Having symptoms of nerve damage after an ankle sprain is not something you should take lightly. You see, aside from ligaments, there are also a bunch of nerves that cross your ankle joint.
Some types of sprains can injure them, causing symptoms that range from altered skin sensation to even losing muscle strength.
Below, we’ll teach you how to recognize if you damaged your nerves and what to do about it. Here are the topics we’ll cover, tap on any of them to navigate through the article:
4 traits of ankle sprain with nerve damage
If you are experiencing any of these, please head over to the nearest emergency room to get your ankle checked. You may have nerve entrapment or another type of injury that can cause severe symptoms if left unattended.
1) Radiating pain
Have you ever felt a sharp-shooting pain running across your ankle? You might notice this as you move your foot around.
This is because certain ankle movements can stretch the already irritated nerve, causing sharp pain along its route.
If this happens, you may have a pinched nerve. This can be a transitional consequence of the ankle injury, due to the swelling.
It should subside as the inflammation decreases. But if it goes on for too long, this can lead to nerve damage.
2) Altered skin sensation
Feeling numbness, burning, prickling, or tingling are common sensations that may indicate a nerve injury.
See, the nerves around your body are like a high-speed highway. With good traffic, electrical signals can freely run along each nerve, from your brain down to your toes and vice versa.
But with a roadblock -like a pinched nerve- these electrical signals won’t be able to pass through properly. This can cause distorted sensations, like numbness in certain parts of your ankle.
At times, some signals can still go across, but your body can’t identify them accurately due to the injury. This causes a pins-and-needles sensation, medically called “paresthesia”.
3) Foot drop
Foot drop means difficulty pointing your foot upwards. It’s more noticeable when you walk, as you might have to lift your hip more than usual or drag your injured foot just to get by.
The reason is that nerve signals send instructions to our muscles, telling them when to move or not. If they’re injured, our muscles can’t work properly, having a harder time starting a contraction.
Having a foot drop after an ankle sprain is a sign of peroneal nerve damage. (1)
4) Loss of muscle size
If the muscles of your injured foot and ankle are much smaller than their healthy counterparts, you likely have a damaged nerve.
This is because the motor function deficits weaken the muscle, thus it gets smaller.
Common nerve injuries after an ankle sprain
The likelihood of suffering a nerve injury depends on the grade of your ankle sprain.
Research shows that for moderate (grade II) ankle sprains, there is a 17% and 10% chance of peroneal and tibial nerve injury. This can even go as high as 86% and 83% for grade III sprains. (2)
The nerves usually affected by ankle sprains include:
Common peroneal nerve
This injury usually comes after an inversion ankle sprain, where your foot accidentally turns inwards. This motion might overstretch and damage the common peroneal nerve. (3)
Foot drop is a typical symptom. (1) In some cases, it also probably leads to radiating pain and altered sensation to your outer calf.
Posterior tibial nerve
A combination of your foot moving outward and upward forcefully can lead to this nerve compression injury. (4) Because of this mechanism, it might be linked to an eversion ankle sprain.
In terms of injury location, this is right where the nerve passes along a bony passage on your inner ankle. Hence, this injury is infamously known as tarsal tunnel syndrome.
Symptoms include sharp shooting pain and numbness under your foot. In long-term cases, it may also lead to a loss of muscle size on your foot. (4)
Treatment options for an ankle sprain with nerve damage
Once you are cleared by a doctor, they might recommend any of the following:
1) Ankle immobilization
Initially, keeping your ankle still may help avoid aggravating ankle movements. Wearing an ankle brace or taping your ankle might be the two best options to assist you with this one.
2) RICE therapy
This treatment means rest, ice, compression, and elevation. Combining all four lessens swelling, which may potentially reduce the pressure on the nerve.
Learn more: How often should you ice your ankle sprain?
Oral and topical anti-inflammatory drugs can also help relieve pain and swelling through their various mechanisms of action.
Additionally, getting a local corticosteroid injection from your doctor may also prove useful. This method can both help diagnose and treat your nerve injury. (5)
4) Physical therapy
A physical therapist can speed up your recovery by:
- Nerve stimulation to aid in pain relief.
- Specialized neural mobilization techniques to boost your nerve’s healing potential.
- Strengthening and balance exercises to both regain and bulletproof your ankle from future sprains.
Foot and ankle surgeons recommend going under the knife in instances of (1, 6):
- All possible nonsurgical treatments have failed.
- When there is no change in your symptoms after 3 to 7 months post-injury.
- Presence of foot drop with little improvement after 4 to 5 weeks post-injury.
How long does it take to recover from nerve damage from an ankle sprain?
A minor nerve injury might take a few weeks to heal. On the other hand, it will probably take a few months to recover from a severe one.
How do you know if a nerve is damaged?
You will likely feel symptoms such as radiating pain, numbness, tingling, and muscle weakness.
How does nerve damage feel when healing?
You might be able to have a better feel in your injured area compared to before. You will also probably notice a gradual decrease in symptom intensity.
Conclusion: Signs of nerve damage in the ankle after a sprain
Suffering a nerve injury with a sprained ankle is plausible due to our foot and ankle anatomy. Early detection is especially important to avoid potential and permanent nerve damage.
So if you are experiencing any of the symptoms above, do not hesitate to get your ankle checked by a medical specialist right away!
- Brief, James M et al. “Peroneal nerve injury with foot drop complicating ankle sprain–a series of four cases with review of the literature.” Bulletin of the NYU hospital for joint diseases vol. 67,4 (2009): 374-7. https://pubmed.ncbi.nlm.nih.gov/20001941/
- Nitz, A J et al. “Nerve injury and grades II and III ankle sprains.” The American journal of sports medicine vol. 13,3 (1985): 177-82. DOI: 10.1177/036354658501300306
- Garozzo, D., Ferraresi, S. & Buffatti, P. Common peroneal nerve palsy complicating ankle sprain: report of 5 cases and review of the literature. J Orthopaed Traumatol 4, 142–145 (2003). https://doi.org/10.1007/s10195-003-0028-z
- Kiel J, Kaiser K. Tarsal Tunnel Syndrome. [Updated 2021 Aug 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513273/
- Johnston, E C, and S J Howell. “Tension neuropathy of the superficial peroneal nerve: associated conditions and results of release.” Foot & ankle international vol. 20,9 (1999): 576-82. DOI: 10.1177/107110079902000907
- Mitsiokapa, Evanthia et al. “Peroneal nerve palsy after ankle sprain: an update.” European journal of orthopaedic surgery & traumatology : orthopedie traumatologie vol. 27,1 (2017): 53-60. DOI: 10.1007/s00590-016-1845-0