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Ankle Sprains & Ankle Pain
A rolled or twisted ankle is one of the most common injuries there is. Most sprains heal well with the right care — but a broken bone, a torn Achilles tendon or an ankle that keeps giving way needs a closer look.
What is an ankle sprain?
A sprain is an injury to the ligaments — the tough bands that hold the ankle bones together. It usually happens when the foot or ankle twists: walking on uneven ground, a fall or a trip, or a sport with cutting and jumping moves (AAOS OrthoInfo (opens in a new tab)). Most sprains are on the outside of the ankle, when the foot rolls inward, and they are the number one reason athletes miss games or practice (AAOS OrthoInfo (opens in a new tab)). Sports such as basketball, soccer, tennis and trail running raise the risk, as do poor balance, ligaments that are too loose, poor ankle alignment, and shoes that give too little support or have slippery soles (AAOS OrthoInfo (opens in a new tab)). Having sprained the ankle before raises the risk of another sprain (AAOS OrthoInfo (opens in a new tab)), although the 2021 U.S. physical therapy guideline found the research on this point conflicting (APTA/JOSPT guideline, 2021 (opens in a new tab)).
How bad is it? The three grades
- Grade 1 (mild): the ligament is stretched, with at most tiny tears. Mild swelling and tenderness; you can usually walk and the ankle feels stable (AAOS OrthoInfo (opens in a new tab)).
- Grade 2 (moderate): a partial tear, with more swelling and bruising, pain on walking and a slightly wobbly feeling (AAOS OrthoInfo (opens in a new tab)).
- Grade 3 (severe): the ligament is torn all the way through. Swelling and bruising are marked, putting weight on the foot is very painful, and the ankle feels unstable (AAOS OrthoInfo (opens in a new tab)).
Bruising and swelling are common signs of a sprain. A severe sprain can feel just like a broken bone, which is why a bad injury needs to be checked (AAOS OrthoInfo (opens in a new tab)).
Other common causes of ankle pain
- Strains are injuries to a muscle or tendon (rather than a ligament), from twisting or pulling. They can happen suddenly or develop over time (MedlinePlus (opens in a new tab)).
- A broken ankle (fracture) causes immediate, severe pain, swelling, bruising and tenderness, and often makes it impossible to put any weight on the foot. Most need at least 6 weeks for early healing and 10–12 weeks to heal completely (AAOS OrthoInfo (opens in a new tab)).
- Achilles tendinitis is irritation of the big tendon at the back of the heel, usually from overuse. It causes morning pain and stiffness along the tendon and pain the day after exercise. Suddenly doing more exercise, tight calf muscles and a change of shoes can bring it on (AAOS OrthoInfo (opens in a new tab)).
- An Achilles tendon rupture is a tear of that tendon. It typically happens when the calf muscle is stretched too quickly, such as landing from a jump or making a sudden cutting move in sport. You may hear a pop, followed by severe pain and swelling near the heel; you may not be able to walk on that leg or stand up on your toes (AAOS OrthoInfo (opens in a new tab)).
- Chronic ankle instability is an ankle that keeps giving way after a sprain. Most people recover fully from a sprain, but some go on to have ongoing instability (APTA/JOSPT guideline, 2021 (opens in a new tab), PubMed (opens in a new tab)). Repeated sprains can lead to long-term pain, cartilage damage and arthritis, and not finishing rehabilitation is the most common reason it happens (AAOS OrthoInfo (opens in a new tab)).
- Ankle arthritis may be wear-and-tear (osteoarthritis), rheumatoid, or “post-traumatic” — arthritis that develops after an injury. An injured joint is about seven times more likely than an uninjured one to become arthritic (AAOS OrthoInfo (opens in a new tab)).
Do I need an X-ray? The Ottawa ankle rules
Doctors use a simple, well-tested checklist called the Ottawa ankle rules to decide whether an injured ankle needs an X-ray. In the study that first developed the rules, every significant ankle fracture was found in people who had pain near the ankle bones and also had tenderness along the back edge or tip of either ankle bone, couldn’t bear weight both right after the injury and in the emergency room, or were 55 or older. A similar rule covers the middle of the foot (Stiell et al., Ann Emerg Med, 1992 (opens in a new tab)). The rules were then refined and tested again, and were 100 percent sensitive for fractures (Stiell et al., JAMA, 1993 (opens in a new tab)). A review of 27 studies with more than 15,000 patients, including children, found a sensitivity of almost 100 percent — so when none of the signs are present a fracture is very unlikely — and estimated the rules could cut unnecessary X-rays by 30–40 percent (systematic review, BMJ, 2003 (opens in a new tab)). Physical therapy guidelines also say the rules should be used to decide when an X-ray is needed (APTA/JOSPT guideline (opens in a new tab)). They are a tool for a trained clinician — if you’re unsure, get checked.
Get urgent care or go to the emergency room if:
- you can’t walk or put any weight on the ankle (NHS (opens in a new tab), NHS (opens in a new tab));
- the ankle looks deformed or out of place, or the foot is numb, cold or tingling (AAOS OrthoInfo (opens in a new tab), NHS (opens in a new tab));
- bone has broken through the skin — an open fracture is an emergency (AAOS OrthoInfo (opens in a new tab));
- you heard a crack, snap, grinding or popping noise when you were hurt, the pain is severe, or you feel faint, dizzy or sick from the pain (NHS (opens in a new tab), NHS (opens in a new tab));
- you felt a snap or pop at the back of the heel or calf and now can’t push off or stand on your toes — see a doctor right away if you think you’ve torn your Achilles tendon (AAOS OrthoInfo (opens in a new tab), AAOS OrthoInfo (opens in a new tab)).
While you are in a cast or boot, watch for signs of a blood clot. Blood clots are one possible complication after Achilles surgery (AAOS OrthoInfo (opens in a new tab)), and a clot in a leg vein (DVT) is more likely after surgery or when you can’t move around much. Get urgent medical advice for throbbing pain or swelling in one leg, usually in the calf or thigh, or red or darkened skin around the painful area — and call 911 if you also feel short of breath or have chest pain (NHS (opens in a new tab)). A very high temperature or feeling hot, cold or shivery after an injury can be a sign of infection and also needs prompt care (NHS (opens in a new tab)).
See your doctor soon if the pain is getting worse or keeps coming back, it stops you doing your normal activities, or it hasn’t improved after 2 weeks of home care (NHS (opens in a new tab)), or if the ankle stays swollen or painful for several weeks or you have trouble putting weight on it (AAOS OrthoInfo (opens in a new tab)). Pain that lasts beyond 4–6 weeks may mean a chronic sprain (AAOS OrthoInfo (opens in a new tab)).
Side by side
Six approaches compared
For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.
| Approach | What it involves | Estimated cost | What to expect |
|---|---|---|---|
| Conventional medicine (AMA) | Protecting the ankle with ice, compression and elevation at first, early weight-bearing in a brace or tape, then a structured exercise and balance program, often with a physical therapist. Short casting for some severe sprains; surgery is rare. | Self-pay X-rays about $50–$300 at an imaging center and more at urgent care or an ER; physical therapy about $100–$200 a session at independent clinics; lace-up braces about $20–$60 and walking boots about $80–$200. Medicare Part B covers needed outpatient physical therapy (you pay 20% after the deductible). | Most sprains feel better within about 2 weeks; severe ones can take 6–12 weeks or months. Finishing rehab matters — skipping it is the most common cause of a chronically unstable ankle. |
| Chiropractic | Hands-on mobilization or manipulation of the ankle and foot joints, usually combined with exercises. | About $55–$100 for a self-pay follow-up visit; first appointments about $90–$200. | Physical therapy guidelines strongly support joint mobilization alongside exercise. Chiropractic-specific studies are small and show short-term pain relief, not proven long-term benefit. A fracture should be ruled out first. |
| Acupuncture | Fine needles (sometimes with electrical stimulation or heat) at points around the ankle and elsewhere, usually alongside standard care. | About $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. | A Cochrane review rated the evidence for acute ankle sprains as very low quality and found no reliable support either way. A physical therapy guideline calls the evidence conflicting. |
| Herbal medicine | Creams and ointments made from comfrey or arnica, rubbed on unbroken skin over the sore area. | Cost estimate being researched. | One trial found a comfrey ointment worked about as well as a diclofenac gel; arnica is unproven for sprains. Never take comfrey or arnica by mouth, never put comfrey on broken skin, and check for interactions. |
| Massage therapy | Soft-tissue massage and gentle swelling-reducing (lymphatic drainage) techniques as part of rehab; foot-sole massage for chronic instability. | At one national chain, about $125–$160 for a 60-minute massage for non-members; memberships about $70–$90 a month. | Physical therapy guidelines include soft-tissue work alongside exercise. Research on massage on its own for ankle sprains is limited and mostly low quality. |
| MBHA Wellness Coach | A step-by-step recovery plan, home balance and strengthening exercises, supportive footwear, healthy weight, and a safe, gradual return to sport. | Cost estimate being researched. | Balance training plus a brace after a first sprain has strong evidence for lowering the chance of spraining it again. |
Approach 1 of 6
Conventional medicine (AMA)
Nearly all ordinary ankle sprains are treated without surgery — even a complete ligament tear can heal with the right protection and rehabilitation (AAOS OrthoInfo (opens in a new tab)). Diagnosis is mostly made by examining the ankle; X-rays are used to rule out a broken bone, and an MRI is usually only needed if symptoms last beyond 6–8 weeks or another injury is suspected (AAOS OrthoInfo (opens in a new tab)).
1. The first few days: protect, ice, compress, elevate
- Rest and elevation: keep weight off the foot at first and raise it above the level of your heart as often as you can during the first 48 hours (AAOS OrthoInfo (opens in a new tab)).
- Ice: in an ice pack or wrapped in a towel, never directly on the skin. AAOS OrthoInfo suggests 20–30 minutes, 3 or 4 times a day (AAOS OrthoInfo (opens in a new tab)); the NHS suggests up to 20 minutes every 2 to 3 hours (NHS (opens in a new tab)).
- Compression: an elastic bandage or wrap supports the ankle and may help control swelling (AAOS OrthoInfo (opens in a new tab)). The NHS calls this first-aid approach PRICE — adding protection, such as a support, to rest, ice, compression and elevation — for the first 2 to 3 days (NHS (opens in a new tab)).
- Pain relievers: over-the-counter anti-inflammatories such as ibuprofen or naproxen can ease pain and swelling (AAOS OrthoInfo (opens in a new tab)); the NHS suggests trying an ibuprofen gel, mousse or spray first (NHS (opens in a new tab)). Check with your provider first if you have heart disease, high blood pressure, kidney or liver disease, or a history of stomach ulcers or bleeding, and never take more, or for longer, than the label says. With nonprescription ibuprofen, stop and call your doctor if the pain lasts more than 10 days (MedlinePlus (opens in a new tab)). A Dutch guideline adds that these medicines aren’t free of complications and may slow natural healing (clinical guideline, BJSM, 2018 (opens in a new tab)).
2. Bracing, taping or a cast?
Current guidance favors getting moving early, with weight-bearing as you can tolerate, rather than long periods of rest (AAOS OrthoInfo (opens in a new tab)). The U.S. physical therapy guideline strongly recommends a brace or tape with gradual return to weight-bearing; for more severe injuries, a semi-rigid brace or a below-knee cast may be used for up to 10 days (APTA/JOSPT guideline, 2021 (opens in a new tab)). A Dutch evidence-based guideline reached a similar conclusion: a short time immobilized can ease pain and swelling, but people do best with tape or a brace combined with an exercise program (clinical guideline, BJSM, 2018 (opens in a new tab)). Crutches may help for a few days when walking is painful (AAOS OrthoInfo (opens in a new tab)).
3. Rehabilitation and balance training
Rehab usually moves through three phases: calming pain and swelling; restoring motion, strength and balance; then building up to straight-line running and finally the twisting and cutting moves of sport (AAOS OrthoInfo (opens in a new tab)). Balance (“proprioception”) training is at the heart of it, because poor balance often leads to repeat sprains (AAOS OrthoInfo (opens in a new tab)). Guidelines strongly recommend a structured exercise program — in the clinic and at home — covering range of motion, stretching, neuromuscular and balance training, and physical therapists may add hands-on joint and soft-tissue work alongside the exercise (APTA/JOSPT guideline (opens in a new tab)). Supervised exercise is preferred over passive treatments (clinical guideline (opens in a new tab)). The guideline advises against therapeutic ultrasound for acute ankle sprains (APTA/JOSPT guideline (opens in a new tab)).
4. When surgery is considered
Surgery is rare. It may be considered when the ankle stays unstable and painful after months of proper rehab, for some “high” ankle sprains, or when there is other damage such as a cartilage injury or tendon tear. Options range from keyhole (arthroscopic) surgery to repairing or rebuilding the ligament (AAOS OrthoInfo (opens in a new tab), clinical guideline (opens in a new tab)).
5. Other ankle problems
- Fractures: a break that hasn’t moved out of place is often treated in a short leg cast or walking boot; displaced breaks and most with a dislocation need surgery with screws, plates or rods. Most people are back to normal activities within 3–4 months (AAOS OrthoInfo (opens in a new tab)).
- Achilles rupture: small, partial tears respond well to treatment without surgery. Complete tears can be treated with or without surgery, and surgeons still debate which is better. Without surgery, the leg is kept in a boot, splint or cast with the toes pointed down for at least about 6 weeks, followed by physical therapy. Complete recovery can take about 12 months, and getting back to your previous level of activity can take up to 18–24 months (AAOS OrthoInfo (opens in a new tab)).
- Achilles tendinitis: rest from high-impact activity, ice, calf stretching and supervised strengthening, softer or open-backed shoes and heel lifts come first. Cortisone injections are not recommended because they can cause the tendon to rupture; surgery is considered only if pain lasts after 6 months of nonsurgical care (AAOS OrthoInfo (opens in a new tab)).
- Arthritis: treatment starts with activity changes, low-impact exercise, weight loss, physical therapy, supportive shoes or braces and anti-inflammatory medicine. For disabling pain, options include fusing the joint or an ankle replacement (AAOS OrthoInfo (opens in a new tab)).
What it costs
- X-rays: self-pay prices for an X-ray run about $50–$300 at an independent imaging center, $250–$500+ at urgent care and $500–$1,500+ at an emergency room. One worked example for a mild ankle injury came to about $320: a $150 urgent-care exam, a $125 X-ray and a $45 brace (The Pricer (opens in a new tab)).
- Physical therapy: about $100–$200 a session at independent clinics and $200–$350+ at hospital-based ones; first evaluations about $150–$400+; insurance copays about $10–$75 a visit (estimates from Hinge Health, a digital physical therapy company (opens in a new tab)). Medicare Part B covers medically necessary outpatient physical therapy with no yearly cap; you pay 20% of the approved amount after the deductible (Medicare.gov (opens in a new tab)).
- Braces: roughly $20–$60 for a lace-up brace, $30–$60 for an air-stirrup brace and $80–$200 for a walking boot (price guide from a Michigan podiatry practice (opens in a new tab)). Prices change, and a clinician should choose the brace for a serious injury.
How well it works — what to expect
Most sprains heal well. Most sprains feel better after about 2 weeks (NHS (opens in a new tab)); the full rehab program ranges from about 2 weeks for minor sprains to 6–12 weeks for severe ones (AAOS OrthoInfo (opens in a new tab)), and a severe sprain can take months to get back to normal (NHS (opens in a new tab)). The NHS advises avoiding strenuous exercise such as running for up to 8 weeks, because of the risk of further damage (NHS (opens in a new tab)).
Approach 2 of 6
Chiropractic
Chiropractors and other manual therapists use their hands to move stiff joints — either gentle, repeated movements (mobilization) or a quick, controlled thrust (manipulation or “adjustment”). After a sprain, the small joints of the ankle and foot can stay stiff, which limits how far the ankle bends.
What the research says
- Physical therapy guideline: the 2021 U.S. guideline gives its strongest grade to hands-on joint and soft-tissue mobilization, done within pain-free movement alongside exercise, to reduce swelling, improve ankle motion and normalize walking after a sprain. For chronic ankle instability it also strongly supports joint mobilization and manipulation to improve ankle bending and balance — in the short term (APTA/JOSPT guideline, 2021 (opens in a new tab)). This guideline was written for physical therapists, not chiropractors, but covers the same kinds of techniques.
- Chiropractic reviews: a 2012 review in a chiropractic journal rated the evidence for manipulative therapy in ankle inversion sprains as “fair” for short-term results and “limited” for the long term, and called for larger, better-designed trials (review, JMPT (opens in a new tab)).
- A small trial: in a 2015 study of 33 people with repeated sprains and an unstable ankle, adding six chiropractic manipulation sessions to a 4-week rehab program reduced pain and joint restrictions more than rehab alone in the short term, but did not improve function scores any more than rehab alone (randomized trial, JMPT (opens in a new tab)).
In short: hands-on joint work can help an ankle move better in the short term, and works best as part of an exercise and balance program rather than on its own.
Safety
A severe sprain can look like a broken bone, so a fracture must be ruled out before anyone works on the ankle (AAOS OrthoInfo (opens in a new tab)). If you have any of the warning signs above — can’t bear weight, deformity, numbness or a suspected Achilles tear — see a medical doctor first.
What it costs
- Without insurance: about $55–$100 for a follow-up visit and about $90–$200 for a first appointment; some lower-cost chains offer cheaper introductory visits (The Pricer (opens in a new tab)).
- With insurance: coverage can lower the cost, but deductibles, copays, coinsurance and visit limits can still leave an out-of-pocket bill (The Pricer (opens in a new tab)).
Approach 3 of 6
Acupuncture
Acupuncture is widely used for ankle sprains in some countries, including China and Korea, either alone or alongside standard care (Cochrane review (opens in a new tab)). The research, unfortunately, doesn’t yet tell us much.
What the research says
- Cochrane review (2014): 20 trials with 2,012 adults with acute ankle sprains, most of them done in China. All had a high risk of bias, and the reviewers rated the quality of evidence as very low. They concluded the evidence does not reliably support either the effectiveness or the safety of acupuncture for acute ankle sprains, and that larger, rigorous trials are needed (Cochrane review (opens in a new tab)).
- Physical therapy guideline (2021): rates the evidence on acupuncture for acute sprains as conflicting. For chronic ankle instability, it says clinicians may use dry needling (a related needling technique) of the muscles on the outside of the lower leg, together with balance training — a weak recommendation (APTA/JOSPT guideline (opens in a new tab)).
In short: acupuncture isn’t a substitute for protecting the ankle and doing your rehab exercises. If you choose to try it, use it alongside them.
Safety
Complications have come from non-sterile needles and poor technique, and improperly done acupuncture can cause infections or other serious problems. Needles must be sterile and single-use, and most states license acupuncturists (NCCIH (opens in a new tab)).
What it costs
Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer (opens in a new tab)).
Approach 4 of 6
Herbal medicine
A few herbal creams are popular for sprains and bruises. The research is thin, and some of these plants are dangerous if swallowed. Herbs can’t heal a torn ligament or a broken bone.
Comfrey ointment (on the skin only)
In a 2005 trial of 164 people with an acute ankle sprain, a comfrey-root ointment rubbed on the ankle for about a week relieved tenderness at least as well as a diclofenac (anti-inflammatory) gel (trial, Phytomedicine (opens in a new tab)). That is one single-blind study, so it can’t settle the question.
Comfrey safety. Comfrey contains pyrrolizidine alkaloids, which can damage the liver and have caused cancer in animal studies; in 2001 the FDA advised supplement makers to take comfrey products off the market (Memorial Sloan Kettering (opens in a new tab), NCCIH (opens in a new tab)). Never take comfrey by mouth: cases of liver toxicity have been reported (Memorial Sloan Kettering (opens in a new tab)). MBHA suggests asking a clinician before using it on the skin, and avoiding it on broken skin or if you are pregnant, breastfeeding or have liver problems.
Arnica gel
Arnica is sold for sprains and bruising, but Memorial Sloan Kettering lists sprains only as a claimed use, without supporting studies; trials in other conditions are mixed (Memorial Sloan Kettering (opens in a new tab)). The NIH notes some evidence that arnica or comfrey gels might help osteoarthritis — a different condition (NCCIH (opens in a new tab)). Arnica taken by mouth has caused serious harm, it should be avoided in pregnancy and breastfeeding, and people allergic to ragweed, marigolds or other daisy-family plants may react to it. It may also add to the effect of blood thinners such as warfarin (Memorial Sloan Kettering (opens in a new tab)).
“Natural painkillers” and other medicines
Some herbs act a bit like anti-inflammatory drugs or affect bleeding. Willow bark contains salicin, a relative of aspirin; taken with anti-inflammatories such as ibuprofen it may raise the risk of stomach and gut damage and bleeding, it may add to the effect of blood thinners, and it shouldn’t be given to children or anyone sensitive to aspirin (Memorial Sloan Kettering (opens in a new tab)). Ginkgo taken with warfarin is linked to a higher risk of major bleeding (NCCIH (opens in a new tab)).
Before you try any herbal product, remember that “natural” doesn’t mean safe, and tell your doctor or pharmacist about every supplement you use (NCCIH (opens in a new tab)) — especially if you take anti-inflammatories, aspirin or a blood thinner, or are pregnant. We don’t list doses here.
Approach 5 of 6
Massage therapy
Massage after an ankle injury is usually part of a rehab program rather than a treatment on its own. The U.S. physical therapy guideline includes hands-on soft-tissue work and lymphatic drainage (a light massage technique), used to reduce swelling and done within pain-free movement and together with exercise, among its strongly recommended treatments after a sprain (APTA/JOSPT guideline, 2021 (opens in a new tab)).
What the research says
- Chronic instability: a review cited in the guideline found that people with unstable ankles rated their ankles much better after hands-on treatments that included massage of the sole of the foot — measured before and after treatment, not against a comparison group (APTA/JOSPT guideline (opens in a new tab)).
- Tuina (Chinese therapeutic massage): a 2025 review of 13 small trials (984 people) with chronic ankle instability found better pain and ankle scores with tuina, but the overall quality of the trials was low, so better research is needed (systematic review, PLoS One (opens in a new tab)).
- Prevention: the NIH has funded research on whether massage can help people with ankle sprains avoid chronic ankle instability (NCCIH (opens in a new tab)); the page doesn’t report results.
Safety
The risk of harm from massage appears to be low, but rare serious problems — a blood clot, nerve injury or broken bone — have been reported, often with vigorous deep-tissue work or in people at higher risk, such as older adults. Don’t use massage to put off seeing a doctor about a medical problem (NCCIH (opens in a new tab)). The NHS advises avoiding massage for the first couple of days after a sprain, to help prevent swelling (NHS (opens in a new tab)). MBHA suggests waiting until a fracture has been ruled out, and avoiding deep pressure on a freshly injured ankle.
What it costs
Prices vary by location. At one national chain, franchise price lists show about $125–$160 for a 60-minute massage for non-members and about $65–$90 for members, whose memberships run about $70–$90 a month (The Pricer (opens in a new tab)).
Approach 6 of 6
MBHA Wellness Coach
An MBHA Wellness Coach helps you follow through on the part of recovery that happens at home — which is most of it. Not finishing rehab is the most common reason a sprain turns into a chronically unstable ankle (AAOS OrthoInfo (opens in a new tab)).
Your recovery plan
- Swelling and pain usually last 2 to 3 days, and putting weight on the foot early, as much as you can tolerate, is typically recommended (AAOS OrthoInfo (opens in a new tab)).
- Once you can move the ankle without pain stopping you, keep moving it so the joint doesn’t become stiff (NHS (opens in a new tab)).
- A coach can help you track swelling and pain, keep your follow-up appointments, and notice warning signs that mean it’s time to call your provider.
Balance and strength exercises at home
The American Academy of Orthopaedic Surgeons publishes a foot and ankle conditioning program that includes calf stretches, calf raises, tracing the alphabet with your foot, picking up marbles and scrunching a towel with your toes, elastic-band ankle exercises and standing on one leg (AAOS OrthoInfo (opens in a new tab)). Balance work can progress to standing on the injured foot with your eyes closed or using a balance board (AAOS OrthoInfo (opens in a new tab)).
- Do the program with your doctor’s or physical therapist’s guidance, and warm up first with 5–10 minutes of easy walking or cycling (AAOS OrthoInfo (opens in a new tab)).
- You shouldn’t feel pain during an exercise — if you do, stop and check with your doctor or therapist (AAOS OrthoInfo (opens in a new tab)).
Footwear
- Wear shoes with the right support for your activity, and take care on uneven ground (AAOS OrthoInfo (opens in a new tab)).
- With a sore ankle, wide, comfortable shoes with a low heel and soft sole are best; avoid high heels and tight, pointy shoes (NHS (opens in a new tab)). For Achilles tendinitis, softer shoes or ones open at the back of the heel can help (AAOS OrthoInfo (opens in a new tab)).
- For ankle arthritis, stiff-soled or rocker-bottom shoes and inserts may ease pain (AAOS OrthoInfo (opens in a new tab)).
A healthy weight
Body weight is one of the factors physical therapists look at because it can affect how a sprain recovers (APTA/JOSPT guideline (opens in a new tab)). For ankle arthritis, losing weight reduces the stress on the joint, and low-impact exercise such as swimming or cycling is easier on it (AAOS OrthoInfo (opens in a new tab)).
Getting back to sport — safely
- How soon you can return depends on the grade of the sprain, any other injuries and how well you keep up your rehab exercises, so talk it over with your doctor (AAOS OrthoInfo (opens in a new tab)). The NHS advises avoiding strenuous exercise such as running for up to 8 weeks (NHS (opens in a new tab)).
- Build up from straight-line activity to cutting and twisting moves (AAOS OrthoInfo (opens in a new tab)), and increase training gradually rather than all at once — a sudden jump in exercise is a common trigger for Achilles tendinitis (AAOS OrthoInfo (opens in a new tab)).
- Warm up properly before exercise (AAOS OrthoInfo (opens in a new tab)); not warming up properly is one of the risk factors for a sprain that the physical therapy guideline lists (APTA/JOSPT guideline (opens in a new tab)).
Preventing the next sprain
A past sprain raises the risk of another one (AAOS OrthoInfo (opens in a new tab)). After a first sprain, guidelines strongly recommend wearing a brace for sport and doing a balance-focused exercise program to lower the chance of spraining it again (APTA/JOSPT guideline (opens in a new tab), clinical guideline (opens in a new tab)). For people with risk factors, a brace can also lower the risk of a first sprain (APTA/JOSPT guideline (opens in a new tab)). A brace on its own, though, isn’t enough to fix balance in an ankle that is already chronically unstable — that takes exercise (APTA/JOSPT guideline (opens in a new tab)).
In their own words
Wellness and lifestyle testimonials
Please read first. These are personal experiences, not medical advice. MBHA makes no medical claims and does not claim any product heals or cures. See a doctor if you can’t put weight on an injured ankle, if it looks deformed, or if pain and swelling aren’t improving. Swollen ankles can be a sign of heart, kidney or circulation problems, and anyone with diabetes or nerve damage in the feet should have foot problems checked promptly.
A note of caution about swollen ankles: they are sometimes a symptom of a serious condition, such as congestive heart failure. I believe it’s important for anyone with this symptom to be evaluated medically, to make sure it isn’t something potentially life-threatening.
I was pruning an overgrown bush over my driveway. The clippings hid the ruts the rain had made, and when I stepped back I twisted my ankle and knee pretty badly. I went inside, rubbed a cream on my knee and ankle, and used a magnetic device over each area for about 15 minutes. My ankle stopped bothering me, but my knee still felt a little strange, so I taped a small magnet over the sore spot and put a far-infrared knee wrap over it. Later I went for a mile-and-a-half walk and came home feeling terrific.
A friend who had always refused to try magnets called and said, ‘Bring whatever you have for my tendonitis — I can’t get out of this chair.’ I took him a magnetic ankle wrap. The next morning he called: ‘I can move my toes.’ The morning after that he was in the kitchen making breakfast, walking.
A customer couldn’t wait to tell me her story. Several years ago she hurt her knee badly, and as a softball player she had put up with a lot of discomfort. She tried wearing a magnetic bracelet on the ankle of that leg, and the knee discomfort went away. She was amazed.
Shared with first names only. Lightly edited for length and spelling.
Member stories
Living with Ankle Sprains & Ankle Pain? Share your experience
Real experiences help others choose. Tell us what you tried — conventional medicine, chiropractic, acupuncture, herbs, massage or coaching — what it cost and what changed.
Sources
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo — Sprained ankle (opens in a new tab)
- AAOS OrthoInfo — Ankle fractures (broken ankle) (opens in a new tab)
- AAOS OrthoInfo — Achilles tendinitis (opens in a new tab)
- AAOS OrthoInfo — Achilles tendon rupture (tear) (opens in a new tab)
- AAOS OrthoInfo — Arthritis of the foot and ankle (opens in a new tab)
- AAOS OrthoInfo — Foot and ankle conditioning program (opens in a new tab)
- NHS — Sprains and strains (opens in a new tab)
- NHS — Ankle pain (opens in a new tab)
- NHS — DVT (deep vein thrombosis) (opens in a new tab)
- MedlinePlus — Sprains and strains (opens in a new tab)
- MedlinePlus — Ibuprofen (drug information) (opens in a new tab)
- Stiell et al. — A study to develop clinical decision rules for the use of radiography in acute ankle injuries, Ann Emerg Med, 1992 (PubMed) (opens in a new tab)
- Stiell et al. — Decision rules for the use of radiography in acute ankle injuries: refinement and prospective validation, JAMA, 1993 (PubMed) (opens in a new tab)
- Bachmann et al. — Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review, BMJ, 2003 (PubMed) (opens in a new tab)
- Martin et al. — Ankle stability and movement coordination impairments: lateral ankle ligament sprains revision 2021, JOSPT (APTA clinical practice guideline, full text) (opens in a new tab)
- Martin et al. — Lateral ankle ligament sprains revision 2021, JOSPT (PubMed) (opens in a new tab)
- Vuurberg et al. — Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline, BJSM, 2018 (PubMed) (opens in a new tab)
- Kim et al. — Acupuncture for treating acute ankle sprains in adults, Cochrane review, 2014 (PubMed) (opens in a new tab)
- Brantingham et al. — Manipulative therapy for lower extremity conditions: update of a literature review, JMPT, 2012 (PubMed) (opens in a new tab)
- Lubbe et al. — Manipulative therapy and rehabilitation for recurrent ankle sprain with functional instability, JMPT, 2015 (PubMed) (opens in a new tab)
- Liu et al. — Tuina for chronic ankle instability: systematic review and meta-analysis, PLoS One, 2025 (PubMed) (opens in a new tab)
- Predel et al. — Comfrey root extract ointment vs diclofenac gel in ankle distortions, Phytomedicine, 2005 (PubMed) (opens in a new tab)
- Memorial Sloan Kettering — Comfrey (opens in a new tab)
- Memorial Sloan Kettering — Arnica (opens in a new tab)
- Memorial Sloan Kettering — Willow bark (opens in a new tab)
- NCCIH — 5 tips: what consumers need to know about dietary supplements (opens in a new tab)
- NCCIH — Osteoarthritis: in depth (opens in a new tab)
- NCCIH — Herb-drug interactions (clinical digest) (opens in a new tab)
- NCCIH — Acupuncture: effectiveness and safety (opens in a new tab)
- NCCIH — Massage therapy: what you need to know (opens in a new tab)
- Medicare.gov — Physical therapy services (opens in a new tab)
- The Pricer — X-ray costs without insurance (opens in a new tab)
- Hinge Health — The true cost of physical therapy (cost guide) (opens in a new tab)
- Balance Foot & Ankle (Michigan podiatry practice) — Ankle brace types and prices (opens in a new tab)
- The Pricer — Chiropractor and chiropractic treatment cost (opens in a new tab)
- The Pricer — Acupuncture cost (opens in a new tab)
- The Pricer — Massage Envy cost (cost guide) (opens in a new tab)
This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.
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