Ankle Sprains in Children

Updated 8/21/2018
Dr. Baravarian discusses ankle sprains and why proper treatment is so important.

Ankle sprains are one of the most common injuries in kids. They are also the most under-treated. Repeat sprains and sprains that aren't treat properly can result in long term pain, chronic conditions and unnecessary surgeries. For this reason, it is important to have the injury is evaluated by a specialist.


Our team of experts understand the special circumstances involving the treatment of children and their developing and growing bones, tendons and joints.


They pride themselves in offering state-of-the-art care, helping your children return to the activities they love, all in a compassionate and patient environment.

What Causes an Ankle Sprain?

Youth athletes are particularly susceptible to sprains, but even non-athletes can sprain their ankles during normal play, while walking on uneven surfaces, or just awkwardly planting the foot.

A sprain is an acute injury that can happen in the blink of an eye, and typically occurs when the foot is twisted or turned too far. The most frequent type of sprain is called an inversion sprain, which is when the outer ligaments stretch or tear when the foot is rolled outward, with the sole facing in. Less common is a medial sprain, which is when the foot rolls inward, and overstretches the inside ligaments.


How Serious is Your Child's Sprained Ankle?

Sprained ankles can cause your child a lot of pain, but most sprains are relatively minor injuries. A sprain happens when there’s a stretch or tear in the ankle’s ligaments. There are three grades of severity for sprained ankles:

Grade 1 Sprain – Mild.

The ligaments are only slightly stretched, marked by swelling and soreness in the joint.

Grade 2 Sprain – Moderate.

There is a small tear in the ligament that loosens the ankle joint. The ankle appears swollen, and patients feel pain and have a hard time putting weight on the injury.

Grade 3 Sprain – Severe.

A severe ankle sprain is a complete tear of the ligament. There is quite a bit of pain and swelling. The ankle will feel very weak and patients won’t be able to put any weight at all on the foot.


If you believe your child or teen has sprained their ankle, they should stop playing immediately so they do not injure the ligament further. Repeat sprains of the same ankle can cause a chronic ankle sprain. Chronic ankle sprains can cause pain for months, or even years, after the initial trauma, flaring up whenever the patient tries to play sports, dance, or exercise.


Treating Ankle Sprains

If your child may have an ankle sprain, call your foot and ankle specialist. They may ask you questions about how the ankle what injured, what the injury feels like, and how much weight your child can bear on the foot. You may be asked to schedule an appointment for a closer examination, or your doctor may be able to give you a home treatment plan.


Many ankle sprains can be successfully treated at home within 4-6 weeks with attentive care and rest.


  • Rest the ankle. Avoid putting weight on the foot as much as possible, especially for the first week. Limit walking, and use crutches or a scooter to get around.
  • Elevate the limb. Prop the leg up with pillows or a footstool when sitting or lying down.
  • Ice. Use ice to bring down the swelling. Wrap a bag of ice or a cold pack in a paper towel and apply it to the ankle immediately after the injury. Ice the sprain for 15-20 minutes every 3-4 hours for the first couple days after the injury.
  • Compression. Your doctor may splint the ankle, or recommend an elastic wrap to limit the joint’s motion and compress the injury. Compression helps your ligaments to heal and prevent further injury.
  • Medication. For pain relief, you can use nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
  • Immobilization. Grade 3 sprains usually require complete immobilization in a cast or a boot. This helps to make sure the ligaments have enough time to heal before they are used again.
  • Surgery. In rare and very severe cases, your foot and ankle specialist might recommend surgery. An arthroscopy is performed through a small incision near the joint. The doctor inserts a narrow, flexible camera into the incision and makes the necessary repairs.


Preventing Ankle Sprains in Kids

Some ankle sprains simply can’t be prevented. Accidents happen, and kids should be able to play and enjoy physical activity as a healthy and normal part of everyday life.


But you can teach your children ways to reduce their chances of spraining an ankle. Here are a few tips for keeping your child’s ligaments safe and strong.


  • Slow down and take caution, especially on slippery or uneven surfaces.
  • Warm up your muscles before running or playing sports with some slow dynamic stretching. Your foot and ankle specialist can demonstrate some good techniques.
  • Rest your body when it’s tired. Fatigued muscles can cramp or give out unexpectedly, which may cause an injury.
  • Buy athletic tape or an over-the-counter ankle brace to use when playing sports.
  • Wear high-top shoes, skates, or rollerblades, and be sure to lace them snug around the ankle to give it enough support.
  • Avoid high-heeled shoes. Young women may start wearing high-heels to follow the latest fashion trends, but high heels are one of the most frequent causes of ankle injury. If your teen must wear heels, make sure they are no higher than 2” and that the heel itself is wide and supportive.
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