Mild to severe swelling and bruising can accompany a sprain to the ankle. Bruising usually indicates tearing of ligament tissue and a more severe sprain. Update Date: 05/05/2008Andrew L. Chen, MD, MS, Orthopedic Surgery and Sports Medicine, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.