Sunday, July 6, 2025
Is Your Ankle Sprain More Serious Than You Think?
Is Your Ankle Sprain More Serious Than You Think?
We’ve all twisted an ankle at some point—during a jog, while playing sports, or just stepping off a curb the wrong way. Often, it’s brushed off as “just a sprain.” But not all sprains are the same, and some ankle injuries can be more serious than they seem at first.
As a specialist, I regularly see people who waited too long to get their ankle checked—only to find out it was more than a simple sprain. Getting the right care early on can really speed up recovery and help avoid lasting problems.
What Is an ankle Sprain?
A sprain happens when the tough bands of tissue (called ligaments) that hold your ankle bones together get stretched or torn.
There are different levels of sprains:
- Mild (Grade 1): Slight stretching, mild swelling, walk with a limp.
- Moderate (Grade 2): Partial tear, more pain, swelling, hard to walk.
- Severe (Grade 3): Complete tear, lots of swelling and bruising come out over 2-3 days. May be uncomfortable to weight bear at all.
What should I do when I sprain the ankle?
The typical treatment is RICE or Rest, ICE, Compression and Elevation but this is often a bit confusing. I would put ice packs on straight away for about 20 minutes at a time. Don’t put directly onto the skin but into a pillow case cover or a thin tea towel to prevent skin burns. You can do 20 minutes on and 20 mins off continuously for the first few hours. This will dramatically help improve your outcome and speed healing. Then put on an ankle support brace (link to videos) or if you haven’t got one then wrap a crepe bandage around it to give it support. Elevation to heart level in the first few hours also helps reduce swelling.
When Is It More Than Just a Sprain?
Some injuries need more than rest and ice. Here are some signs to watch for:
- Pain above your ankle - or when twisting your foot outward could mean a high ankle sprain (LINK), which takes longer to heal and may even need surgery.
- Avulsion fracture: Sometimes a piece of bone gets pulled off. It feels like a bad sprain, but may need surgery.
- Actual broken bones: If you can’t put weight on your foot or have swelling and bruising that doesn’t improve, you might have a fracture. Time for an Xray.
- Cartilage damage: If you feel deep ankle pain or a “clicking” feeling, this might be the cause and can lead to long-term problems.
- Tendon damage : important tendons run around your ankle and these can also be sprained or tear and may require different treatment.
- Nerve or blood vessel injury: Rare, but if your foot feels numb, tingly, cold, or weak, get help immediately.
Long-Term Issues to Watch Out For
If your ligaments don’t heal well, your ankle might feel like it “gives way” and unreliable. This can lead to more sprains and long-term joint issues.
When to See a Specialist
See a doctor if you notice:
- Ongoing or severe pain
- Swelling or bruising that’s not getting better
- You can’t walk properly 2–3 days after the injury
- Your ankle feels like it keeps “giving way”
- Tingling, numbness, or pain higher up your leg
Recovery Times
- Mild sprains: 1–2 weeks
- Moderate sprains: 4–6 weeks
- Severe or complex injuries: 3+ months, possibly needing surgery
If you’re still limping after a month or can’t get back to your usual activities, it’s time to get it checked out.
Treatment Options
Depending on the injury, treatment may include:
- Braces or boots to support your ankle
- Physiotherapy for strength and balance to work on the dynamic stabilisers of the ankle
- Surgery, if needed for serious damage
About 80% of patients with serious sprains get away without needing surgery. A proper diagnosis at the outset often speeds up recovery and streamlines treatment.
Final Word
Ankle injuries can be tricky. Many heal with rest, but if something doesn’t feel right, don’t ignore it. Getting the right help early can make a big difference.
If you’ve had an ankle injury and you're unsure what’s going on, it’s always safer to get it looked at sooner rather than later.
This article was written by Mr Andrew Goldberg, Consultant Orthopaedic Foot & Ankle Surgeon in London for children and adults. If you would like to book a consultation with Mr Goldberg please call +44(0)207 042 1818 or by email at info@goldbergpp.com
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