A sprained ankle or twisted ankle as it is sometimes known, is a common cause of ankle pain. A sprain is stretching and or tearing of ligaments. The most common is an inversion sprain (or lateral ligament sprain) where the ankle turns over so the sole of the foot faces inwards, damaging the ligaments on the outside of the ankle. The most common damage sustained in a sprained ankle is to the anterior talofibular ligament. This ligament connects the talus (ankle bone) with the fibula (smaller of the two bones in the lower leg). If the sprain is severe there might also be damage to the calcaneofibular ligament (connects the heel bone to the fibula) which is further back towards the heel. This ligament only becomes injured in more severe injuries due to its increased strength and laxity whilst the toes are pointed (a common position for ankle sprains).

Knowing the symptoms that can be experienced with a sprain is important in determining that the injury is not really a break in the bone. When a sprain occurs, blood vessels will leak fluid into the tissue that surrounds the joint. White blood cells responsible for inflammation migrate to the area, and blood flow increases as well. Along with this inflammation, swelling from the fluid and pain is experienced. The nerves in the area become more sensitive when the injury is suffered, so pain is felt as throbbing and will worsen if there is pressure placed on the area. Warmth and redness are also seen as blood flow is increased. Also present is a decreased ability to move the joint, and difficulty using the affected leg.

If an ankle sprain does not heal properly, the joint may become unstable and may develop chronic pain. Receiving proper treatment and performing exercises that promote ankle function is important to strengthen the ankle and prevent further injury. The amount of therapy that a person can handle will depend on their level of pain and the grade of sprain they experienced. It is not recommended to return to sports or extreme physical activities until hopping on the ankle is achieved without pain. Wearing high-top tennis shoes may also help prevent ankle sprains if the shoes used are laced snugly and if the ankle is taped with a wide, nonelastic adhesive tape.

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