by Boston Gregg

An Ankle Sprain occurs when one or more ligaments on the outer side of the ankle are stretched or torn. Sprains can range from mild to severe and are usually caused by overstretching beyond one’s normal range of motion.

A “popping” sound is very common to hear at the moment when you sprains your ankle. A “cracking” noise means it’s most likely a fractured bone. Swelling can be normal for this type of injury, but if your ankle appears deformed or crooked at the same time, it’s most likely a fracture. Numbness also indicates a fracture.
Your doctor will be able to determine the severity of your ankle sprain by comparing your symptoms and physical exam to the characteristics of each of the three grade levels.

Some 25,000 people sprain their ankle every single day.

Grade I: Partial tear to a ligament.

Signs & Symptoms:

  • Mild tenderness, swelling, and pain
  • Slight to no functional loss (often patients can bear weight with minimal pain from the ankle.)

Grade II: Incomplete tear of a ligament with moderate functional impairment.

Signs & Symptoms:

  • Moderate pain and swelling
  • Mild to moderate bruising or discoloration
  • Tenderness surrounding the area
  • Some loss in range of motion and functionality
  • Pain while bearing weight and ambulating.

Grade III: Complete tear and loss of integrity in ligament.

Signs & Symptoms:

  • Severe swelling
  • Severe bruising or discoloration of the skin due to bleeding underneath
  • Loss of functionality and motion
  • Unable to bear weight or ambulate.

Treatment Options: Chances are your ankle sprain won’t require a visit to the doctor unless severe. Follow the R.I.C.E. and/or M.E.A.T. protocol after an injury to promote healing and flexibility in the hopes of getting back up and moving quickly again. Most people have used the RICE protocol in some capacity when dealing with injury in the past.


  • Rest. Take weight off your ankle and take a break from your normal activities for a day or two. Continuing to use your ankle following a sprain can pose the risk of slowing down the healing process and even worsening your injury. In mild sprains though, some activity can actually benefit the healing process due to increased circulation. If you’ve given your body a day or two to rest first, most medical experts would suggest ambulation.
  • Ice your ankle for 15 to 20 minutes at a time, every 3 to 4 hours, during the first 48 hours after an injury. Icing an injury for longer than 20 minutes at a time can pose real threats to the tissue its touching. Ice provides pain-relief as well as prevents swelling by lower the amount of blood flowing.
  • Compression bandages (i.e. Ace bandage) are used to reduce swelling. The wrap should be snug but not too tight. There should be no threat of cutting off circulation completely. If your toes become cold or turn blue, wrap your ankle a bit looser.
  • Elevate your leg above your heart or waist to reduce swelling. Elevating your foot, especially during the first 24 hours, will help prevent swelling and the risk of internal bleeding.


  • Movement: Controlled movement of affected limb can stimulate circulation and the healing process. Movement promotes the normal functionality within the body.
  • Exercise: Much like movement, controlled and appropriately recommended exercises can shorten one’s recovery time. A physical therapist might encourage a patient with an ankle sprain to write out the alphabet with the affected limb. Don’t push your body harder than you normally do, this can lead to more damage.
  • Analgesics: Over-the-counter medications like Tylenol should be used for acute pain. Severe pain related to an injury will often be prescribed more serious painkillers.
  • Treatment: Physical therapy helps patients regain their mobility following an injury such as a Grade III sprain. Most sprains are less severe than Grade III. Grade I and often Grade II don’t require medical attention.

It’s important to be able to read your own body. Don’t attempt to push yourself too hard or you may end up injuring yourself even more. If your condition worsens, contact your doctor immediately.


OrthoNeuro Blogs are intended to be inform and educate readers about common conditions within orthopedics and neurology. Information within these blogs can benefit your livelihood and health but, should not replace actual medical attention from your doctor.


Haddad, S. L. (2016, February). Sprained Ankle. Retrieved from
Wolfe, M. W. (2001, January 1). Management of Ankle Sprains. Retrieved from
Untitled. (2016). Ankle Sprain. Retrieved from


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