Ankle Sprain and Strain Signs and Symptoms

The symptoms of ankle sprains and strains can be quite similar, but there are some important distinctions. Both involve localized pain, ankle swelling, and instability, but the location and side effects of that pain and instability can differ depending on whether a muscle or ligament is involved.


Symptoms of an ankle sprain

In an ankle sprain, the following signs and symptoms may occur:

Localized pain at the site of the sprain. For example, if the deltoid ligament has been sprained, pain would be localized to the inside of the ankle. Pain is often described as sudden and sharp, and worsens with movement or placing weight on the ankle. Pain may be relieved somewhat by rest and elevation of the ankle.

Swelling at the site of the sprain. In the case of a deltoid ligament sprain, the inside of the ankle may be noticeably swollen. Or swelling may occur on the outside of the ankle if one or more ligaments in the lateral ligament complex are sprained.

Bruising over the site of the sprain. In addition to swelling, patients may notice bluish, reddish, or purplish skin discolorations over the sprain site as an indication that ligaments have torn and blood is rushing to the area.

Limited ability to move the ankle. In more severe sprains, patients may not be able to turn, bend, or flex the foot. Weight-bearing activities such as walking may become difficult or impossible.

Popping sound or sensation. When the injury occurs, patients may hear or feel a “pop” as the ligament is stretched or torn.

Intense pain at the time of the trauma. In cases of severe sprains when the ligament(s) is partially or completely torn, the pain is sudden and severe enough to make patients stop whatever they are doing and become immobile.

Symptoms of an ankle strain

While most ankle sprains are acute injuries that occur following a single trauma, ankle strains can be either acute or chronic. Acute strains can occur following a single trauma, such as slipping and falling on a patch of ice or running and jumping during sports. Chronic strains usually occur due to longer-term overuse of the ankle muscles, and frequently occur in long-distance runners, soccer and American football players, gymnasts, and dancers.


The following signs and symptoms may be indicators of an ankle strain:

Pain. Pain may either appear immediately at the onset of an acute strain, or appear gradually in the case of a chronic strain that develops over time due to overuse of the ankle muscles. (The latter is more common).

See Common Running Injuries: Pain in the Ankle or Back of the Heel

Swelling, redness, and inflammation that is localized to the site of the strain. For example, if the calf muscles (gastrocnemius and soleus) are strained where they meet the ankle, the lower calf and the area encircling the ankle bone may show swelling or redness. The area of inflammation may appear flushed or warm to the touch.

See Common Running Injuries: Calf and Shin Pain

Muscle spasms, cramps, and muscle weakness in the ankle. The ankle or lower calf may twitch or tense up, or the ankle may no longer be able to function normally. For example, a strained ankle may no longer support a person’s weight, or the person may lose the ability to jump or run without pain.

Limited range of motion. If one or more muscles and/or tendons in the ankle are strained, the ankle may no longer be able to move normally without pain, or the person may lose control of the ankle completely. For example, in the case of a mild strain, a patient may no longer be able to rotate or flex the ankle without feeling some level of discomfort, while in the case of a severe strain, the ankle may go completely limp.

In order to get the correct diagnosis and treatment, patients are advised to seek medical attention for any painful or debilitating symptoms. Ankle sprains and strains can have similar symptoms, as well as similar causes and risk factors.