Sprained Ankle Not Healing After 2 Weeks? What to Know

A sprained ankle that still hurts after two weeks is not always a sign of something wrong. Mild sprains often settle within a couple of weeks, but moderate and severe sprains can take six to twelve weeks of rehab. Get checked if you cannot bear weight, swelling is not easing, the ankle feels unstable, or pain is getting worse.

Key takeaways

  • Healing time depends on severity: OrthoInfo, from the American Academy of Orthopaedic Surgeons, says rehab takes about two weeks for minor sprains and six to twelve weeks for more severe ones.
  • Two weeks is a checkpoint, not a deadline: the NHS says most sprains improve within about two weeks, so little or no improvement by then deserves a closer look.
  • Some injuries hide behind a "sprain": small fractures, high ankle sprains, cartilage damage and tendon injuries can slow recovery.
  • Rehab matters: OrthoInfo names incomplete rehabilitation as the most common cause of chronic ankle instability.
  • Imaging is not always needed: X-rays check for fractures; MRI is usually reserved for symptoms that persist.

How long should a sprained ankle take to heal?

Ankle sprains are graded by how badly the ligaments are damaged. OrthoInfo describes three grades:

GradeWhat happened to the ligamentTypical signsTypical recovery
Grade 1 (mild)Stretched or tiny tearsMild swelling and tenderness, usually able to walk, no instabilityOften around 1 to 2 weeks
Grade 2 (moderate)Partial tearModerate swelling and bruising, some pain on walking, slight loosenessSeveral weeks, often with a brace
Grade 3 (severe)Complete tearSignificant swelling and bruising, severe pain on weight bearing, clear instabilityMany weeks to months; may need a short period in a cast or boot

MedlinePlus notes that mild sprains often heal in 7 to 10 days, while severe sprains can take several weeks for pain and swelling to settle. The NHS adds that you should avoid strenuous activity such as running for up to 8 weeks to reduce the risk of re-injury, and that severe injuries can take months to recover fully.

So if you had a moderate or severe sprain, some pain, stiffness and swelling at the end of the day can still be normal at two weeks. What matters is the direction of travel: you should be steadily improving, walking more comfortably and needing less support each week.

What are the red flags?

Seek urgent care (an emergency department or your local urgent care service) if:

  • You heard a crack or pop and could not use the ankle straight away.
  • The ankle or foot looks deformed or sits at an odd angle.
  • The foot is numb, tingling, cold, or blue or gray in color.
  • Pain is severe and getting worse rather than better.

See a doctor soon (within a day or two) if:

  • You still cannot bear weight or walk more than a few steps.
  • Swelling or bruising is increasing instead of fading. MedlinePlus advises contacting a provider if swelling has not started to improve within two days.
  • The skin over the ankle becomes red, hot and more painful, or you develop a fever, which could suggest infection.
  • Your calf becomes swollen, warm and tender, which needs prompt assessment to rule out a blood clot, especially if you have been immobilized.
  • The ankle keeps "giving way" on flat ground.

Why might your ankle not be healing?

The sprain was more severe than it seemed

Swelling can hide how much damage there is in the first few days. A sprain that felt mild may turn out to be a partial or complete tear that simply needs more time and structured rehab.

A missed fracture

OrthoInfo notes that severe sprains can look like fractures, which is why X-rays are used to rule out a break. Small fractures around the ankle, or at the outer edge of the foot, can be overlooked if no X-ray was taken. Pain that pinpoints over a bone, rather than over soft tissue, is a reason to ask about imaging.

A high ankle sprain

A high ankle sprain injures the ligaments that hold the two lower leg bones together just above the ankle. It often comes from the foot being twisted outward. These injuries usually take longer to heal than common outer ankle sprains and sometimes need different treatment.

Cartilage or tendon injury

OrthoInfo lists cartilage injuries and tendon ruptures among the injuries that can occur alongside a sprain and extend healing time. Ongoing deep ankle pain, catching, locking or swelling after activity can point to a cartilage problem. Pain along the back of the outer ankle can suggest a tendon injury.

Doing too much, or too little

Returning to sport too soon can re-injure healing ligaments. On the other hand, keeping the ankle completely still for too long leads to stiffness and weakness. Both can stall recovery.

When do you need an X-ray or MRI?

Diagnosis is mainly based on how the injury happened and a physical exam. Clinicians often use a validated checklist called the Ottawa ankle rules to decide whether an X-ray is needed, based on whether you can bear weight and whether specific spots on the ankle and foot bones are tender. According to OrthoInfo:

  • X-rays rule out a fracture.
  • Stress X-rays can show whether ligament damage is making the joint unstable.
  • MRI is not routinely required but can assess ligaments, cartilage and tendons, look for a high ankle sprain, or investigate symptoms lasting beyond six to eight weeks.

OrthoInfo also notes that pain lasting more than four to six weeks may indicate a chronic sprain, and symptoms persisting beyond six to eight weeks warrant further evaluation.

Rehab basics: how to get back on track

OrthoInfo describes rehab in three overlapping phases. A physiotherapist can tailor these to your injury, and the NHS notes that physiotherapy may help if recovery is slower than expected.

  1. Protect and settle (first days): rest, ice wrapped in a cloth, compression and elevation, with weight bearing as tolerated. Moderate sprains may use a removable brace or boot. The NHS advises avoiding heat, alcohol and massage for the first couple of days.
  2. Restore movement and strength: gentle range of motion exercises (such as tracing the alphabet with your toes), calf raises, resisted ankle movements with a band, and early balance work such as standing on the injured leg next to a counter.
  3. Return to activity: harder balance challenges, hopping, then straight-line jogging before twisting and cutting sports. Taping or a brace may help in the early return.

Balance training deserves special attention, because impaired balance is one of the risk factors for repeat sprains. Our article on longevity exercises includes simple balance moves that also help long term. Tools for sore surrounding muscles can make you more comfortable, but they do not replace rehab: see our review of whether massage guns are worth it before using one, and avoid the injured ligament itself. For general aches, our guide to options for muscle pain relief covers what the evidence supports.

For pain, a pharmacist can advise on simple pain relievers or anti-inflammatory gels that suit you, especially if you have other health conditions or take other medicines.

Frequently asked questions

Is it normal for a sprained ankle to still be swollen after two weeks?

Some swelling, especially by the end of the day, can be normal after a moderate or severe sprain at two weeks. What should not happen is swelling that is increasing, a hot red ankle, or no improvement at all. If swelling is not settling, or you still struggle to walk, ask a doctor or physiotherapist to examine it.

Can you walk on a sprained ankle that is not fully healed?

Usually yes, within comfort. Early, gradual weight bearing is part of standard rehab for most sprains, and total rest for too long causes stiffness and weakness. Use a brace if advised, and stop if walking causes sharp or worsening pain. If you cannot take more than a few steps, get the ankle checked.

What happens if a sprained ankle is never properly rehabbed?

Without rehab, the ankle may stay weak and unstable. OrthoInfo identifies incomplete rehabilitation as the most common cause of chronic ankle instability, and repeated sprains can lead to ongoing pain and damage to cartilage and bone over time. Completing balance and strength exercises, even after pain fades, lowers the chance of this happening.

This article is for general information and is not medical advice.

Last reviewed: October 2026.

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