Reduced mobility.
• Increased risk of arthritis in the joint.

Getting early care for your injury at a fracture clinic such as Access Ortho will minimise the risks of ongoing concerns following an ankle sprain or strain.

Can ankle sprains cause long-term problems?

Without proper treatment and rehabilitation, ankle sprains can lead to ongoing instability and recurrent injuries. It is important to seek orthopaedic advice following an ankle sprain.

What exercises help prevent ankle sprains?

Your physiotherapist will guide you on the best exercises for recovery following an ankle sprain. Typically, these exercises will include the following: 

• Calf raises – Strengthens lower leg muscles.
• Resistance band ankle movements – Builds ankle stability.
• Single-leg balance drills – Improves proprioception.
• Wobble board training – Trains reaction to uneven surfaces.

How soon can I return to sports after an ankle sprain?

Deciding when to return to sport after an ankle sprain will depend on your injury, recovery rate and the sport you wish to return to. Ideally, you will have:

• Full, pain-free range of motion.
• Strength in your injured ankle that matches your uninjured ankle.
• You can perform sport-specific drills without discomfort.

Mild sprains may allow return in 2–4 weeks; severe sprains may require several months.

Do I need an X-ray for an ankle sprain?

Imaging following an ankle injury is recommended if there is suspicion of a fracture, severe pain on weight-bearing, or tenderness over the bones. Access Ortho refers patients to local radiology practices for rapid X-rays, MRIs, or ultrasounds when needed.

What’s the best treatment for a high ankle sprain?

High ankle sprains (syndesmotic injuries) require longer healing and may need:

• Immobilisation in a boot.
• Extended rehabilitation.
• Surgery is required in cases of significant ligament separation.

How can I reduce swelling in my sprained ankle?

Following the RICE method and resting will help minimise swelling following an ankle injury. Ideally, you should:

• Apply ice regularly during the first 48 hours.
• Use compression bandages or sleeves.
• Elevate the ankle above heart level.
• Avoid prolonged standing or walking early in recovery.

When do ankle sprains require surgery?

Surgery following an ankle sprain is considered if:

• There is a complete ligament rupture with ongoing instability.
• The injury is associated with a fracture.
• Non-surgical treatment fails to restore stability.

What is a high ankle sprain?

A high ankle sprain (syndesmotic sprain) is an injury to the ligaments that join the lower leg bones above the ankle joint.

Unlike other ankle sprains, high ankle sprains typically occur when the foot twists outward and take longer to heal.

What’s the best treatment for a high ankle sprain?

High ankle sprains require longer recovery and may need:

• Immobilisation in a boot.
• Extended rehabilitation focused on stability.
• Surgery is required in cases of significant ligament separation or instability.