A parent’s guide from Bayshore Podiatry Center in South Tampa.
Quick take
- Most ankle sprains get better, but “rest only” often leads to repeat sprains.
- The goal is to restore motion, strength, and balance—not just reduce pain.
- A normal X-ray does not always mean “nothing happened,” but it also does not automatically mean a growth plate fracture.
- If your child keeps rolling the ankle, persistent instability deserves a plan.
Table of contents
- What an ankle sprain really is
- Red flags after an ankle injury
- What you can do in the first week
- Sprain vs fracture: what parents should know
- How we evaluate ankle injuries
- Rehab that prevents repeat sprains
- When imaging is needed
- FAQs
- Sources
What an ankle sprain really is
An ankle sprain is an injury to the ligaments that stabilize the ankle. In kids, the growth plates add complexity, but the guiding principle stays the same:
A stable ankle requires mobility, strength, and neuromuscular control.
Many children feel better quickly and return to sport before their ankle is actually ready. That is how “one sprain” becomes “the ankle keeps giving out.”
Red flags after an ankle injury
Seek urgent care if:
- Your child cannot bear weight
- There is obvious deformity
- Severe swelling or bruising appears quickly
- There is an open wound or concern for fracture
Book an evaluation soon if:
- Limping persists
- Pain is not improving
- Pain is focused on the bone and very tender to touch
- Your child repeatedly sprains the same ankle
What you can do in the first week
1) Protect the ankle
A lace-up brace or supportive wrap can help early.
2) Reduce swelling and pain
Elevation and compression can help. Ice can be useful for symptom control.
3) Start gentle movement as tolerated
Early motion (within comfort) helps stiffness and function. If every step causes a limp, that’s a sign to back off and get evaluated.
4) Avoid the trap of “rest only”
Rest can calm symptoms, but it does not retrain balance and control.
Sprain vs fracture: what parents should know
“The X-ray is normal”
A normal X-ray is reassuring, but it does not mean the ankle is ready for sport.
Many radiograph-negative ankle injuries behave like sprains and do well with a removable brace and guided return to activity. The key is functional recovery.
“It must be a growth plate fracture”
Sometimes growth plate injuries occur. The point is not to label every injury as a fracture by default. The point is to treat the child in front of you:
- If they can walk without limping and symptoms improve steadily, a functional brace and progressive rehab is usually reasonable.
- If they cannot bear weight, pain is severe, or symptoms are not improving, you need a deeper evaluation.
How we evaluate ankle injuries in clinic
History
- How the injury happened (twist, landing, collision)
- Immediate swelling and ability to walk afterward
- Where the pain is (bone vs ligament area)
- Prior ankle injuries
Exam
- Tenderness location
- Ligament stability testing (as tolerated)
- Range of motion
- Functional tests (balance, hopping, controlled movements)
Imaging
X-rays are most useful when bony tenderness and inability to bear weight raise concern for fracture. If symptoms persist or a specific injury is suspected, advanced imaging may be appropriate.
Rehab that prevents repeat sprains
This is the part that changes outcomes. We almost always recommend physical therapy after ankle sprains. When the ankle sprain occurs, your child loses their natural sense of position in space and their reflexes are muted. This creates more frequent and usually worsening ankle sprains. We have trusted partners that help your child re-establish ankle confidence.
A good rehab plan restores:
- Range of motion (especially dorsiflexion)
- Strength (calf, peroneals, hips)
- Balance and proprioception (single-leg stability)
- Sport-specific control (cutting, jumping, landing)
The parent-friendly test
If your child cannot do single-leg balance and simple hop drills without pain or “wobble,” the ankle is not ready for full sport yet.
Bracing during return to sport
Some kids benefit from a brace during the transition back, especially if they have a history of repeat sprains. We usually recommend bracing early on while rehabilitating and strengthening the ankle. Braces can be required for up to a year and that is ok!
When to consider chronic ankle instability
If the ankle “gives out,” rolls easily, or keeps spraining, that is not bad luck—it’s a stability and control problem that deserves a plan.
Ignoring it often leads to more missed practices, lingering pain, and loss of confidence.
FAQs
How long does an ankle sprain take to heal?
It depends on severity and on rehab follow-through. Pain often improves before function is restored.
Does my child need physical therapy?
Not always, but many kids do better with structured rehab, especially after repeat sprains.
Should we stop sports completely?
Often we modify activity temporarily and return progressively. The goal is a safe return, not a rushed return.
When to book an evaluation
If your child is limping, unable to bear weight, has significant swelling, or keeps spraining the same ankle, we can help you build a clear recovery and prevention plan.
Bayshore Podiatry Center serves families across South Tampa and Hyde Park. Book your appointment here!
Medical disclaimer
This article is for dducational information only. Seek urgent care for severe pain, deformity, inability to bear weight, or concerning swelling/redness/fever.
Sources
- JOSPT Clinical Practice Guideline: Lateral Ankle Ligament Sprains
- Boutis K, et al. Radiograph-Negative Lateral Ankle Injuries in Children. JAMA Pediatr.
- Mandarakas M, et al. Chronic ankle instability in children: systematic review.
- Pediatric ankle fracture management references (guidelines and reviews)
