Ligaments are strong, fibrous tissues that hold bones together. Several ligaments around the ankle provide stability to the ankle joint. These ligaments can be stretched or torn when a twisting injury of the ankle occurs. As noted by the American Orthopaedic Foot and Ankle Society, the most common twisting injury causes the sole of the foot to face inward, toward the other foot. This damages ligaments on the outside of the ankle.
A partial ligament tear produces a moderate sprain and a complete tear causes a severe sprain. Pain, a popping sound, swelling, bruising, stiffness and instability are signs of torn ankle ligaments. A severe ankle sprain typically causes severe signs, which may be similar to those seen with an ankle fracture.
Pain and Popping
Pain is the most common immediate sign of a partial or complete ligament tear of the ankle. The pain can be moderate or severe and is generally maximum in the area of the torn ligament. A popping sound may be heard at the time of the injury with a complete ligament tear.
Swelling and Bruising
A partial or complete ligament tear causes ankle swelling due to bleeding and inflammation in the area. Bruising also occurs, as blood leaks into the tissues beneath the skin. The amount of swelling and bruising generally depends on the severity of the ligament tear -- it is moderate with a partial tear and severe with a full tear. Swelling and bruising may worsen in the first couple days after the injury.
Stiffness and Instability
Swelling, bruising and pain typically lead to ankle stiffness after a partial or complete ligament tear. With a complete tear, the ankle will also feel unstable when the person attempts to stand on the leg.
See a doctor if you have moderate or severe ankle pain, swelling or bruising, or if you are unable to put weight on your ankle. An x-ray may be necessary to determine whether you have a severe sprain or a fracture. Without appropriate treatment, torn ligaments may fail to heal properly, leading to recurrent ankle sprains, chronic ankle pain or ankle arthritis, according to the American Academy of Orthopaedic Surgeons. Severe ankle sprains may take weeks to months to recover fully.
Rest, ice, compression and elevation are generally recommended as initial treatments for torn ankle ligaments. Nonsteroidal anti-inflammatory medications, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), are useful for pain. Crutches are generally needed until bearing weight on the ankle is possible.
A removable walking boot, an air-filled or gel-filled ankle brace, or a short leg cast is often used to provide support and promote healing, especially for severe sprains. As pain and swelling resolve, resuming normal movement of the ankle becomes a high priority to prevent long-term stiffness. Physical therapy is often recommended to help regain normal movement and to strengthen muscles around the ankle.
Surgery may be necessary if another injury, such as a fracture, accompanies the torn ligament. Surgery is sometimes recommended for severe sprains even in the absence of other injuries or for chronic ankle instability.
Reviewed by Mary D. Daley, M.D.
- Mayo Clinic: Sprains and Strains
- American Family Physician: Management of Ankle Sprains
- American Family Physician: How to Care for Your Ankle Sprain
- American Family Physician: The Injured Ankle
- American Academy of Orthopaedic Surgeons: Sprained Ankle
- American Orthopaedic Foot and Ankle Society: Ankle Sprain