Ankle Sprain

Description

An ankle sprain is a stretch or partial tear of the ligaments that hold the ankle together, usually from a twist or roll. Sprains are common in older children and teens; in younger children with open growth plates, a similar twist more often injures the growth plate instead.

How it happens (the mechanism)

About nine in ten ankle sprains happen when the foot rolls inward (an inversion injury), overstretching the ligaments on the outer side of the ankle. The age twist is important: in a child whose growth plates are still open, the growth plate is often the weak link rather than the ligament — so bony tenderness after a roll may signal a growth-plate fracture, not a sprain, which is why the doctor checks exactly where it hurts.

Symptoms

Pain, swelling, and bruising on the outer ankle after a roll, with tenderness over the ligaments and difficulty bearing weight.

Doctor examination and imaging

The doctor checks where the tenderness sits — over the ligaments versus the bone — and the ankle’s stability; X-rays are used when a fracture is a concern.

Treatment

Early care is rest, ice, compression, and elevation, plus a brace or boot for support. As pain settles, gentle motion is added, then strengthening and balance exercises, then a staged return to running and sport.

Recovery and long-term outlook

Most ankle sprains heal well. Finishing the strengthening and balance work before returning to full sport is the strongest protection against the most common complication — spraining it again.

When to call the doctor

Call if pain is severe or worsening, your child will not bear weight or use the leg at all, the area becomes very swollen, red, or warm, your child develops a fever, or things are not improving with rest as expected.

Learn more

OrthoInfo (AAOS) — Sprained Ankle: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.