If you’ve sprained your ankle, I truly feel for you. An ankle sprain is such a frustrating injury. Believe me, I’ve been through the pain myself! In your situation it’s totally natural to want to know how long your ankle sprain recovery will take.
Mild ankle sprains usually only last 2-3 weeks. However, a moderately sprained ankle can take 6-12 weeks to recover enough for full running training. Severe ankle sprains which require surgery may take up to 6 months for full post-operative recovery and return to sport.
So that’s the quick answer. But let’s go a little deeper into understanding ankle sprains, and look at what determines the healing time, and what you can do to speed up your recovery and get back to the sports and activities you enjoy.
What is the recovery time for a sprained ankle?
As a sports rehab therapist, I have to point out that every injury case is different. But in this article, let’s take a look at how long a sprained ankle typically lasts.
The biggest factor when it comes to determining how long a sprained ankle will take to heal, is the severity of the injury itself.
As I covered in a previous article on ankle sprains (which I think you’ll find really helpful, so be sure to check it out), sprains are categorised by level of severity from Grade I to III.
Grade I: Mild Ankle Sprain
2-3 week recovery time. The least severe of ankle sprains, a Grade I sprain will cause microscopic damage to the structure of the involved ankle ligament(s). Symptoms will include light localised tenderness and perhaps a little swelling, but not always. You will be unlikely to experience any instability around the ankle joint.
Typically the symptoms of a Grade I ankle sprain will only last 2-3 weeks. You will be able to walk on the ankle with minimal pain after only a few days and will be able to gradually reintroduce running after 7-10 days.
Don’t be fooled though. Just because this is a less severe ankle injury, it doesn’t mean you can get away with not doing any ankle rehab exercises to build strength and stability in your ankles, and improve your balance on one leg.
I’ll be sharing some ankle rehab exercises to help your recover, later in this article.
Grade II: Moderate Ankle Sprain
6-12 week recovery time. This is where you’ve partially ruptured (torn) one of more of your ankle ligament(s). Grade II ankle sprains come with acute pain around the ankle joint, and visible swelling. You may also notice bruising around the ankle, and down into the foot. Initially weight bearing will be uncomfortable, and the action of walking will be painful.
Don’t be alarmed that the bruising tracks down into your foot; that’s simply gravity having its effect on the bruising. There may possibly be a little joint instability around your ankle, but not always.
Because of the more substantial damage to the ankle ligaments in a Grade II sprain (compared to a Grade I sprain), the recovery process will take longer.
Your ankle sprain rehab may take up to 12 weeks, before you can return to full sport. The process will being with treatment to manage the pain and reduce the swelling, before moving on to focus on building strength and stability around the ankle, as well as working on balance and proprioception.
Grade III: Severe Ankle Sprain
4-6 month recovery time. The most severe type of ankle ligament sprain is a Grade III rupture, where there is a complete (full thickness) tear of the involved ankle ligaments. A Grade III ankle sprain will come with a large amount of swelling around the ankle and foot, and acute pain when moving the ankle.
It will likely be too painful for you to weight bear on the injured ankle for the initial few weeks after the injury, and significant joint instability will be present when tested.
Because of the complete rupture of the ankle ligaments in a Grade III ankle sprain, surgical repair is usually required. Post-operative rehab can take up to six months, before you will be ready to return to full sport.
So as you can see, the treatment, rehab and recovery time needed for any ankle sprain will vary greatly depending on the severity of the sprain.
How do you know if your ankle injury is serious?
To provide a proper diagnosis for how badly you have injured your ankle, your physiotherapist will need to perform a proper musculoskeletal assessment.
This is what that kind of ankle assessment would look like:
However, there are a handful of signs and symptoms which will tell you how serious your ankle injury is, almost immediately.
1. Your Pain (Severity, Irritability & Nature)
How painful your ankle is, both immediately after your sprain, and later in the day, will give you a clue as to how serious your ankle injury is.
Fairly obviously, the more severe your pain is, the more likely it is that you’ve sprained your ankle badly (Grade II or III).
However, rather than just asking yourself “how intense is the pain?” you should also consider how irritable the pain is – how easily you are able to elicit the pain. If you’re able to weight bear and walk without bringing on your pain, then your ankle sprain is most likely less serious. However, if weight bearing is immediately painful, then your ankle sprain is more serious.
Monitor how your ankle sprain feels as the next few hours progress after your sprain. You may notice that the initial sharp pain becomes more of a dull ache as slight bruising and light swelling appears. However, if the sharp pain persists as you move your foot and ankle, it’s more likely that you’ve injured your ankle more seriously.
2. Swelling Around a Sprained Ankle
Your body’s natural response to this (and any) type of ligament injury is to create inflammation and swelling. Inflammation is actually an important part of the early healing process. As a very rough guide, the more inflammation and swelling that occurs as a reaction to your ankle sprain, the more likely it is that you’ve seriously injured your ankle.
3. Bruising Around a Sprained Ankle
All bruising is a form of internal bleeding. If you’ve sprained your ankle seriously, the damaged ligament tissue (and other surrounding soft tissues) may well cause some bleeding beneath the skin, which will show as bruising. As previously mentioned, this sometimes ends up looking like a bruised foot, because of the way gravity causes the blood to pool below the site of your ankle sprain. Again, the more bruising, the more severe the ankle sprain often is.
4. Instability & Pain upon Weight Bearing
Mild ankle sprains (Grade I) usually allow you to weight bear gently and walk carefully on the injured ankle. However, if your ankle is to painful to weight bear, it feels like your ankle is going to give-way if you try to stand on it, you have most likely sprained your ankle more seriously.
How do you make a sprained ankle heal faster?
The best treatment for an ankle sprain is dictated by the severity of the injury. However, whether you have a Grade I, II or III ankle sprain, there are some things you can do from day one to help your sprained ankle to heal faster.
The old acronym R.I.C.E is definitely appropriate here, although in more severe cases I’d add a ‘P’ to make it P.R.I.C.E!
Protection – If your ankle is painful upon weight bearing, and/or feels unstable, you might want to protect the injured ligaments and ankle joint in general by putting your ankle in an aircast boot until such time that you can get a proper diagnosis and treatment.
Rest – You need to allow your sprained ankle to rest and avoid activities and movements that cause your ankle pain and discomfort. You’ll become familiar with the sharp pain that you feel when your injured ligaments are stressed. Consider the fact that while those ligaments are healing, every time you feel that pain, you’re potentially doing more damage and slowing your recovery. Listen to your body. Pain is there for a reason!
Ice – You can use an ice pack on your sprained ankle to manage the swelling. Apply the ice pack (covered with a damp cloth) for 20 minutes every 2-3 hours.
Compression – Elastic bandages provide compression around your ankle which will help to reduce the swelling around your sprained ankle. Be sure to apply the compression evenly and don’t wrap them so tight that you cut off the blood supply to your foot.
Elevation – Another simple tactic to help manage the swelling of a sprained ankle, is to keep the affected ankle elevated. Keeping your foot above your heart allow gravity to stop blood and fluids pooling around your injured ankle.
Sprained Ankle Self Treatment
Now, beyond P.R.I.C.E, there are a number of things you can do (particularly with Grade I and II ankle sprains) which will help your sprained ankle to heal faster.
The first tip is to work on maintaining your pain free range of ankle movement as soon as possible. Actively moving your ankle through a pain free range of movement (however small those movements may feel) will help you to maintain as much strength as possible in the surrounding muscles. In comparison, complete immobilisation of the ankle will cause these muscles to lose strength much faster.
Doctor Jo does a great job of demonstrating some of these exercises in this video:
The second tip is for later in the healing process. As your ankle ligaments begin to heal, and the swelling is reducing, you can begin some cross-friction massage to help breakdown scar tissue and promote proper healing of the ligament tissue.
Physiotherapists Bob & Brad will teach you how to perform this type of cross-friction massage in this great video:
Rehab exercises focused on single leg balance will help you to rebuild your proprioception and active stability around the injured ankle.
In fact, when ankle sprains are just left to heal naturally with no treatment and rehab exercises, we often encounter problems further in the future.
What happens if an ankle sprain is left untreated?
If left untreated, a sprained ankle can become chronically unstable. Injured ankle ligaments can often heal with a degree of laxity and scar tissue, resulting in less ankle stability. Ankle sprains sometimes also result in a loss of accessory movement at the ankle joint, affecting your ability to move your ankles through a proper range of motion as you walk and run.
I often hear people saying that they have weak ankles, and that they’ve suffered multiple ankle sprains on the left, the right, or both sides. Frequently this is because the first sprain wasn’t properly treated, and the resulting weakness and deficit in ankle stability left them prone to further injuries.
Sadly, I’ve treated a couple of ex-footballers in their 50s and 60s both of whom have debilitating arthritis in their ankles as a result of multiple ankle sprains during their sporting careers. The ankle trauma effectively compounds.
The best way to stop this from happening to you is for you to get proper treatment and rehab for your first ankle sprain, to help prevent future ankle sprains.
How long should you stay off a sprained ankle?
Okay, so this is the million dollar question for anybody with a sprained ankle who is just itching to get back to their sport or chosen activity!
Ultimately you should be guided by your physio and listen to your body at every stage of the process. Don’t rush it.
Of course, the true answer depends on the severity of your ankle sprain, but I’ve written a handy article which will help you to know if and when you can run with a sprained ankle, and how to re-introduce running when the time comes. The article also shares a follow-along ankle strengthening rehab routine you must try!