Is My Ankle Sprained or Just Twisted?

Is My Ankle Sprained or Just Twisted?

According to researchers, about 2 million ankle sprains occur in the US each year. Many of these are a direct result of twisting the ankle. If something like this occurred to you, you might be wondering, "Is my ankle sprained or just twisted?"

If you now have a swollen or bruised ankle, then you most likely have sprained it. If you were able to "walk-off" the injury or if your ankle doesn't feel too painful, then you likely only twisted it.

Is My Ankle Sprained or Just Twisted?

With most ankle sprains, pain is almost immediately felt. Inflammation and bruising will also follow almost right after.

If you only twisted your ankle, you'll still feel pain, but the discomfort is quicker to dissipate. If there's no sprain, swelling is unlikely.

What Exactly Happens If I Sprain My Ankle?

When you sprain your ankle, it means that you've overstretched or even tore one or more ligaments. Ligaments are very tough and durable layers of fibrous tissues. Each ligament serves as connective tissue for two bones in the joints.

Three ligament systems in the ankle can get sprained. These include the following:

  • Lateral ligament complex
  • Medial deltoid ligament
  • Syndesmotic ligaments

Within the lateral ligament complex are three specific ligaments. Of these, the anterior talofibular (ATFL) is the weakest. For this reason, experts say that up to 70% of lateral ankle sprains occur in this ligament.

The two other ligaments are the calcaneofibular (CFL) and the posterior talofibular (PTFL). The CFL is the second-most often injured. The PTFL is the strongest, and therefore the least frequently injured.

Is My Ankle Sprained if I Twisted It?

Many ankle sprains occur when the ankle gets twisted, “rolled,” or “turned” in an awkward way. However, you can still twist, turn, or roll your ankle without spraining it. In this case, you've only stretched a ligament past its usual point.

Sometimes, walking on an uneven surface may cause you to "turn" your ankle but not sprain it.

At the time you've twisted your ankle, the overstretching of the ligament can cause pain. However, if the affected ligament didn't sustain a tear, it should feel better soon. If no swelling occurs a few minutes after twisting your ankle, then it's very likely that you don't have a sprain.

How Do Ankle Sprains Occur?

A sprain occurs when you've done something to force your ankle to move out of its usual position. It's this forced movement that can overstretch or even tear one or more of your ankle ligaments.

On that note, let's explore some of the most common ways in which ankle sprains occur.

Losing Your Balance

One accidental cause of a sprained ankle is when you take a step and lose your balance. For example, you may have miscalculated the height of the ground, which made you teeter. This can then lead to an awkward landing or even twisting of your foot.

Slip and Fall Accidents

Slips and falls, which result in more than one million US hospital visits each year, can also lead to sprains. When you slip, your feet lose traction, which can then displace or misalign your ankle. If you also fall, you may land on your ankle, and the force can move it out of its normal position.

Uneven Surfaces

It's also possible to develop a sprain if you exercise, run, jog, or walk on an uneven surface. When you step on rocky ground, for instance, it can force your feet to twist, roll, or turn. A severe twisting motion can then cause a partial or complete tear in one or more of your ankle ligaments.

Sports Accidents

Suppose that you're playing sports and another player steps or lands on your foot. This sudden force alone can already injure your ankle, resulting in a sprain. However, you can suffer from a torn ligament if you suddenly remove your foot from under that person.

What Else Can I Expect from a Sprained Ankle?

If you did sprain your ankle, you might have heard (or felt) a popping sound at the time of the incident. Most people don't hear or feel this if no ligament tear occurs after rolling, twisting, or turning an ankle.

However, you may still miss this popping noise, especially if you're in a noisy room when you got injured. If you do have a sprain, you can expect the following changes to occur in your sprained ankle.


Soon after you've sprained your ankle, you'll notice the injured area to become swollen. This occurs as more fluid and white blood cells get delivered to the sprained ligament. This is one of the first steps that your body takes to heal your battered ankle.

If you only have a minor sprain, the swelling should go down within a week. If the inflammation persists, you may have a severe sprain that warrants a visit to the doctor. Grade 3 sprains, which are the worst, can take six weeks or more to heal.

Heat and Redness

When you get injured, your body's automatic response is to send more blood to that affected area. It does so to deliver not only more white blood cells but also oxygen and nutrients. However, the increased blood flow can make the injured area feel warm and develop a reddish tint.

Soreness and Pain

Any kind of injury triggers the release of chemicals necessary for the body to heal. These include histamine, prostaglandins, and bradykinin. They are essential in the recovery process as they isolate the "traumatized" area of the body.

However, these chemicals also force the blood vessels to leak fluids into the tissues. Aside from swelling, this leakage may also trigger nerves, thus causing pain.

The pain or discomfort you'll feel following a sprain also serves as a reminder of your injury. Suppose that you attempt to walk on a sprained ankle. The pain and inflammation will then remind you to put as little weight and stress as you can on that injured ankle.


Small blood vessels and fibers have likely burst during the sprain incident. Remember: a sprain is bad enough to tear tough ligaments. So, you can just imagine the kind of damage it can do to more sensitive and fragile blood vessels.

In any case, this bursting allows blood to enter and spread into the surrounding tissues. From here, the skin may take on a reddish, bluish, or purplish hue.

Limited Range of Motion

You can also expect some level of restriction when you try to move a sprained ankle. This is often due to the pain and swelling that hinder the movable parts of your ankle. Of course, the torn ligament needs to heal first so that it can recover its movability.

Ankle Instability

According to experts, one in five acute ankle sprains results in ankle instability. These, in turn, can progress into chronic instability if not treated early.

In any case, ankle instability occurs when the ankle's outer (lateral) side gives way. As your sprain heals, it's normal for some level of instability to occur. However, it's also because of this that you'd want to take it easy and allow your injury to heal as quickly as possible.

Otherwise, your unstable ankle can give way, and from there, sustain new injuries. The more this happens, the greater your risk of having chronic ankle instability (CAI).

What Can Happen If I Sprain My Ankle Again?

Some studies suggest that recurrent ankle sprains have a prevalence rate of 40%. So, when you sprain your ankle, your risks of injuring it again is high. As mentioned above, repeated sprains can ultimately lead to chronic ankle instability.

Having CAI, however, can put you at a higher risk of developing ankle osteoarthritis (OA).

One study, for instance, looked at 406 ankles (309 patients) with ankle osteoarthritis. 78% of the participants either had a fracture or ligament injury in the same arthritic ankle. At the very least, this suggests a strong correlation between CAI and ankle OA.

The more sprains you get, the greater your risks for developing a tendon injury too. In the US, tendon and ligament injuries occur at a rate of 16.5 million cases each year. That should be enough to make you pay better attention to your sprained ankle.

So How Do I Take Care of My Sprained Ankle Then?

The R.I.C.E. protocol stands for "rest," "ice," "compression," and "elevation." Since then, healthcare providers have updated this to P.R.I.C.E, in which the P stands for "protection." Today, experts are saying that it needs another upgrade, this time, to P.O.L.I.C.E.

It stands for "protection," "optimal loading," "ice," "compression," and "elevation." Medical experts believe this to be a much better approach to sprains (and strains).


Protection refers to how you must rest your injured body part (in this case, your ankle) for a few days. During this phase, you may also need an assistive device, such as crutches or ankle braces, to walk. The goal is to safeguard your sprain from sustaining yet another injury.

Optimum Loading

Optimum loading refers to the phase in which you can already gently move your ankle. For instance, after resting for two to three days, you can start doing ankle circles or flexes. You can then move on to exercises like ankle extensions and some other basic stretches.

The most important thing here is to start “re-introducing” movement to your ankles. That's because over-resting will only make you feel sorer. It can also impair your body's ability to recover. 


Ice is the first-aid treatment for most tissue injuries, including ankle sprains. The use of cold therapy can help reduce inflammation around your injured ligament. It may also help minimize the pain or discomfort following the injury.


Using an ankle compression support strap can help stabilize your sprained ankle. This, in turn, prevents your overstretched or torn ligament from moving too much. These devices are thin enough that you can wear them inside your shoes.


Elevation means to put an injured body part in a position that's higher than the heart. It helps minimize pain and inflammation in the sprained or strained tissues. To elevate your ankle, you can simply rest it on top of a stack of pillows as you lie down in bed.

What Can I Do to Prevent Spraining or Twisting My Ankle?

Many health experts agree that stretching can help improve flexibility. They also say that stretching boosts one's range of motion. So, stretching before doing any activity may help lower your risks of ankle injuries.

In addition, stretching contributes to improved circulation. This, in turn, feeds more blood, oxygen, and nutrients to your tissues. Well-fed tissues, in turn, can perform better and endure activities longer.

Now, keep in mind that fatigue can make your legs and knees buckle. This can put your feet at risk of turning, twisting, or rolling. So, in a way, stretching may also prevent these common causes of ankle sprains.

Using a protective and supportive ankle brace is also a good alternative to ankle taping. Such devices stabilize the ankles, much like how taping does. Unlike taping, though, braces are reusable, not to mention more comfortable.

Keep Twisted or Sprained Ankles at Bay

There you have it, the only guide that fully answers your question, "Is my ankle sprained or just twisted?" If the pain goes away after a few minutes, and your ankle doesn't swell, then you likely only twisted it. However, if the pain stays and the affected ankle becomes inflamed, then you have a sprain.

If you do end up with a sprain, follow the P.O.L.I.C.E. protocol so you can help your ankle recover faster. And don't forget to follow our tips to prevent future ankle injuries.

If you're looking for preventive and supportive ankle braces, PowerRebound can help. Please feel free to check out our collection of ankle braces and supports.

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