What is the typical healing time for a sprained ankle?

Ankle Sprain Healing Timeline

The typical healing time for an ankle sprain ranges from 2-4 weeks for mild (Grade I) sprains to 6-8 weeks for more severe (Grade II-III) sprains, with pain typically decreasing rapidly in the first 2 weeks after injury. 1

Healing Timeline by Severity

• Grade I (mild) ankle sprains allow return to light work in approximately 2 weeks and full recovery in 3-4 weeks depending on task requirements 2, 1
• Grade II-III (moderate to severe) sprains allow return to light work in 3-6 weeks and full recovery in 6-8 weeks depending on task requirements and physiotherapy results 2, 1
• Pain typically decreases rapidly during the first 2 weeks after injury, regardless of severity 1

Treatment Recommendations

Initial Management (0-72 hours)

• Apply the PRICE protocol (Protection, Rest, Ice, Compression, Elevation) for the first 72 hours to control pain and swelling 1, 3
• Use NSAIDs for pain management and to help reduce swelling 1, 3
• Apply an ankle brace for functional support rather than rigid immobilization or elastic bandage 2, 3
• Begin early weight-bearing as tolerated with appropriate support 3

Early Rehabilitation (Days 3-10)

• Implement functional treatment with external support (preferably a lace-up brace) which is superior to immobilization 2, 1
• Begin active range of motion exercises (dorsiflexion and plantarflexion) 3
• If immobilization is needed for pain control, limit it to a maximum of 10 days 2

Progressive Rehabilitation (Weeks 2-8)

• Initiate exercise therapy early, as it reduces the risk of recurrent injuries and functional ankle instability 2, 1
• Include progressive strengthening exercises with resistance bands in all four directions 3
• Incorporate proprioceptive training including single-leg stance exercises 1, 3
• Continue using an ankle brace for 4-6 weeks during activities 2, 3
• Consider manual joint mobilization combined with exercise therapy for additional benefits in pain reduction and range of motion 2, 3

Common Complications and Long-Term Outcomes

• After 1 year, 5-33% of patients still experience pain and complaints of instability 1
• Recurrent ankle sprains occur in 3-34% of patients within the first year 1
• High-level sports participation is a potential unfavorable prognostic factor for developing residual complaints 1
• Up to 72.6% of patients report some residual symptoms 6-18 months after injury 4

Important Considerations and Pitfalls to Avoid

• Avoid prolonged immobilization (>10 days) as it leads to poorer outcomes compared to functional treatment 2, 3
• Do not rely solely on compression bandages without proper functional support, as they are less effective than ankle braces 2, 3
• Do not discontinue exercises once pain subsides, as this increases the risk of recurrent injury; complete the full 4-6 week program 3
• Avoid delaying the initiation of therapeutic exercises, as this can lead to prolonged recovery and increased risk of recurrent injury 2, 3
• Be aware that reinjury significantly increases the risk of moderate to severe residual symptoms (OR 7.21) 4

Return to Activity Guidelines

• Grade I sprains: Return to light work in 2 weeks, full recovery in 3-4 weeks 2, 1
• Grade II-III sprains: Return to light work in 3-6 weeks, full recovery in 6-8 weeks 2, 1
• Continue proprioceptive training even after recovery to prevent recurrent sprains 3
• Functional treatment allows patients to return to work faster (8.23 days sooner on average) and return to sports activities sooner (4.88 days faster) compared to immobilization 1