Sprained Ankle Pain: Understanding The Different Pain Levels

A sprained ankle happens when the ligaments supporting your ankle are stretched or torn. Ankle sprains commonly occur during physical activities such as sports or simply tripping and twisting your ankle. A sprained ankle can lead to numerous symptoms, including swelling, pain, and difficulty walking or bearing weight on the affected ankle, limiting daily activities and affecting overall mobility. 

While most people will experience at least one sprained ankle in their lifetime, it is important to understand how to manage pain levels for a successful recovery. Otherwise, it can lead to further complications, such as chronic pain or instability in the ankle joint.

How Often Do Ankle Sprain Injuries Occur?

Ankle sprains are one of the most common injuries, with about 25,000 people suffering from it every day. This amounts to approximately 2 million ankle sprains annually in the United States alone. It’s even more common for athletes. It’s estimated that around 16 to 40% of all sports-related injuries are ankle sprains. The following are just a few examples of how ankle sprains can happen:

Uneven Surfaces Can Lead To Falls Or Trips

Walking, running, or playing on uneven surfaces, such as grassy fields or rocky trails, increases the chances of rolling your ankle and causing a sprain. This is because when you step on an uneven surface, your ankle may twist or turn unnaturally, putting pressure on the ligaments and causing them to stretch or tear. This is especially common in outdoor sports or recreational activities.

Jumping And Landing Incorrectly

In certain activities that involve jumping, such as volleyball or basketball, there is a risk of landing incorrectly and spraining your ankle. This can happen if you land on someone’s foot or your own foot lands awkwardly on the ground.

Losing Balance

Even in daily activities like walking or climbing stairs, you can lose your balance and twist your ankle. This is more likely to happen if you have weak ankles or unstable footwear. Sometimes, losing your balance can also result from a previous injury or an underlying condition.

Sports Participation That Involves Cutting Or Jumping Actions

Sports involving quick changes in direction as well as sudden movements, such as tennis, football, or gymnastics, put a high amount of stress on the ankles and increase the risk of sprains. This is because the body’s weight is supported by one leg while the other leg performs cutting or jumping actions, making it easier to roll or twist your ankle.

What Does It Feel Like To Have A Sprained Ankle?

Ankle sprains can be mild or severe, with varying levels of pain and discomfort. The following are some common sensations and symptoms associated with different levels of ankle sprains:

  • Swelling and bruising: When a ligament is stretched or torn, it can cause damage to the small blood vessels in the area, leading to bruising. Additionally, the body’s natural response to a sprain is to send more blood to the affected area to heal and repair the damaged tissue. Increased blood flow can lead to swelling, which may accompany bruising due to small blood vessels breaking.
  • Pain with and without weight-bearing or activity: The severity of ankle sprain pain can vary depending on the extent of the injury. A mild sprain may only cause discomfort when walking or performing activities that put pressure on the affected ankle, while a severe sprain can result in constant pain, regardless of weight-bearing or activity.
  • Popping sensation or sound: Some people may experience a popping sensation or sound when they sprain their ankles. This could be due to the ligament tearing or the bone moving out of place temporarily.
  • Instability: A severe sprain can cause instability in the ankle joint, making it difficult to bear weight or move without feeling like your ankle is giving out. The ligaments provide stability and support to the ankle joint, so when they are damaged, it can result in a feeling of instability.
  • Tenderness: The body’s natural response is to protect the injured area by sending pain signals when touched. This means that the affected area can feel tender to the touch. Even light pressure on a sprained ankle can cause discomfort or pain.
  • Limited range of motion: In a severe sprain, the affected ankle may not be able to move as freely as it did before the injury. This is because the damaged ligaments cannot support and stabilize the joint effectively.

Pain Levels According To The Severity Of Damage

Because there is a wide range of severity for ankle sprains, the level of pain experienced can vary greatly. Generally, the more severe the damage to the ligaments, the more intense and persistent the pain will be. The following are some general guidelines on how pain levels may differ depending on the severity of an ankle sprain:

Grade 1 (Mild)

A grade 1 or mild ankle sprain is the most common type of sprain and involves slight stretching or tearing of a ligament. Pain levels for this type of injury may range from minimal discomfort to moderate pain, with little to no swelling or bruising.

Grade 2 (Moderate)

A grade 2 sprain involves a partial tear of a ligament, resulting in moderate pain and discomfort. Swelling and bruising may be more pronounced, and the affected ankle may feel unstable or weak.

Grade 3 (Severe) 

A grade 3 or severe ankle sprain is when the ligament in the ankle is torn completely. A complete tear generally leads to both significant instability and pain. Pain levels for this type of sprain may be intense and persistent, making it difficult to bear weight or move the ankle without support. Swelling and bruising are usually present, and the range of motion may be severely limited.

Differentiating Between A Sprain And Other Ankle Injuries

Ankle sprains, fractures, and strains can all cause pain and discomfort in the ankle. However, they each involve different types of injuries and require different treatment approaches. Knowing how to differentiate between these injuries is essential to seek appropriate medical care. For example, a strain may be treated differently than a sprain, and an untreated fracture can lead to further complications. Here are some ways to distinguish between ankle sprains, fractures, and strains:

  • Sprains: As previously explained, a sprain is an injury to the ankle ligaments that connect the bones in the joint. Regarding pain level, a sprain usually falls somewhere between a fracture and a strain – it is usually more severe than a strain but less intense than a fracture. Sprains also involve swelling, bruising, and instability in the joint.
  • Fractures: A fracture is a crack or break in one of the ankle bones. Unlike sprains, fractures typically cause sharp and localized pain that may be accompanied by significant swelling and bruising. It may also be difficult or impossible to bear weight on the affected foot.
  • Strains: A strain is an injury to an ankle tendon or muscle that connects muscles to bones. Strains usually occur due to overstretching or tearing of these tissues, resulting in acute pain and tenderness in the affected area. However, unlike sprains and fractures, strains do not usually involve swelling or bruising. Additionally, strains may not affect mobility as much as sprains or fractures, and the pain tends to be more diffuse rather than localized.

Should You Visit A Doctor For Your Sprain?

Some mild sprains can be treated at home with rest, ice, compression, and elevation (RICE). However, in some cases, seeking medical attention for a sprain is crucial to ensure proper healing and prevent further damage. Here are some situations that may indicate the need to visit a doctor for your ankle sprain:

Signs Of Severe Injury

If you experience intense and persistent pain, severe swelling and bruising, or significant instability in the affected joint, these may be signs of a severe sprain or other injury. If this is the case, you should seek medical attention right away to determine the extent of the damage and receive appropriate treatment.

Persistent Or Worsening Symptoms

If your symptoms do not improve with at-home treatment or seem to be getting worse, it is crucial to visit a doctor. This may indicate more severe damage that requires medical intervention.

Complications Of Untreated Ankle Sprains

If you don’t get treatment for a badly sprained ankle, it can result in chronic ankle instability, causing the joint to become weak and unstable. This can increase the risk of future injuries and negatively impact your daily activities. Seeking medical attention for an ankle sprain can help prevent long-term complications and promote proper healing.

Immediate Care For Ankle Sprains

Some mild sprains can be treated at home with the RICE protocol. This protocol is commonly used to reduce pain and swelling and promote healing after an ankle sprain. Here are the steps for implementing the RICE protocol immediately after an injury:

  • Rest: It is essential to avoid putting weight on the affected ankle and to rest it as much as possible. Rest will give the injured ligaments time to heal.
  • Ice: Applying ice to the sprained ankle can help reduce swelling and pain. Use a towel between your ankle and the ice pack, and apply for 15-20 minutes at a time, several times a day.
  • Compression: Wrap an elastic bandage around the sprained ankle to help reduce swelling and support the joint. Make sure not to wrap it too tightly, as this can restrict blood flow. 
  • Elevation: Elevating the injured ankle above heart level can help to reduce swelling and promote healing. Use pillows or cushions to prop up your ankle while sitting or lying down.

It is advisable to follow the RICE protocol for the first 48-72 hours after the injury. You should visit a doctor for further treatment if symptoms do not improve.

Medical Treatments For Pain Relief

In addition to at-home care and physical therapy, doctors may prescribe medication for pain relief after an ankle sprain. Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce swelling around the sprained ankle. 

When OTC medications are not effective at providing pain relief, your doctor will likely prescribe a stronger pain reliever for short-term use. They may also recommend corticosteroids, which are injected into the ankle joint to reduce inflammation and relieve pain. 

Although some of these medical treatments can help provide pain relief, long-term use can result in side effects as well as mask underlying issues. It is also important to realize that prescription-strength pain relievers can be addictive.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

There are several types of NSAIDs available, including ibuprofen and naproxen. NSAIDs inhibit the production of prostaglandins, which cause pain and inflammation in the body. However, prolonged use can lead to side effects such as stomach ulcers and kidney damage.

Physical Therapy And Rehabilitation Options

Physical therapy is a vital part of the recovery process for ankle sprains. It helps improve strength, flexibility, and stability in the affected joint and can help prevent future injuries. Here are some exercises and rehabilitation techniques commonly used in physical therapy for ankle sprains:


This exercise involves drawing the letters of the alphabet with your toes while sitting or lying down. This simple movement helps improve the range of motion, strengthen muscles and ligaments, and promote healing.


Similar to the alphabet exercise, this involves rotating your foot in a circular motion. Doing so can improve your ankle’s range of motion as well as its flexibility.

Flex And Extend

Sitting with your feet flat on the ground, slowly point your toes towards the ceiling and then back down to the floor. This exercise helps strengthen the ankle’s muscles and improve flexibility.

In And Out Bends

Sitting with your feet flat on the ground, slowly bend your ankle inward and then outward. This exercise helps strengthen the muscles that support the ankle joint.

Towel Curls

Lay a towel on the floor and place your feet on it. Then use your toes to scrunch the towel towards you. Doing so will help promote stability by strengthening the muscles in your foot and ankle.

Seated Calf Stretch

Sitting with your legs straight out in front of you, wrap a towel or resistance band around the ball of your foot. Gently pull the towel or band towards your body until you can feel a stretch in your calf muscle. Hold for 30 seconds and repeat on the other leg.

Standing Calf Stretch

Standing facing a wall, place your hands on the wall and step one foot back. Keep both feet flat on the ground and lean forward gently until you can feel your calf muscle stretch. Then hold the position for 30 seconds. Repeat the stretch with your other leg.


Using a step or sturdy platform, gently step one foot up onto the surface and then back down. This exercise helps improve strength and balance in the ankle joint.

Heel Raises

Standing with your feet shoulder-width apart, slowly rise up onto your toes and then back down. Doing this exercise helps strengthen your foot and ankle muscles.

Preventing Future Ankle Sprains

Ankle sprains can be very painful and limiting, so it is wise to take steps to prevent them. The following are a few tips to reduce your risk of future ankle sprains:

  • Exercise or play sports after warming up: Be sure to warm up before you do any physical activity. Doing so will increase the blood flow to your muscles and prepare them for movement, thereby reducing the risk of strains or sprains.
  • Increase your flexibility: Regular stretching, particularly exercises targeting the ankles and calves, can help improve flexibility and reduce the risk of ankle sprains.
  • Exercise caution when jogging, walking, or working on uneven surfaces: Be mindful of your surroundings and wear appropriate shoes with good traction so you don’t slip or twist your ankle.
  • Use an ankle support brace or tape on a weak or previously damaged ankle: This can help provide support and stability to the joint during physical activity.
  • Wear activity-appropriate footwear: Different activities require different levels of support and protection, so make sure to wear appropriate footwear for each activity. For example, wear high-top athletic shoes for sports that involve jumping to protect your ankles.
  • Avoid engaging in sports or other activities you are not conditioned for: Gradually increase the intensity and duration of your physical activities to prevent overexertion and potential injuries. Trying a new sport or physical activity without proper conditioning and training can increase your risk of sprains and other injuries.
  • Exercises for balance are part of stability training: Incorporating exercises such as yoga, Pilates, and balance boards into your fitness routine can help improve stability in the ankle joint.

Accelerate Healing From Painful Ankle Sprains

Ankle sprains can cause pain and inconvenience in daily activities. Seeking treatment through physical therapy and rehabilitation options is crucial for a speedy recovery and preventing future injuries. By incorporating exercises for strength, flexibility, stability, and balance into your routine, you can accelerate healing and get back to your regular activities in no time. 

If you’re experiencing ankle pain or have suffered an ankle sprain, consider our Neuragenex treatment protocol. Our Neurofunctional Pain Management approach targets the underlying neurological causes of your ankle sprain pain. We use several drug-free, non-invasive treatment modalities as part of our whole-person treatment protocol to help provide long-term relief from chronic pain.