Ankle Sprain
Rolled or twisted your ankle? Learn what an ankle sprain is, how it's diagnosed, and how physiotherapy helps you recover faster while reducing the risk of future sprains.
An ankle sprain occurs when one or more ankle ligaments are stretched or torn, most commonly after the foot rolls inward. Most ankle sprains heal well with appropriate rehabilitation, but incomplete recovery can increase the risk of chronic ankle instability.
QUICK OVERVIEW
Ankle Sprain at a Glance
COMMON SIGNS & SYMPTOMS
Is This What You're Feeling?
Pain Around the Ankle
Pain usually occurs on the outside of the ankle after twisting.
Swelling
Swelling often develops rapidly after injury.
Bruising
Bruising may appear over the following days.
Difficulty Walking
Walking may be painful, especially immediately after injury.
Tenderness
The injured ligament is painful to touch.
Feeling of Instability
The ankle may feel weak or likely to "give way."
Reduced Range of Motion
Stiffness or pain when moving the ankle.
Difficulty Running or Jumping
Sports and higher-level activities are often limited until rehabilitation is complete.
COMMON CAUSES
Why Does It Happen?
Inversion Injury
The most common mechanism is the foot rolling inward, overstretching the lateral ankle ligaments.
Sports Injuries
Football, basketball, volleyball, badminton, tennis, and trail running commonly involve ankle sprains.
Uneven Ground
Walking or running on uneven surfaces increases risk.
Landing Awkwardly
Jumping and landing with poor foot position.
Previous Ankle Sprain
A previous sprain significantly increases the risk of another injury if rehabilitation is incomplete.
Poor Balance
Reduced proprioception contributes to recurrent sprains.
RISK FACTORS
Who Is Most at Risk?
Athletes
Particularly those involved in jumping and pivoting sports.
Runners
Especially trail runners and those on uneven terrain.
Dancers and Gymnasts
Frequent jumping and landing increase ankle loading.
Individuals with Previous Ankle Sprains
The strongest predictor of a future ankle sprain.
People with Poor Balance
Reduced neuromuscular control increases injury risk.
Individuals Wearing Inappropriate Footwear
Unsupportive footwear may contribute in some situations.
DIAGNOSIS
How Is It Diagnosed?
Clinical Assessment
Medical History
- How the injury happened
- Ability to bear weight
- Swelling and bruising
- Previous ankle injuries
- Activity level
- Sporting goals
Physical Examination
- Swelling
- Tenderness
- Range of motion
- Walking pattern
- Strength
- Balance
Special Tests & Imaging
Special Tests
- Anterior Drawer Test (ATFL)
- Talar Tilt Test (CFL)
- Syndesmosis squeeze test (if high ankle sprain suspected)
- Functional balance assessment
Diagnosis is based on your history, examination findings, and imaging when appropriate.
Imaging
X-rays may be recommended using the Ottawa Ankle Rules to identify possible fractures. MRI or ultrasound may be considered if symptoms persist, a severe ligament injury is suspected, cartilage or tendon injury is suspected, or surgery is being considered.
SEEKING HELP
When Should You Get Help?
Self-Management
Usually appropriate if:
- Mild pain
- Minimal swelling
- Able to walk comfortably
- Symptoms improve over several days
Book a Physiotherapy Assessment
Recommended if:
- Significant swelling
- Difficulty walking
- Recurrent ankle sprains
- Ongoing instability
- Pain lasting longer than one to two weeks
- Returning to sport
Seek Immediate Medical Attention
Seek urgent assessment if you experience:
- Inability to bear weight immediately after injury
- Severe deformity
- Significant numbness
- Open wounds
- Severe pain over the bones of the ankle or foot
- Suspected fracture or dislocation
TREATMENT OPTIONS
Treatment Options
Education
Understanding the injury and expected healing process helps guide recovery.
PEACE & LOVE Approach
Modern management emphasizes Protection, Elevation, Avoid anti-inflammatories early, Compression, Education, followed by Load, Optimism, Vascularisation, and Exercise.
Exercise Therapy
Progressive strengthening, balance training, and functional rehabilitation are first-line treatments.
Bracing or Taping
May provide short-term support during early rehabilitation or return to sport.
Medication
Pain-relieving medication may be appropriate under medical supervision.
Surgery
Surgery is uncommon and generally reserved for chronic ankle instability that does not improve with rehabilitation, certain severe ligament injuries, or associated fractures/cartilage injuries.
PHYSIOTHERAPY
How Physiotherapy Helps
Physiotherapy helps restore normal ankle function while reducing the risk of future sprains.
Treatment may include:
- Swelling management
- Mobility exercises
- Strengthening
- Balance training
- Proprioception exercises
- Walking retraining
- Running progression
- Jump training
- Sport-specific rehabilitation
- Return-to-sport testing
RECOVERY JOURNEY
Recovery Timeline
Recovery should be guided by function, strength, and stability — not just time since injury.
EXERCISE LIBRARY
Recommended Exercises
Ankle Alphabet
EasyTarget: Mobility
Repetitions: 1–2 rounds
Calf Raises
Easy to ModerateTarget: Calf strength
Repetitions: 10–15 × 3 sets
Resistance Band Ankle Eversion
ModerateTarget: Peroneal muscles
Repetitions: 10–15 × 3 sets
Single-Leg Balance
ModerateTarget: Proprioception
Hold: 30 seconds × 3 repetitions
Single-Leg Heel Raise
ModerateTarget: Calf endurance
Repetitions: 10–15 × 3 sets
Hop and Land Progression
AdvancedTarget: Dynamic stability and return to sport
Repetitions: Individualized
LONG-TERM HEALTH
Prevention Tips
Complete Your Rehabilitation
The strongest protection against recurrent ankle sprains is completing a full rehabilitation programme.
Improve Balance
Regular balance exercises significantly reduce the risk of recurrent ankle injuries.
Strengthen the Lower Leg
Strong calf and peroneal muscles improve ankle stability.
Warm Up Before Sport
Perform a structured warm-up before training or competition.
Use Appropriate Footwear
Wear activity-specific footwear that fits well and provides adequate support.
Consider Bracing During Return to Sport
Some athletes benefit from ankle bracing or taping during the initial return to high-risk sports.
EXPLORE MORE
Related Conditions
Foot & Ankle Pain
Achilles Tendinopathy
Peroneal Tendinopathy
High Ankle Sprain (Syndesmotic Injury)
Chronic Ankle Instability
Ankle Fracture
Plantar Fasciitis
Posterior Tibial Tendinopathy
Stress Fractures of the Foot
Post-Surgical Rehabilitation
LEARN MORE
Related Resources
Get Back on Your Feet with Confidence
A sprained ankle may seem like a minor injury, but incomplete rehabilitation is one of the leading causes of recurrent ankle sprains and chronic instability. A physiotherapy assessment can identify the severity of your injury and guide you through a personalised rehabilitation programme to restore strength, balance, and confidence while helping you return safely to work, sport, and everyday activities.
Book Your Ankle Assessment TodayMost ankle sprains heal well with progressive rehabilitation and balance training.