Minor ankle injuries

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Minor ankle injuries, such as ankle sprains or minor fractures to the fibula, are common in childhood. These injuries tend to heal quickly. Learn more about minor ankle injuries and their treatment.

Key points

Ankle injuries are common in children.
Ankle injuries can cause pain and swelling.
X-rays are usually not needed if your child has a minor fibular fracture or ankle sprain injury.
See a health-care provider if you suspect a more serious injury such as a fracture, if there is pain anywhere other than the outside of the ankle or if things are not improving in a couple days or the pain is getting worse.

Introduction

What is a minor ankle injury?

A minor ankle injury is an injury to the ligaments of the ankle (sprain) and/or bone on the outside of the ankle (fibula fracture).

An ankle sprain is when the ligaments surrounding the ankle joint get stretched or torn.

Tibia, fibula and partially torn ligament or ankle sprain — An ankle sprain is an injury to the small ligaments in the ankle. Sprains often occur during a fall when the foot is twisted onto its outer edge.

When the fibula is involved, this is called a minor ankle fracture. This can be due to either a break in the growth plate of the fibula or a chip from the tip of the fibula.

Ankle with break in the growth plate and ankle with tip of the fibula broken off — A minor fracture of the ankle usually involves the fibula. Two types of fractures are most common in children. One involves a break in the growth centre of the fibula (Salter-Harris I or II fracture). The other involves a chip of bone on the tip of the fibula.

Minor ankle injuries are common in children. Your child may have twisted their ankle playing sports or landed on their foot in a strange way to cause this injury.

Signs and symptoms

Signs and symptoms of minor ankle injury

After an ankle injury, your child may have:

difficulty walking
mild to severe pain
less movement in the ankle

Other signs may include:

swelling and bruising around the front and side of the ankle
tenderness around the areas of the bones
little or no tenderness over the bony prominences (fibula)

Diagnosis

How is a minor ankle injury diagnosed?

A health-care provider can determine if your child has a minor ankle injury without X-rays by doing a detailed exam of the ankle. If your child has a minor ankle injury, your child does not need an X-ray to confirm the diagnosis. The X-ray results do not change how these injuries are managed.

Helping your child

Sprains or minor ankle fractures heal well with time. If your child is diagnosed with a minor ankle injury, they do not need a cast or need to visit a bone specialist. If your child is having trouble walking, they may use crutches and/or an ankle brace that can support the injured ankle while it is healing.

Taking care of your child at home

Rest, ice, compression, elevate

Your child should limit activity for the first few days after the injury.

Apply ice to the injured area for the first two to three days. Make sure to cover the skin with cloth prior to applying ice and do not keep the ice on for longer than 15 minutes at a time.

If your child is having difficulty walking, you can use an ankle brace to support the ankle. If you are using a tensor bandage for support, ensure that it is not too tight and that the toes are still pink.

While your child is sitting or lying down, elevate their ankle to help reduce swelling.

Medications

You might also need to use medication to control your child’s pain. Ibuprofen and acetaminophen are usually recommended for managing pain.

Ibuprofen and acetaminophen do not interact with each other. Ibuprofen may be slightly better in treating pain and inflammation caused by an injury.

If your child has a pre-existing medical condition or is already taking other medicines, talk to their health-care provider to make sure that acetaminophen or ibuprofen is safe for your child.

Follow-up care

Return to activity

Pain should be the guide of your child’s activities

If an activity hurts, your child should stop doing that activity and try it again a few days later.

It may take up to three weeks for your child’s ankle to heal. Your child can use ankle supports and/or crutches as needed to make them more comfortable while the ankle is healing. Feel free to remove the support and/or stop using crutches any time your child says they feel little or no pain with activities.

Return to sport

Your child can return to sports when there is full movement and full strength in the ankle. You can test ankle strength by asking your child to hop on the injured leg five times. Check if your child shows signs of pain or is unsteady while hopping. Also, see if your child can run easily in a little zigzag.

Before returning to highly competitive sport, you may want to see a doctor who knows about athletic and sport-related injuries.

It is normal to have pain and swelling once in a while for the first three months. However, most children are doing all the activities they were doing before, including sports, by three months after the injury.

When to seek medical attention

Your child should see a health-care provider if:

The ankle is getting worse instead of better.
You are worried about how your child’s ankle is healing.
There is still a lot of difficulty in walking and ongoing pain after 48 hours.
The ankle is red or your child develops a fever.

Last updated: March 12th 2024