Ankle sprain: how to recover well and stop it happening again

Rolling or twisting your ankle, stepping off a kerb, on a stair or during sport, is one of the most common injuries there is. Most sprains heal well. But many people sprain the same ankle again, often because the strength and balance lost after the first sprain were never rebuilt.

Does it need an X-ray?

See a doctor or go to an emergency department if:

• you could not put any weight on it straight after the injury, or cannot take four steps now

• there is tenderness right on the bony knobs on either side of the ankle, or on the bones of the midfoot

• the ankle or foot looks deformed

• the foot is numb, cold or pale

• pain and swelling are severe or getting worse after a few days

These can be signs of a fracture or a more serious injury.

The first few days

• Protect it: avoid what clearly makes it much worse. Crutches can help if walking is very painful.

• Ice: 15 to 20 minutes at a time, a few times a day, with a cloth between ice and skin.

• Elevate: rest it above the level of your heart when you can, to reduce swelling.

• Compression with a bandage may help with swelling, as long as it is not too tight.

• Move gently: start moving the ankle and walking as soon as pain allows. Gentle early movement generally helps more than keeping it still.

Rehabilitation

As the pain settles, the focus moves to rebuilding the ankle:

1. Range of motion: drawing the alphabet with your toes, pointing and flexing the foot.

2. Strength: heel raises, then with resistance bands, then on one leg.

3. Balance: standing on the injured leg, first holding on, then without support, then with eyes closed or on a cushion.

4. Return to activity: walking, then jogging, then hopping and changing direction for sport.

Balance training is the part people most often skip, and it matters most for preventing another sprain.

How physiotherapy helps

A physiotherapist will check how badly the ligaments are injured, rule out signs that need an X-ray, and guide you through the stages above at the right pace. They can also help if your ankle stays stiff, swollen or unstable for weeks, or if you have sprained it more than once.

Preventing another sprain

• keep doing balance exercises for a few months after you feel better

• warm up before sport

• wear supportive footwear for your activity

• consider taping or a brace for sport while returning, if your physiotherapist advises

Find a physiotherapist near you

Search for physiotherapists who treat sports injuries on PhysioDesk Reach and contact them directly.

This article is general information, not medical advice.