Ankle Sprain vs. Ankle Strain: What’s the Difference?

Reviewed by the Physiotherapy Team at Waterloo Sports Medicine Centre 

Twisting your ankle during sports, exercise, or even stepping off a curb can lead to pain, swelling, and difficulty walking. But is it an ankle sprain or an ankle strain? While these injuries have similar symptoms, they affect different tissues and may require slightly different treatment approaches. 

What Is an Ankle Sprain? 

An ankle sprain occurs when one or more ligaments (the tough bands of tissue that connect bones to each other) are stretched or torn. Most ankle sprains happen when the foot rolls inward, causing injury to the ligaments on the outside of the ankle.

Common Causes of an Ankle Sprain 

• Rolling or twisting the ankle 

• Landing awkwardly from a jump 

• Sports involving cutting, pivoting, or sudden changes in direction 

• Walking or running on uneven surfaces 

  
  

Risk Factors 

• Previous ankle sprains 

• Poor balance or reduced ankle stability 

• Participation in sports such as basketball, soccer, or volleyball 

• Inadequate footwear 

  
  

What Is an Ankle Strain? 

An ankle strain occurs when a muscle or tendon (the tissue that connects muscle to bone) is overstretched or torn. Strains are less common than ankle sprains but can occur when the muscles around the ankle are overloaded or stretched beyond their limits. 

Common Causes of an Ankle Strain 

• Sudden acceleration or deceleration 

• Overuse during running or sports 

• Muscle fatigue 

• Inadequate warm-up before activity 
  

Risk Factors 

• Muscle weakness or tightness 

• Previous lower extremity injuries 

• Rapid increases in training intensity 

• Poor conditioning  

Ankle Sprain	Ankle Strain
Pain around the ligaments, usually on the outside of the ankle	Pain within the muscle or tendon
Swelling and bruising	Muscle tenderness or cramping
Feeling of instability or "giving way"	Pain when contracting or stretching the muscle
Difficulty bearing weight	Weakness during movement

How Can Physiotherapy Help? 

Because symptoms can overlap, a physiotherapy assessment can help determine the exact injury and guide appropriate treatment. Early treatment can reduce pain, improve healing, and lower the risk of ongoing ankle problems. 

Your physiotherapy treatment may include: 

• Education on activity modification and safe return to sport 

• Strategies to reduce pain and swelling 

• Range-of-motion exercises 

• Progressive strengthening exercises 

• Balance and proprioception training 

• Gait retraining and sport-specific exercises 

• Bracing or taping recommendations when appropriate

Research shows that exercise-based rehabilitation can reduce the risk of recurrent ankle injuries and improve long-term function. 

Healing and Recovery Timeline 

	Severity	Typical Recovery Time
Ankle Sprain	Grade I (mild)	1–3 weeks
	Grade II (moderate)	3–6 weeks
	Grade III (severe)	8–12+ weeks
Ankle Strain	Mild	2–4 weeks
	Moderate	4–8 weeks
	Severe tear	Several months

At Waterloo Sports Medicine Centre, our physiotherapists can help you regain strength, stability, and confidence in your ankle.