An ankle sprain is a common injury where the ligaments—tough, fibrous bands of tissue connecting the bones of the ankle joint—are stretched beyond their capacity or torn. Most sprains, approximately 90%, involve the lateral ligaments on the outside of the ankle. Ligaments stabilize the joint, and when compromised, the ankle becomes mechanically unstable. Continuing to bear weight or participate in physical activity on an injured ankle significantly increases the risk of worsening the injury and impacting the long-term health of the joint.
The Immediate Risks of Continuing Activity
Ignoring the initial pain and continuing to use a sprained ankle prevents the acute healing phase from stabilizing the injury site. When a ligament is torn, tiny blood vessels rupture, leading to localized internal bleeding and swelling (edema). Bearing weight on the injured joint immediately after the trauma forces the bones to move against the damaged, unstable ligaments.
This continued movement prevents the formation of a stable initial clot necessary for repair. The mechanical stress of walking or running pulls apart the damaged fibers, converting a partial tear into a more significant one. A mild Grade I sprain (stretching) can be quickly amplified into a Grade II sprain (partial tear) or even a complete Grade III rupture.
Continued activity also exacerbates the inflammatory response, leading to greater localized swelling. Each step acts as a pump, forcing more fluid and blood into the injured tissue, increasing pressure and pain. Excessive swelling impedes the delivery of necessary oxygen and nutrients, delaying the overall healing timeline. This cycle of stress and increased inflammation works against the body’s attempt to repair the ligament.
Grading Ankle Sprains and When to Seek Professional Help
Ankle sprains are classified into three grades based on the extent of ligament damage, guiding assessment and recovery. A Grade I sprain involves microscopic stretching of the fibers, resulting in mild pain, minimal swelling, and little instability. Individuals with a Grade I sprain can usually bear weight with slight discomfort.
A Grade II sprain involves a partial tear of the ligament, causing moderate pain, visible swelling, bruising, and functional impairment. The ankle joint may feel loose, and putting full weight on the foot is often difficult and painful. The most severe injury, a Grade III sprain, is a complete rupture of one or more ligaments, causing severe pain, significant swelling, and gross joint instability.
It is important to seek professional medical assessment immediately if a fracture is possible, as symptoms can be similar to a sprain. The Ottawa Ankle Rules guide determining the need for an X-ray. An X-ray is recommended if the patient cannot bear weight and take four consecutive steps both immediately after the injury and during assessment. X-rays are also recommended if there is tenderness along the posterior edge of the tibia or fibula, or at the navicular bone or the base of the fifth metatarsal.
Long-Term Consequences of Ignoring a Sprain
Failing to rest a sprained ankle can lead to chronic issues. The primary long-term consequence is Chronic Ankle Instability (CAI), affecting up to 40% of people who sustain an acute sprain. CAI occurs when damaged ligaments heal in a lengthened or compromised position, failing to provide necessary mechanical restraint to the joint.
This mechanical laxity is coupled with a deficit in proprioception, the body’s sense of joint position and movement. The injury damages sensory nerves within the ligament tissue, impairing the joint’s ability to signal the brain for rapid muscle activation. As a result, the ankle is prone to recurrent sprains, often described as the joint “giving way” during activity or walking.
Over time, this repeated micro-trauma and joint misalignment significantly increases the risk of developing post-traumatic osteoarthritis. Abnormal motion causes uneven wear and tear on the articular cartilage lining the ends of the bones. This accelerated degeneration can lead to persistent pain, stiffness, and reduced mobility years later, limiting physical activity.