If you have a child who plays competitive sports, you’ve likely faced an ankle injury at some point. The moment it happens, the questions start racing through your mind:
- Should we go to urgent care or the emergency room?
- Does my child need an X-ray?
- Can we wait until tomorrow to get it checked out?
Fortunately, there’s a trusted set of guidelines called The Ottawa Ankle Rules that help doctors (and parents) decide when an X-ray is necessary.
When to Get an Ankle X-ray
According to The Ottawa Ankle Rules, your child should get an ankle x-ray if they have any of these symptoms after a sports injury:
- Bone tenderness over the bony bump on either side of the ankle (especially toward the back).
- Inability to put weight on the injured ankle for at least four steps.
- Bone tenderness along the inner or outer edge of the mid-foot (where the foot is widest).
These signs can indicate a fracture, and an X-ray can help confirm the diagnosis so treatment can begin quickly.
Many ankle sprains cause swelling and bruising, but these symptoms alone don’t always require an urgent X-ray.
However, seek immediate medical care if your child has:
- Numbness or tingling in the foot.
- Severe, worsening pain.
- A visibly deformed ankle or foot.
- Any other symptoms that make you concerned.
If none of these red flags are present, it’s often safe to wait until the next business day to see your primary care provider or a CHKD sports medicine physician.
How to Care for a Sprained Ankle at Home
While waiting for your appointment, you can help your child recover and manage pain by:
- Icing the ankle for 15–20 minutes every few hours.
- Elevating the foot above heart level to reduce swelling.
When in Doubt, Call CHKD’s Sports Injury Hotline
Even with expert guidelines, nothing replaces your instincts as a parent. If you feel something isn’t right — or if you simply want peace of mind — call CHKD’s Sports Injury Hotline for a same-day or next-day appointment in most cases. The phone line is available by calling (757) 668-PLAY (7529), Monday-Friday, 7:30 a.m. to 10 p.m.
For severe injuries or if your child can’t walk at all, the CHKD Emergency Department is open 24/7.
With the right information, you can make a confident decision about whether your child’s sports injury needs an X-ray or simply some rest and recovery time.
