Ankle sprain
An ankle sprain occurs when one or more ankle ligaments are overstretched or injured. The most common type occurs when the foot rolls inward and the outer ankle ligaments are stressed.
Mild pain and tenderness around the ankle, often with little or no swelling. Walking is usually possible although some movements may be painful.
Ankle sprains often occur when the ankle is suddenly forced beyond the ligaments' tolerance. In football this commonly happens during landing, changes of direction or contact with another player.
Common situations
- •Landing on another player's foot
- •Rapid change of direction
- •The ankle rolling during running
- •Tackles or other contact
- •Previous ankle sprain with persistent deficits in balance or strength
The risk of ankle sprains and recurrent sprains can be reduced through balance and strength training and a gradual return after previous injuries.
- •Regular balance and proprioception training
- •Strength training for the calf, ankle and foot
- •Training of landing and changes of direction
- •Gradual return to full loading after an ankle injury
- •Ankle braces or taping may be considered for recurrent sprains
Stop activities that cause pain and reduce loading. Cold, compression and elevation may be used for symptom relief. Gradually begin loading the ankle within pain tolerance.
Movement and loading
Restore normal walking and range of motion with gradually increasing load.
Goals
Reduce pain and restore normal ankle mobility.
Progression criteria
Normal walking and basic ankle movements are tolerated without significant pain.
Strength and balance
Train the calf, ankle and balance with progressively increasing load.
Goals
Restore strength, stability and control.
Progression criteria
Single-leg exercises, calf raises and balance exercises can be performed without significant pain.
Running and football
Progress from jogging to sprinting, jumping and changes of direction.
Goals
Return to full football function.
Progression criteria
Sprinting, jumping and changes of direction can be performed without pain or significant post-exercise reaction.
- Normal walking without pain
- Full ankle range of motion
- Good single-leg strength and balance
- Pain-free running, jumping and changes of direction
- Full training without significant reaction afterward
The information in the Injury Center is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.
Ankle sprain
An ankle sprain occurs when one or more ankle ligaments are overstretched or injured. The most common type occurs when the foot rolls inward and the outer ankle ligaments are stressed.
Mild — Ofta 1–3 veckor vid en lätt stukning, men individuell återhämtning varierar.
Symptoms
Mild pain and tenderness around the ankle, often with little or no swelling. Walking is usually possible although some movements may be painful.
Acute Treatment
Stop activities that cause pain and reduce loading. Cold, compression and elevation may be used for symptom relief. Gradually begin loading the ankle within pain tolerance.
Rehabilitation
Restore normal walking and range of motion with gradually increasing load.
Goals
Reduce pain and restore normal ankle mobility.
Progression criteria
Normal walking and basic ankle movements are tolerated without significant pain.
Train the calf, ankle and balance with progressively increasing load.
Goals
Restore strength, stability and control.
Progression criteria
Single-leg exercises, calf raises and balance exercises can be performed without significant pain.
Progress from jogging to sprinting, jumping and changes of direction.
Goals
Return to full football function.
Progression criteria
Sprinting, jumping and changes of direction can be performed without pain or significant post-exercise reaction.
Return to Play
- ☐ Normal walking without pain
- ☐ Full ankle range of motion
- ☐ Good single-leg strength and balance
- ☐ Pain-free running, jumping and changes of direction
- ☐ Full training without significant reaction afterward
Moderate — Ofta flera veckor. Måttliga stukningar kan kräva längre rehabilitering innan full idrottsbelastning tolereras.
Symptoms
Clear pain, swelling and tenderness around the ankle. Walking is affected and some movements or loading may be difficult.
Acute Treatment
Stop the activity and reduce load as needed. Cold, compression and elevation may be used for symptom relief. The ankle should then be progressively loaded and moved within tolerance.
Rehabilitation
Gradual return to walking and normal ankle movement.
Goals
Reduce swelling and pain and restore mobility.
Progression criteria
Normal or near-normal walking and increasing range of motion are tolerated.
Progressive training of the calf, ankle and balance.
Goals
Restore strength, balance and dynamic stability.
Progression criteria
Single-leg exercises, calf raises and jumping are tolerated without significant pain or instability.
Gradual return to running, sprinting, jumping and changes of direction.
Goals
Tolerate the full demands of football.
Progression criteria
Full-intensity football activities and training are tolerated without pain or significant swelling reaction.
Return to Play
- ☐ Near-normal or full range of motion
- ☐ Adequate strength and balance
- ☐ Pain-free running and sprinting
- ☐ Pain-free jumping and changes of direction
- ☐ Full training without significant swelling or pain afterward
Severe — Ofta flera veckor till månader beroende på skadans omfattning. Allvarliga ledbandsskador kan kräva längre rehabilitering och ibland kirurgisk behandling.
Symptoms
Severe pain, marked swelling and significant functional impairment. Bearing weight may be difficult or impossible. Instability or extensive bruising may occur.
Acute Treatment
Stop the activity and protect the ankle from further loading. Use support or crutches if needed to reduce load. Severe pain, inability to bear weight or suspected fracture should be medically assessed.
Rehabilitation
Protect the ankle and adjust loading according to pain and medical assessment.
Goals
Control pain and swelling and restore basic mobility.
Progression criteria
Loading and walking can be progressively increased without significant worsening.
Progressive training of the ankle, calf and balance as the tissues tolerate loading.
Goals
Restore strength, mobility and dynamic stability.
Progression criteria
Single-leg loading, strengthening and jumping are tolerated without pain or instability.
Gradual return to sprinting, jumping, changes of direction and contact.
Goals
Restore full function and load tolerance.
Progression criteria
Full football training can be completed without pain, instability or significant swelling reaction.
Return to Play
- ☐ Medical assessment when fracture or significant ligament injury is suspected
- ☐ Full or near-full range of motion
- ☐ Adequate strength and balance
- ☐ Pain-free sprinting, jumping and changes of direction
- ☐ Full training and contact activities without instability or swelling reaction
When to Seek Medical Care
Seek medical care if you cannot bear weight normally, if pain or swelling is severe, or if a fracture or significant ligament injury is suspected.
- Inability to bear weight
- Visible deformity
- Severe or rapidly increasing swelling
- Marked tenderness over the bone
- Numbness or altered sensation
- Persistent pain or instability despite rehabilitation
References
- Sprained Ankle — American Academy of Orthopaedic Surgeons (https://orthoinfo.aaos.org/en/diseases--conditions/sprained-ankle/)