Are you experiencing a Grade 1 ankle sprain, or are you a physical therapy student with questions about recovery time?
How long will the swelling, pain, bruising, immobilization, rehabilitation with crutches, work and sports hiatus, and more last?
As a physical therapist, I can answer all of your frequently asked questions. Based on my experience and scientific studies published worldwide on the subject, you can rest assured for the rest of your recovery journey 🙂.
Take-home message: Grade 1 ankle sprains might take a few days to 5/6 weeks to heal. Pain and swelling can persist for longer, sometimes up to a year. However, you can often resume all your activities within just a few weeks!
Last update: October 2023
Disclaimer: Affiliate links. Complete disclosure in legal notices. Written by Nelly Darbois, physical therapist and scientific writer
Whats is Grade 1 Ankle Sprain?
Ankle injuries can encompass a range of issues, from twisted ankles to sprains and torn ligaments.
Grade 1 ankle sprains = mild ankle sprains.
Unlike Grade 2 and 3 sprains, Grade 1 sprains involve minimal damage to the ligament, with only slight stretching or minor fiber tears.
Grade 1 sprains typically maintain their function as stabilizers for the ankle.
While there is a general guideline that suggests Grade 1 sprains recover more quickly than Grade 2 and 3 sprains, the reality is more nuanced.
Medical recovery, much like the rules of language, can be subject to exceptions and variations influenced by various parameters that may not always be straightforward.
For example, the severity of the sprain does not always correlate with the progression of pain.
How do I know if my ankle sprain is Grade 1?
It’s not always easy to tell if an ankle sprain is Grade 1 or 2. Even by a healthcare professional!
However, the severity of the sprain doesn’t necessarily correlate with the length of recovery time.
Even if you know the grade of your ankle sprain, the treatment and recovery process will be similar!
Some signs that you may have a grade 1 sprain include mild pain, swelling, and tenderness around the ankle. You may also be able to put weight on the affected foot without much difficulty.
If you have a grade 2 sprain, you may experience moderate pain, swelling, and tenderness, and may have difficulty putting weight on the affected foot.
As you can see, there’s not much difference!
How long does swelling persist following a Grade 1 ankle sprain?
Swelling is a common concern after sustaining an ankle sprain, particularly among. Here are the key takeaways regarding swelling.
Swelling occurs due to the accumulation of fluids within the different layers of ankle tissue, a response to the inflammation of the ligament and surrounding areas.
This inflammatory process serves to facilitate the repair of damaged tissues by delivering essential substances to the injured area via these fluids, thereby expediting the natural healing process.
Typically, swelling reaches its peak in the first few days immediately following the injury.
However, it’s important to note that even with a Grade 1 ankle sprain, swelling can persist and remain noticeable for two to three months.
Isolated swelling shouldn’t be a major cause for concern. Over the course of months or even years, the ankle will gradually return to its usual size, a phenomenon that holds true even for more severe sprains.
Interestingly, the presence of swelling doesn’t necessarily correlate with difficulties in walking or engaging in sports activities. In fact, it may seem counterintuitive, but individuals with significant ankle edema are often still capable of performing as well as those with little to no swelling.
What’s the recovery time for a bruised Grade 1 sprained ankle?
A hematoma, in essence, is a pool of blood beneath the skin. When your ankle experiences instability, tiny blood vessels, known as capillaries, can rupture. Interestingly, this can even occur from a simple blood test, and it’s not inherently a significant concern.
The hematoma itself isn’t directly visible, but what’s often observed post-sprain is bruising. Bruises can display various shades, including yellow, purple, red, or green, as a result of blood escaping from its vessels.
This often becomes a point of concern for patients.
The different colors in a bruise are linked to the components within hemoglobin, a component of blood. While it remains within blood vessels, it doesn’t affect skin coloration.
However, once it escapes, the skin takes on these hues.
Initially, the skin appears red, swollen, and sensitive, and over time, the colors become more pronounced. It’s not uncommon for the bruise to expand, but this expansion, when isolated, is not indicative of a more severe sprain.
Compared to swelling, bruising and hematomas tend to have a shorter duration. Their presence can last from a few days to a few weeks, rarely extending to a few months.
As with swelling, this reaction is considered “normal” in response to the minor physical trauma associated with a Grade 1 sprain. Presence of bruising doesn’t necessarily imply a more severe ankle sprain.
What’s the typical duration of pain following a Grade 1 ankle sprain?
First, let’s explore what leads to pain after a Grade 1 sprain before delving into how long it usually lasts.
What Causes the Pain?
A Grade 1 ankle sprain generates numerous small debris from the torn ligament fibers. These fragments come into contact with various chemical substances, triggering an inflammatory response (Basbaum 2009).
The inflammatory response gives rise to the production of new chemical compounds that activate specific sensors (nociceptors) within the ankle ligament. These sensors then transmit the pain signals to the brain via nerves.
The immediate pain experienced following the ankle sprain is referred to as acute pain. If this pain persists beyond a few months, it’s categorized as chronic pain (which is rare in the case of a sprain).
Immediate pain after a sprain is a normal and useful response. It encourages rest for the ankle, allowing the ligament to heal properly.
How Long Does Ankle Pain Endure?
Existing data on pain duration after ankle sprains (Grade 1, 2 and 3) suggest the following (van Rijn 2008):
- Pain rapidly diminishes within the initial two weeks post-sprain.
- Up to two out of three individuals will experience no further pain after a year.
- Up to nine out of ten individuals will be pain-free after three years.
It’s important to note that there is no correlation between the sprain’s severity and the duration of pain. Even with a Grade 3 sprain, you could be one of those who experience almost no pain after two weeks 🦾!
Pain from an ankle sprain significantly decreases within the first two weeks, with up to two out of three people being pain-free after a maximum of one year.
What Does Persistent Pain Indicate?
Based on current scientific knowledge, it is estimated that it takes between 6 weeks and 3 months for a ligament to fully heal (Hubbard 2008). Therefore, persistent pain for three months can be reasonably explained by this factor.
Beyond this three-month period, several reasons can account for prolonged ankle sprain pain. These causes can be categorized into two groups.
Local causes: Additional anatomical abnormalities may have developed in your ankle alongside the initial ligament injury.
The list of these abnormalities is extensive (including cartilage injuries, bone spurs, tenosynovitis, nerve injuries, and more).
Determining the precise cause of the pain can sometimes be challenging, and it may not necessarily lead to more specific treatment options beyond symptom management.
Neurological causes: Dysfunction in your nervous system’s pain management mechanisms may play a role in persistent pain.
What’s the typical duration of immobilization following a Grade 1 ankle sprain?
The duration of immobilization varies depending on several factors, including the sprain’s severity, whether it’s a first occurrence, and your personal preferences:
- Are you eager to get back to activity as quickly as possible, even if it entails a slightly higher risk?
- Or do you prefer to err on the side of caution, even if it means a longer recovery period?
Physical therapists and doctors play a role in guiding you through this decision-making process. There is no one-size-fits-all minimum immobilization period.
For Grade 1 ankle sprains, immobilization primarily serves the purpose of alleviating pain. It is typically achieved using an aircast-type splint or brace, or sometimes with no immobilization at all.
In most cases, this immobilization is required for just a few days, and at most, a few weeks.
Is it safe to walk with a Grade 1 ankle sprain?
Walking on a Grade 1 ankle sprain can be feasible, with some adjustments to your walking approach. You may need to use crutches, limit your walking distance, and progressively increase your activity level.
Walking on a Grade 1 ankle sprain is unlikely to exacerbate the injury, provided you follow a gradual increase in activity.
The primary concern is the risk of re-twisting your ankle and worsening instability. However, you can mitigate this risk by avoiding uneven terrain and refraining from running initially.
How long will you need crutches?
For Grade 1 ankle sprains, the recovery period spans a few weeks. You can start walking with crutches on the first day, and typically, crutches are no longer necessary after a few days, depending on your pain and perceived stability.
You can gradually reintroduce running as early as three weeks after the sprain, but it should be approached with caution and in a controlled manner.
When can I return to work after a Grade 1 ankle sprain?
The period during which you can resume work largely hinges on the nature of your job, particularly whether it involves substantial walking or standing.
Some individuals may not require any time off, while others might need several days or even weeks.
This is a matter to be discussed with your doctor, physical therapist, and a representative from your workplace.
In the case of an ankle sprain, the typical period for taking time off work is a maximum of three weeks.
How long should I refrain from activities after a Grade 1 ankle sprain?
Below is a table outlining the typical timeframes for resuming various activities following a Grade 1 ankle sprain:
|Activity||Length of Time|
|You can drive again||A few days to a few weeks|
|You can resume cycling||1 week to 6 weeks|
|You can gradually return to walking on uneven terrain||A few days or weeks|
|You can gradually return to running||A few weeks|
|You can resume other sports activities||1 to 6 months depending on the activity and its intensity|
|You are completely healed||A few weeks to a few months|
These timeframes provide a general overview, but the duration can vary based on specific factors, including:
- The type of sprain you’ve experienced.
- Whether it’s a first-time occurrence or a recurrence.
- The current state of your pain, discomfort, and instability.
- Your pre-injury activity level.
In studies examining healing times after ankle sprains, individuals have reported feeling completely healed in as little as 2 weeks, while others took as long as 36 months. These represent two extremes (Pepper 2008)!
The physical therapists or doctors overseeing your ankle sprain recovery will consider these various factors to guide you through the gradual resumption of activities.
Additionally, it’s worth noting that your chances of making a better recovery (Choi 2020) are higher if:
- You have a Grade 1 sprain (though this contrasts with a 2008 systematic review that found ligament rupture does not increase the risk of a poorer or longer recovery, Pepper 2008).
- Your BMI falls within the range of 18 to 25.
- You are young.
Conversely, factors such as your gender, prior activity level, and occupation do not seem to significantly influence your recovery.
Maintain an optimistic outlook: the vast majority of individuals can return to their activities after experiencing a Grade 1 ankle sprain 🙂.
Ways to Shorten Your Grade 1 Ankle Sprain Recovery?
When it comes to healing your Grade 1 ankle sprain, there isn’t a magic pill, manual therapy, or miraculous technique that can speed up the recovery!
The most effective advice is to maintain as much activity as you can while keeping in mind two crucial factors:
- Pain: It’s acceptable to engage in activities if the pain is manageable.
- Progression: Avoid attempting vigorous activities like running just a few days after your Grade 1 ankle sprain, especially if you’ve avoided putting weight on it for a few days.
- Start by gradually walking indoors and outdoors (with or without crutches), progressively increasing the distances, durations, and intensity.
- When the pain is tolerable, and you no longer feel unstable, you can gradually reintroduce running on level and soft terrain.
Don’t feel guilty if you don’t strictly adhere to recommended physical therapy sessions because you believe you’re doing well, or if you face difficulties scheduling appointments. Everything should still be fine!
You can already access a plethora of online videos and articles offering ankle sprain exercises.
While there are many variations, I believe it’s better to gradually return to your daily activities!
If you encounter specific limitations, personalized exercises tailored to your needs will be beneficial. Time will also play a significant role in your healing, regardless of your actions.
Take-home message: Recovery from Grade 1 ankle sprains typically spans from a few days to approximately 5 to 6 weeks. Pain and swelling may endure for an extended period, occasionally up to a year. Nevertheless, in many cases, you can often return to your regular activities within just a few weeks!
Here’s what I wanted to tell you about this! I wish you a very good recovery! Do you have any comments or questions? Your comments are welcome 🙂 !
You may also like:
Choi WS, Cho JH, Lee DH, Chung JY, Lim SM, Park YU. Prognostic factors of acute ankle sprain: Need for ultrasonography to predict prognosis. J Orthop Sci. 2020 Mar;25(2):303-309. doi: 10.1016/j.jos.2019.04.012. Epub 2019 Jun 7. PMID: 31151752.
Sport : Steinberg N, Adams R, Ayalon M, Dotan N, Bretter S, Waddington G. Recent Ankle Injury, Sport Participation Level, and Tests of Proprioception. J Sport Rehabil. 2019 Nov 1;28(8):824-830. doi: 10.1123/jsr.2018-0164. PMID: 30300059.
Swelling : Pugia ML, Middel CJ, Seward SW, Pollock JL, Hall RC, Lowe L, Mahony L, Henderson NE. Comparison of acute swelling and function in subjects with lateral ankle injury. J Orthop Sports Phys Ther. 2001 Jul;31(7):384-8. doi: 10.2519/jospt.2001.31.7.384. PMID: 11451309.
Hubbard -Turner, Tricia & Hicks-Little, Charlie. (2008). Ankle Ligament Healing After an Acute Ankle Sprain: An Evidence-Based Approach. Journal of athletic training. 43. 523-9.
Badekas, T., Takvorian, M., & Souras, N. (2013). Treatment principles for osteochondral lesions in foot and ankle. International orthopaedics, 37(9), 1697–1706
Pain: Basbaum, A. I., Bautista, D. M., Scherrer, G., & Julius, D. (2009). Cellular and molecular mechanisms of pain. Cell, 139(2), 267–284
Pepper 2008. van Rijn RM, van Os AG, Bernsen RM, Luijsterburg PA, Koes BW, Bierma-Zeinstra SM. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med. 2008 Apr;121(4):324-331.e6
Recovery time : Sharma GK, Dhillon MS, Dhatt SS. The influence of foot and ankle injury patterns and treatment delays on outcomes in a tertiary hospital; a one-year prospective observation. Foot (Edinb). 2016 Mar;26:48-52. doi: 10.1016/j.foot.2015.12.001. Epub 2015 Dec 13. PMID: 26895255.
Gribble PA, Kleis RE, Simon JE, Vela LI, Thomas AC. Differences in health-related quality of life among patients after ankle injury. Front Sports Act Living. 2022 Aug 3;4:909921. doi: 10.3389/fspor.2022.909921. PMID: 35992155; PMCID: PMC9382240.
Written by Nelly Darbois
I love writing articles based on my experience as a physiotherapist (since 2012), scientific writer, and extensive researcher in international scientific literature.
I live in the French Alps 🌞❄️, where I work as a scientific editor for my own website, which is where you are right now.