How Do You Sprain An Ankle? | 5 Causes + 5 Solutions

Written by on May 4, 2022 — Medically reviewed by Mich Torres (PT)

About 23,000 ankle sprains happen daily in the United States alone. (1) So why does it happen so frequently? How do you sprain an ankle?

Well, ankle sprains occur when your foot rolls excessively to one side in an awkward way. This can sprain your ankle ligaments, by overstretching or tearing them.

Now, there are several situations that can increase the likelihood of having a sprained ankle. We’ll discuss them below, along with other things you should know about this injury.

This is what we’ll cover. Click on any of the following bullets to learn about that topic:

Or read on below to know how does an ankle gets sprained.

5 ways to get a sprained ankle

An ankle sprain occurs due to different factors that come into play. The most commons ones are:

1) Participating in sports activities

If you are a sports fan or have played in one, you know how common ankle injuries are. In fact, up to 40% of sports injuries result in a sprained ankle. (2)

Take basketball as an example, coming in with a 41% rate of an ankle sprain. (2) This is due to the nature of the game, where there’s a lot of body movement and contact required to play the sport well.

In sports, most ankle sprains tend to happen when landing on your feet. If you land accidentally on a player’s foot or awkwardly on the court, your ankle may get injured.

This injury can also happen after sharp twists or turns during the game, or after a body collision. (3)

2) Not warming up properly

A good warm-up will prepare your muscles for the physical activity you’ll do. Thanks to this, your joints will be able to react faster and reduce your risk of sprains.

The problem is that for most people, warming up means swaying their limbs and increasing their heart rate. This isn’t a warm-up that can prevent ankle sprains.

In order to have preventative properties, the warm-up has to be specific. It should at least include exercises specifically for your foot and ankle.

However, these exercises don’t have to be complicated. You can effectively warm up your ankles by being doing some balance exercises while barefoot, for 5-10 minutes. (4)

3) Having a high BMI

Body mass index (BMI) is a measure of your body fat in comparison with your weight and height. And according to the American Academy of Orthopaedic Surgeons, having a high BMI can make you prone to ankle injuries. (5)

Researchers think this because increased body weight can decrease the level of balance and stability. (6) This makes carrying around the excess load much harder for your ankle joint to take control of, making it prone to injury.

4) By walking on uneven surfaces

On an uneven surface, your ankle is exposed to more dynamic and unpredictable terrain. A common example of this is hiking areas.

One simple misstep can make your foot roll accidentally. Even a bad fall can cause a severe sprain or a broken bone.

An easy way to prevent this is by warming up your ankles before going for a hike. Also, make sure to use the right footwear, depending on the characteristics of the terrain.

5) Wearing high heels

Woman removing her high heels and rubbing her sprained ankle

85% of sprains happen when you roll your ankle inward. (7) This means that you’re prone to rolling your ankle while your foot is pointed downwards and in.

Wearing shoes with high heels adds to this problem. This type of shoe places your foot in a downward position, making it vulnerable to ankle injuries. (8)

With continued use, these shoes can also cause weaken your ankle muscles. (9) This makes it harder for them to stabilize your ankle joint, increasing your risk of sprains.

How to know how bad is your sprain?

There are 3 degrees of ankle sprain severity. The higher the grade means more damage to the ankle ligaments. These are:

Grade I

This is what we call a “mild sprain.” Here, the ligament stretched beyond its limits. It’s common to have some pain and minimal swelling around your ankle joint.

Grade II

This is a moderate sprain. Here, there’s a slight tear to the ankle ligament. The pain and swelling are worse than in mild sprains, to the point of compromising your ankle range of motion.

You may have some tenderness around your ankle bones. To prevent it from becoming a more severe sprain, you may unconsciously walk with a visible limp.

Grade III

This is a severe sprain, meaning there’s a complete tear of the ankle ligament.

It’s highly likely to experience severe pain, swelling, and bruising around the ankle and foot. Due to these, trying to bear weight on your sprained ankle can be very difficult.

Learn more: The 3 grades of ankle sprains + their treatments.

How to diagnose an ankle sprain

If you can’t bear weight on your injured ankle, it’s best to go to a doctor to rule out any ankle fractures. Your doctor will likely do the following:

A physical exam

Your doctor will inspect any differences between both your ankles. Signs of redness, bruising, and swelling can indicate a torn ligament on your ankle.

The physician will then move your ankle. Any restricted range of motion, bony tenderness, or joint laxity can help narrow down the diagnosis as an ankle injury.

Requesting imaging tests

Depending on your injury, your doctor might also need to check the tissues inside your ankle joint. This can be done through an X-ray or an MRI.

An x-ray is an easy way to rule out if there are any broken bones. While the MRI will show the severity of the damage in the ligament. (10)

These images combined with the physical exam and your medical history will influence your doctor’s diagnosis. This is key to suggesting the proper treatment for your particular ankle injury.

5 Best treatments to heal an injured ankle

The most common treatments for sprained ankles include, but are not limited to:

1) Use the RICE approach the first few days after your injury

Ankle pain and swelling are often at their worst during the first week of the injury. The RICE protocol can help reduce these symptoms.

It’s an acronym for rest, ice, compression, and elevation. This combination of treatments can lower your pain sensitivity and flushes away any excess fluid build-up.

This will help: How to RICE your ankle sprain?

2) Tape your ankle joint for added protection

In severe sprains, it can be painful and uncomfortable to walk. Taping your ankle will help with this by providing external support to your joint.

Taping works by restricting the ankle’s range of motion. This can add protection and stability around the joint, preventing further injury and boosting recovery.

Check this out: How to tape your ankle sprain in 8 steps.

3) Do ankle exercises once you can tolerate pain

As your ankle heals, your symptoms will start to get better. This can also be a great sign to start doing ankle-specific exercises.

Doing specific exercises will make sure your injury heals properly. It will also help your ankle get back to how it was before the incident.

The best way to go at this is by doing range of motion, stretching, and strengthening exercises. They will provide a well-rounded treatment.

Try this: 12 Physio-approved exercises to heal your ankle sprain.

4) Get yourself a good physical therapist

Physical therapist taping the sprained ankle of a patient

If you need a more hands-on approach to boost your recovery, then you should go to a qualified physical therapy clinic.

Apart from enhancing your healing process, your physical therapist (PT) will help prevent future complications, like chronic ankle instability (CAI).

This is a condition where you feel ankle pain and unsteadiness even after a year after the injury. It can be easily prevented with a sound rehabilitation program, though.

This can help: Physical therapy for ankle sprains and tips to find the best clinic for you.

5) Consider ankle surgery

Although very uncommon, some people may benefit from undergoing ankle surgery, like (11):

  • When non-surgical treatments fail to deliver good results.
  • When your sprain also comes with an ankle fracture.
  • If you are an athlete with severe ankle instability.
  • If you have a complete tear of all ankle ligaments with massive joint bleeding.

There are a lot of ankle procedures, the most common are ligament repair and arthroscopy.


What are the symptoms of an ankle sprain?

Pain and swelling are top of the list. There can also be a bit of bruising and tenderness as well.

Is it OK to walk on a sprained ankle?

Yes, as long as there is minimal to zero pain and swelling.

Learn more: When is it ok to walk with an ankle sprain?

How can I prevent an ankle sprain?

Maintain good muscle strength and avoid high-heeled shoes when possible.

Conclusion: How can you sprain your ankle?

There are a lot of instances that may cause your foot to roll awkwardly – from a sports accident to a misstep while wearing high-heels.

The key here is to be proactive about your health choices:

  • Stay physically active.
  • Have a good warm-up routine.
  • Tread carefully on an uneven surface.

These things may not be much, but they can save you the hassle of dealing with a sprained ankle.


  1. Hubbard, Tricia J, and Erik A Wikstrom. “Ankle sprain: pathophysiology, predisposing factors, and management strategies.” Open access journal of sports medicine vol. 1 115-22. 16 Jul. 2010, DOI: 10.2147/oajsm.s9060
  2. Halabchi, Farzin, and Mohammad Hassabi. “Acute ankle sprain in athletes: Clinical aspects and algorithmic approach.” World journal of orthopedics vol. 11,12 534-558. 18 Dec. 2020, DOI: 10.5312/wjo.v11.i12.534
  3. McKay, G D et al. “Ankle injuries in basketball: injury rate and risk factors.” British journal of sports medicine vol. 35,2 (2001): 103-8. DOI: 10.1136/bjsm.35.2.103
  4. Padua, Elvira et al. “Effectiveness of Warm-Up Routine on the Ankle Injuries Prevention in Young Female Basketball Players: A Randomized Controlled Trial.” Medicina (Kaunas, Lithuania) vol. 55,10 690. 16 Oct. 2019, DOI: 10.3390/medicina55100690
  5. American Academy of Orthopaedic Surgeons. “The Impact of Obesity on Bone and Joint Health”. March 2015.
  6. Lee, Jae Joon et al. “Relationship Between Obesity and Balance in the Community-Dwelling Elderly Population: A Cross-Sectional Analysis.” American journal of physical medicine & rehabilitation vol. 99,1 (2020): 65-70. DOI: 10.1097/PHM.0000000000001292
  7. Ferran, Nicholas Antonio, and Nicola Maffulli. “Epidemiology of sprains of the lateral ankle ligament complex.” Foot and ankle clinics vol. 11,3 (2006): 659-62. DOI: 10.1016/j.fcl.2006.07.002
  8. Yu, Jia et al. “The influence of high-heeled shoes on strain and tension force of the anterior talofibular ligament and plantar fascia during balanced standing and walking.” Medical engineering & physics vol. 38,10 (2016): 1152-6. DOI: 10.1016/j.medengphy.2016.07.009
  9. Kim, M-H et al. “Reducing the frequency of wearing high-heeled shoes and increasing ankle strength can prevent ankle injury in women.” International journal of clinical practice vol. 69,8 (2015): 909-10. DOI: 10.1111/ijcp.12684
  10. Sawant, Yogini Nilkantha, and Darshana Sanghvi. “Magnetic resonance imaging of ankle ligaments: A pictorial essay.” The Indian journal of radiology & imaging vol. 28,4 (2018): 419-426. DOI: 10.4103/ijri.IJRI_77_16
  11. Petersen, Wolf et al. “Treatment of acute ankle ligament injuries: a systematic review.” Archives of orthopaedic and trauma surgery vol. 133,8 (2013): 1129-41. DOI: 10.1007/s00402-013-1742-5

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