Swelling is a physiologic response to the trauma resulting in injury to small blood vessels promoting the bruising that is seen, but also an escape of fluid from the vascular system into the interstitial or soft tissue. The initial phase of healing following the bodies initial management of local bleeding through clotting is an inflammatory phase with introduction of factors and other transmitters promoting migration of cells necessary to promote healing of the tissue. There are many factors that may contribute to the swelling of the area and not all equate to severity of injury. With that said, it would make sense that the greater the injury, the more likely to have greater tissue involvement and the swelling would be worse. When this occurs in a closed compartment of tissue, a concerning secondary condition known as compartment syndrome may occur. For most injuries beyond swelling we consider pain to the area, local deformity, and associated dysfunction of part to grade severity. If there is no noted deformity, the part functions pain free with no appreciated altered movements and, in the case of an ankle's ability to bear weight on the extremity, understand swelling is a physiologic response that will resolve with rest, elevation, and time. If it fails to do so, this may be a greater indicator of injury.