By: Tim James, PT, DPT, ATC, CHKD Sports Medicine
If you have a competitive teenager involved in multiple sports, they’ve probably experienced some sort of ankle injury at one point. Like many parents, you may have wondered: “Should we go to urgent care or the emergency room? Do we need to get X-rays, or should we wait it out?”
Thankfully, there is a well-established list of criteria, the Ottawa ankle rules, to help providers determine whether your child needs an X-ray. You can use this list to help guide your decision-making:
It’s time to get an X-ray if your child has any of the following symptoms:
- Tenderness over the bony prominence on either side of the ankle, particularly if it’s in the back.
- Inability to bear any weight for four steps (limping counts as weight-bearing).
- Tenderness over the outer or inner edge of the foot (where the foot is widest).
Excessive swelling or bruising is a common occurrence after an ankle sprain, but this alone does not warrant an X-ray or immediate medical attention. Numbness, tingling, severe pain, or any other concerning complaint requires more immediate evaluation. Otherwise, it’s likely okay to wait a couple days to schedule an appointment with your healthcare provider or a CHKD sports medicine physician. In the meantime, you can address the pain by icing and elevating the ankle.
Finally, it’s important to play it safe. As a parent, you can always use your own judgment as to when it’s time to be seen by a medical professional. If something is making you nervous, you should go get it checked out. A CHKD urgent care center or our emergency department can help if the injury happens outside normal business hours.
Appointments with our CHKD sports medicine physicians are available during normal business hours, Monday through Friday. Schedule an appointment by calling (757) 668-PLAY.
About CHKD Sports Medicine

CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in
physical therapy and
injury prevention programs for active children and teens. Our team is composed of
pediatric orthopedic surgeons,
sports medicine specialists, physician assistants,
certified athletic trainers and
pediatric sports medicine physical therapists.