How Long Will a Sprained Ankle Stay Swollen? No Worries!

How long will a sprained ankle stay swollen? How long for swelling to go down? Is it serious if the swelling lasts long? 2 weeks? 2 months?

Ankle sprains are a common reason for visits to the physical therapist.

Here are the answers to one of the most common questions asked by people with an ankle sprain, whether or not it’s their first time: why is my sprained ankle still swollen? When should I worry about a swollen sprained ankle?

Last update: April 2023
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Sprained ankle, twisted ankle, or rolled ankle: the same thing?

In everyday language, we often use the terms “twisted ankle“, “rolled ankle” or “sprained ankle” to refer to an ankle sprain, which is an injury to one or more ligaments in the ankle joint.

There are several joints and ligaments in the ankle, which is why we refer to different types of sprains depending on their location.

• The most common type of sprain is the external ankle sprain, which causes pain on the outside of the foot, at the level of the outer malleolus.
  
  Another term for this is lateral ankle sprain, or anterior talofibular ligament sprain, because the ligament affected was formerly known as the talofibular ligament and is mostly affected at its anterior bundle.
• The internal ankle sprain, or medial ankle sprain, affects the ligament on the inside of the ankle, causing pain towards the inner malleolus.
• Other ligaments in one of the ankle joints can also be affected, but this is less common.

Treatment will generally be the same regardless of the location of the sprain.

The different stages of ankle sprain

Sprains are divided into three grades based on their severity, regardless of location.

• A grade 1 sprain, or mild sprain, occurs when the ligament is only stretched but not torn.
• A grade 2 sprain, or moderate sprain, occurs when the ankle ligament is partially torn.
• A grade 3 sprain, or severe sprain, occurs when the ligament is completely torn, and the insertion of the ligament into the bone is also torn, which is why it is sometimes referred to as an avulsion fracture.

Pregnant women are more prone to ankle sprains due to increased ligament laxity resulting from hormonal changes during pregnancy.

What are the symptoms of ankle sprain?

Symptoms of an ankle sprain include :

• pain in the ankle, which may worsen with movement or touch,
• difficulty walking or standing,
• and swelling and bruising in the ankle area, especially in the first few days.

Ankle sprains usually occur as a result of trauma or a fall, and may sometimes be accompanied by a fracture.

In such cases, an X-ray (or MRI) may be necessary to check for and locate the fracture (the most common type being a malleolar fracture).

X-rays are not always necessary for ankle sprains, as it depends on the nature of the trauma and the symptoms reported and observed by the individual.

Swollen ankles pictures

Some people need to have an idea of what a swollen ankle usually looks like. Here’s a picture of a moderate swelling of the outer ankle bone (the one on the side).

It is possible that your ankle may be much more swollen than in this picture without it meaning that your problem is more serious!

Why does the ankle swell after a sprain?

Swelling is due to a buildup of fluids in the various layers of tissues in the ankle. It is related to inflammation of the ligament and surrounding tissues.

The inflammation that triggers the swelling is actually a very healthy and therapeutic response! It is an automatic reaction of our immune system, which we inherited from our ancestors.

This inflammation brings all the necessary substances to the damaged area through fluids, to help the damaged structures heal naturally as quickly as possible. 🚀

How long will a sprained ankle stay swollen?

Like with a knee replacement, the ankle joint swells after a sprain. This often causes worry and concern for people who see a swollen foot, persistent swelling, or a blue ankle for a long time.

However, swelling after an ankle sprain is usually a common occurrence.

It can last for several weeks or even months (and even years) without being a cause for concern. Although it may be a bit uncomfortable, the pain will gradually decrease after an ankle sprain, even if the swelling persists.

Ankle sprain: swelling (edema) and hematoma Ankle sprain: swelling around the outer malleolus in the days following the sprain.

• The edema can persist for several weeks or even months, but the hematoma gradually fades away.
• Generally, the swelling is at its maximum in the first few days after the injury.
• But it can still be relatively large even 2 or 3 months after an ankle sprain, even at stage 1. This isolated sign should not be a cause for concern.

The ankle will gradually return to its normal size over months or years, even after a severe sprain.

And if it takes a while to recover, you should look on the bright side: in the vast majority of cases, you can still resume all physical and sports activities you want.

Why is my sprained ankle still swollen?

There can be many factors that affect how quickly a sprained ankle will heal and how long the swelling will persist.

• The severity of the injury,
• the level of activity during the healing process,
• and individual differences in healing rates can all play a role.

In addition, factors such as age, general health, and pre-existing conditions can also impact the healing process.

How long is too long for ankle swelling?

It is never too long for ankle swelling, as isolated swelling is not a problem in itself if it is not associated with other symptoms. Some people may have a swollen ankle for months and still be able to resume their normal and athletic activities.

So don’t worry, with time, the swelling should eventually subside.

When to worry about sprained ankle?

Even though it may look impressive and your swelling is substantial and persists, it’s not a cause for concern.

Prolonged swelling without other symptoms (such as fever or unbearable pain) can indeed raise some worries, but there is nothing specific to be done. You can consult someone for reassurance, but there are no specific actions to take or particular treatments to implement.

It’s other signs that should potentially “worry” you in the weeks following the sprain, and these are more of an exception than the rule.

These signs are:

• Severe difficulty walking without experiencing significant ankle instability. Your ankle twists almost every time you walk.
• You have so much pain that you can’t even place your foot on the ground, let alone put weight on it for weeks after the sprain.
• You can no longer move your foot and toes.

These signs indicate the need for a medical evaluation. But not isolated swelling, even if it persists!

How to reduce swelling in a swollen ankle?

Time is by far your best ally!

Ultrasound therapy and other physiotherapy methods (cold application, electrotherapy), massage, and kinesiotaping are not effective in the short or long term for reducing swelling.

The following tips can be followed for short-term action on swelling, but as soon as they are no longer applied, the swelling returns:

• Wear compression socks or stockings (class 2) (see on Amazon).
• Elevate your ankle (legs and feet higher than hip and heart level).
• Limit time spent in a static standing position.

Massage does not allow for long-term swelling reduction, but you can self-massage if you find it helpful and if it temporarily reduces the swelling.

Important and often counter-intuitive: an ankle swelling does not necessarily mean it will be difficult to resume walking or even sports activities. People who have the most ankle swelling do not necessarily do less than those who have less or none at all.

This applies in the days following an ankle sprain, but also longer afterwards.

Clinicians should refrain from making assumptions about function based on ankle swelling.

Pugia, 2001

Revitive Medic is not useful against swelling

How long does it take to recover from an ankle sprain?

Of course, it all depends on the severity of the ankle sprain and whether it is a first episode of sprain or not.

1️⃣ 2️⃣ For grade 1 and 2 sprains, recovery takes a few weeks. Pain usually decreases and disappears within a few days. Swelling lasts for a few weeks.

After a grade 1 or 2 ankle sprain, walking is possible from the first day with crutches by placing the foot on the ground, and crutches are abandoned after a few days. Running can often be resumed as early as 3 weeks after the sprain, but in a very progressive and controlled manner.

3️⃣ For grade 3 sprains, recovery takes longer. Pain often persists for more than a week, and swelling for several months.

Ligaments, however, generally heal after 6 weeks, and progressive resumption of physical activities other than walking is possible after these 6 weeks. Again, resumption should be very progressive and controlled.

Sometimes, ankle pain persists 6 months after the sprain. In this case, a complete physical therapy assessment should be performed to assess the pain:

• Are they related to a too rapid and intense resumption of a sport, walking, or other physical activities, or to a lot of standing or carrying weight?
• Are they reduced on certain days of the week?
• Are they associated with swelling and other discomforts?
• Do they prevent certain activities?
• Are they relieved by painkillers?

I wrote a more comprehensive article on recovery after a twisteded ankle.

Ankle sprain without swelling: is it possible?

It is indeed possible for some people to have an ankle sprain without swelling or edema!

Swelling is not systematic and is not a sign of severity.

Inflammation is very mild in some people after a sprain. Therefore, their ankle hardly swells, or it is barely noticeable.

Furthermore, depending on people’s morphology, some edemas can also go unnoticed.

Swelling is not a sign that can diagnose an ankle sprain. And it is possible to have a sprain without swelling!

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Do you have any comments or questions? Your comments are welcome 🙂!

If you feel the need to learn more about the recovery period after a sprained ankle, I wrote this guide in eBook format:

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You may also like:

• Why Twisted Ankle Still Hurts?
• How Long is the Healing Time for an Ankle Sprain?
• Walking After Rolled Ankle: When and How?

📚 SOURCES

Kinesio Taping Does Not Decrease Swelling in Acute, Lateral Ankle Sprain of Athletes: A Randomised Trial. 2015

Effect of Neuromuscular Electrical Stimulation on Ankle Swelling in the Early Period After Ankle Sprain, 2007.

Comparison of Acute Swelling and Function in Subjects With Lateral Ankle Injury. 2001; and 2005’similar study

In Deutsch: Wie lange dauert die Genesung von einer Knöchelverstauchung?