Sprained ankles can stay swollen anywhere from days to months, with the duration of swelling largely depending on the severity of injury and what steps have been taking to help reduce the swelling.

Sprained ankles are extremely common injuries and can come in many different levels of severity. Whether it’s a mild ankle sprain or a sever ankle sprain, there will usually be some level of swelling present.

The swelling associated with a sprained ankle can cause issues on its own, and many people wonder “When will the swelling go down?”. We will explore the swelling timelines for sprained ankles, as well as general strategies to speed up the process of reducing swelling.

Grade 1 – How long does a sprained ankle stay swollen?

In this case, we will consider a mildly sprained ankle to be in the Grade 1 ankle sprain category, meaning there is a very small amount of tearing to the involved ankle ligaments.

The person will still be able to weight bear and can perform most daily activities with their sprained ankle. However, even though it’s considered a mild sprain, the person may struggle with sports and recreation due to pain and/or sensation of weakness.

Grade 1 ankle sprains, or mild ankle sprains, will usually have some pockets of swelling local to the injured ligament. For example, with lateral ankle sprains, the anterior talofibular ligament (ATFL ligament) is often injured, so it’s common to see swelling around the lateral aspect of the ankle (outside of the ankle) and sometimes closer to the front of the ankle.

Swelling from a Grade 1 ankle sprain can last from a few days to a couple weeks depending on level of activity and any strategies used to reduce swelling. In this case, ice, elevation, and compression are all strategies that can be used to minimize the amount and duration of swelling in the ankle joint.

Grade 2 – How long does a sprained ankle stay swollen?

We will consider a moderate ankle sprain to be in the category of Grade 2 ankle sprains, whereby one or more ligament is partially torn, but not completely ruptured. There may be significant joint pain, and pain local to the torn ligament itself.

There will be a more aggressive mechanism of injury with this type of sprained ankle. There could be direct contact with an opponent, the sensation of a pop in the ankle, difficultly walking, and difficulty with many daily activities.

A moderate sprain may look fairly nasty in terms of immediate bruising and creating a highly swollen ankle. When there is more severe and widespread damage to the ligaments that support the ankle, we can expect a more comprehensive healing process.

In this case, the inflammatory phase of healing will be much more pronounced, so there will be a larger amount of widespread swelling local to the injured ligaments and perhaps more generally around the ankle joint as well.

Swelling from grade 2 ankle sprains will usually take 1-4 weeks to subside, but this can vary depending on how much stress the ankle joint is exposed to during recovery, and if any strategies have been incorporated to help reduce swelling.

For a Grade 2 ankle sprain, ice, compression, and elevation can all work together to help decrease swelling and the amount of time it sticks around for. Ankle sprains heal according to typical tissue healing timelines, and these strategies are best employed in the initial stages of healing.

In regards to more anecdotal clinical experience, elevation and compression are the most effective ways to notice reduced swelling, but ice may also have a roll in mitigating swelling and especially pain caused by swelling (Wells et al, 2019), as this type of ankle sprain can include severe pain.

Grade 3 – How long does a sprained ankle stay swollen?

We will consider a severe sprain to be in the category of Grade 3 ankle sprains, whereby one more ligaments that cross the ankle joint are fully ruptured and no longer intact. A severe sprain will often require an x-ray to help distinguish between a sprained vs. broken ankle.

After this type of ankle sprain, the person will have significant difficulty weight bearing, as well as a substantial amount of immediate swelling and bruising. This type of sprained ankle can lead to significant ankle instability.

Grade 3 ankle sprains can stay swollen for a couple weeks to a couple months. As mentioned with moderate ankle sprains, the extent and distribution of damage to the ligaments and surrounding structures will be a primary factor in how much swelling there is and how long it stays for. Like always, strategies that you effectively employ to reduce ankle swelling will also play a large role.

In the case of severe ankle sprains, another thing to keep in mind is that if you have been non-weight bearing for a while during your initial recovery, beginning to put weight on the ankle again can temporarily increase symptoms again, including increasing swelling.

Therefore, many people with severe sprains find their swelling will fluctuate quite a bit day-to-day, especially after the first week or two of recovery. Additionally, persistent swelling is a common complaint among these patients.

For a Grade 3 sprained ankle, ice, elevation, and compression become even more crucial for the management of swelling. Ice can be helpful for pain, and while evidence around effectiveness for reducing swelling in acute ankle sprains is mixed (Miranda et al, 2021), many people find relief from icing an ankle sprain.

Compression is also effective, but depending on the level of pain, some people may find it uncomfortable to be constantly applying compression in the form of a tensor bandage or compression sock, particularly with a severe sprain.

Therefore, elevation is one of the best ways to reduce swelling in severe ankle sprains. This will naturally help protect the ankle, as you are staying off your feet during this time, and gravity will provide the necessary direct assistance to help drain the inflammatory byproducts via the lymphatic system. In other words, elevation is a great way to help drain the swelling from the ankle.

What else can you do to reduce swelling in a sprained ankle?

We referred a lot to components of the RICE principle, which stands for Rest, Ice, Compression, and Elevation. While this is a great principle to follow in the acute stage of recovery from a sprained ankle, there are other things you can keep in mind to reduce swelling, as well as prevent an increase in swelling during the rehab process.

Physical Therapy

Physical therapy is highly recommended when recovering from a sprained ankle. Even an initial consult can provide a lot of guidance on how to manage your sprained ankle. The physical therapist will be able to diagnose the ligaments that have been injured, the severity of sprain, and by getting to know a little more about you, they can tailor swelling management strategies to your personal needs.

If possible, having regular follow-up appointments will ensure the smoothest possible recovery, and is a great way to answer questions regarding suitability of return to activities, such as leisure activities or sports.

Moreover, given a sprained ankle leads to ankle instability (Zhang et al, 2023), a physical therapist can help provide activity-based strategies for injury prevention to help minimize the chances of doing this all over again, which will ultimately help avoid the development of a chronic ankle sprain.

Pacing and Planning

Ankle swelling often increased throughout the day, especially if you are on your feet. The soft tissue in the ankle joints are reasonably stressed during standing and walking, and to compound this, the force of gravity acting to swelling in the ankle will make it much harder for it to drain from the ankle (elevation counteracts this). For this reason, you may find you have less welling in the morning and more swelling at night.

Therefore, spreading out your activities throughout the day and taking small breaks to rest, ice, elevation, and/or compress the ankle will help prevent excessive accumulation of swelling throughout the day, and will also ensure the ligaments heal properly, thus avoiding a chronic ankle sprain.

Wearing graded compression socks is a great way to help minimize swelling while being on your feet, and putting your foot up on a chair can give it a break from the pooling of swelling that occurs when your entire body is on top of the sprained ankle, and ice can provide a further effect on pain and swelling.

Summary

Swelling is one of the most common symptoms of a sprained ankle. The amount and duration of swelling will vary depending on the extent and severity of damage to the ankle ligaments, any other injuries involved, and strategies that are taken throughout recovery to help manage the swelling.

When in doubt, we always recommend seeking guidance from a physical therapist to help optimize your approach to swelling reduction, as well as overall recovery. Knowledge is power, and not only will this allow for more optimal recovery, but it can provide peace of mind as well.

References

Miranda, J. P., Silva, W. T., Silva, H. J., Mascarenhas, R. O., & Oliveira, V. C. (2021). Effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain: a systematic review of randomized controlled trials. Physical Therapy in Sport, 49, 243-249.

Wells, B., Allen, C., Deyle, G., & Croy, T. (2019). Management of acute grade II lateral ankle sprains with an emphasis on ligament protection: a descriptive case series. International journal of sports physical therapy, 14(3), 445.

Zhang, J., Yang, K., Wang, C., Gu, W., Li, X., Fu, S., … & Shi, Z. (2023). Risk factors for chronic ankle instability after first episode of lateral ankle sprain: A retrospective analysis of 362 cases. Journal of Sport and Health Science.

Disclaimer:

The content here is designed for information & education purposes only and is not intended for medical advice.