Ankle Sprains Are Common — But They Shouldn’t Be Ignored
A rolled ankle is something many people experience at some point in their lives.
It can happen during:
- Sports
- Running
- Hiking
- Walking on uneven surfaces
- Stepping off a curb
- Everyday activities
Many people treat ankle sprains as a minor injury:
“It’s just a sprained ankle. I’ll walk it off.”
While some ankle sprains recover quickly, others can lead to:
- Persistent pain
- Repeated ankle rolling
- Weakness
- Reduced balance
- Loss of confidence during activity
- Chronic ankle instability
The good news?
With the right rehabilitation approach, most people can recover fully and return to the activities they enjoy.
Physiotherapy plays an important role in restoring:
Mobility Strength Balance Coordination Confidence in movement
What Is an Ankle Sprain?
An ankle sprain occurs when the ligaments supporting the ankle are stretched or injured beyond their normal capacity.
Ligaments are strong bands of connective tissue that help stabilize joints.
The ankle relies on several important ligaments, including:
Lateral ankle ligaments (outside of the ankle)
These are the most commonly injured:
- Anterior talofibular ligament (ATFL)
- Calcaneofibular ligament (CFL)
- Posterior talofibular ligament (PTFL)
Most ankle sprains occur when the foot rolls inward, causing an inversion injury.
This places stress on the outside ligaments of the ankle.
How Common Are Ankle Sprains?
Ankle sprains are among the most common musculoskeletal injuries.
They frequently occur in:
- Basketball players
- Soccer players
- Volleyball athletes
- Runners
- Military populations
- Recreational athletes
However, ankle sprains are not limited to athletes.
A simple misstep while walking can create enough force to injure the ankle.
What Happens During an Ankle Sprain?
During an ankle sprain, the tissues around the joint experience excessive stress.
Depending on severity, this may involve:
Grade 1 Sprain
Mild ligament stretching.
Common signs:
- Mild tenderness
- Minimal swelling
- Little loss of function
- Able to walk with discomfort
Grade 2 Sprain
Partial ligament tearing.
Common signs:
- Moderate swelling
- Bruising
- Pain with walking
- Reduced range of motion
- Difficulty with activity
Grade 3 Sprain
Complete ligament tear.
Common signs:
- Significant swelling
- Instability
- Difficulty bearing weight
- Feeling that the ankle may give way
A healthcare professional can help determine severity and appropriate management.
Common Symptoms After an Ankle Sprain
Symptoms may include:
Pain
Often located around:
- Outside of the ankle
- Around the joint line
- Near injured ligaments
Pain may increase with:
- Walking
- Running
- Cutting movements
- Jumping
- Uneven surfaces
Swelling
Swelling is a normal response following injury.
However, excessive swelling can limit:
- Ankle movement
- Muscle activation
- Walking mechanics
Reduced Mobility
Many people experience reduced:
- Ankle dorsiflexion (bringing toes upward)
- Squatting depth
- Walking efficiency
Limited ankle mobility can also affect movement at the:
- Knee
- Hip
- Lower back
Weakness and Instability
After an ankle sprain, the muscles around the ankle may become weaker.
The nervous system may also become less effective at detecting ankle position.
This is called reduced proprioception.
Proprioception is your body’s ability to know where your joints are in space.
Why Some Ankle Sprains Keep Coming Back
A common mistake is stopping rehabilitation once pain improves.
Pain reduction does not always mean the ankle has fully recovered.
After an ankle sprain, many people still have:
- Reduced balance
- Decreased strength
- Poor landing mechanics
- Limited mobility
- Reduced confidence
This can increase the risk of future sprains.
Research suggests that individuals who have experienced one ankle sprain are at a higher risk of recurrent ankle injuries, especially without proper rehabilitation.
Should You Rest After an Ankle Sprain?
Immediately after an injury, some relative rest may be helpful.
However, complete immobilization and avoiding movement for too long may delay recovery.
Modern rehabilitation focuses on:
- Protecting the injury early
- Restoring movement
- Gradually loading the tissues
- Rebuilding strength
A commonly used approach is:
PEACE & LOVE
PEACE (Early Management)
P – Protect
- Avoid activities that significantly worsen symptoms.
E – Elevate
- Help manage swelling.
A – Avoid anti-inflammatory overuse
- Inflammation is part of the healing process.
C – Compress
- Support swelling management.
E – Educate
- Understanding the injury improves recovery.
LOVE (Rehabilitation)
L – Load
- Gradually introduce movement and weight-bearing.
O – Optimism
- Confidence and expectations influence recovery.
V – Vascularisation
- Encourage pain-free cardiovascular activity.
E – Exercise
- Restore strength, mobility, and control.
The Role of Physiotherapy for Ankle Sprains
Physiotherapy focuses on more than reducing pain.
A physiotherapist will assess:
- Ankle range of motion
- Ligament stability
- Strength
- Balance
- Walking mechanics
- Running mechanics
- Lower limb control
Treatment is based on your goals.
For example:
A recreational walker may need improved walking tolerance.
An athlete may need:
- Sprinting
- Cutting
- Jumping
- Sport-specific drills
5 Evidence-Based Exercises for Ankle Sprain Recovery
1. Ankle Range of Motion Circles
Goal:
Restore ankle mobility and reduce stiffness.
How:
- Slowly move the ankle through circles
- Move in both directions
Perform:
2 sets of 10 each direction
2. Calf Raises
Goal:
Improve calf and ankle strength.
How:
- Stand holding support
- Rise onto your toes
- Slowly lower back down
Progression:
- Double-leg → single-leg
Perform:
3 sets of 12 repetitions
3. Single-Leg Balance
Goal:
Improve ankle stability and proprioception.
How:
- Stand on one foot
- Maintain control
- Progress by adding movement or unstable surfaces
Perform:
3 rounds of 30 seconds
4. Resistance Band Ankle Strengthening
Targets:
- Peroneals
- Tibialis anterior
- Calf muscles
Movements:
- Ankle eversion
- Inversion
- Plantarflexion
- Dorsiflexion
Perform:
2–3 sets of 12 repetitions
5. Step-Downs
Goal:
Improve lower limb control.
Targets:
- Ankle stability
- Quadriceps strength
- Hip control
How:
- Slowly lower one foot toward the ground
- Maintain knee alignment
- Control the movement
Perform:
3 sets of 8–10 repetitions
Returning to Sport After an Ankle Sprain
Returning too quickly is one of the biggest reasons ankle sprains recur.
Before returning to sport, you should be able to:
Walk without pain Restore ankle mobility Perform single-leg balance Complete strength exercises Hop and land with control Perform sport-specific movements confidently
A physiotherapist can help create a graded return-to-sport plan.
Do Ankle Braces Prevent Future Sprains?
For some athletes, ankle braces or taping may reduce the risk of recurrent sprains.
However, braces should not replace rehabilitation.
The strongest long-term protection comes from improving:
- Strength
- Balance
- Coordination
- Movement control
When Should You See a Physiotherapist?
Consider physiotherapy if:
- Pain persists after a few days
- Swelling remains significant
- You cannot walk normally
- Your ankle feels unstable
- You repeatedly roll your ankle
- You are unable to return to sport
- You want to prevent future injuries
Early rehabilitation can help prevent chronic ankle problems.
When Should You Seek Medical Assessment?
Seek medical assessment if you experience:
- Inability to take four steps after injury
- Significant bone tenderness
- Severe swelling or deformity
- Numbness or loss of sensation
- Symptoms that are not improving
Common Myths About Ankle Sprains
Myth 1: “If I can walk, it’s not serious.”
Reality:
You can sometimes walk with significant ligament injury.
Function alone does not determine severity.
Myth 2: “Once the pain is gone, I’m healed.”
Reality:
Strength and balance deficits can remain even after pain improves.
Myth 3: “Ankle sprains are unavoidable.”
Reality:
Many recurrent ankle sprains can be reduced with proper strengthening and balance training.
The Compound Rehab Approach to Ankle Sprains
At Compound Rehab, we believe recovery should focus on restoring the entire movement system.
An ankle injury affects more than just the ankle.
We assess:
- Foot mechanics
- Ankle mobility
- Knee control
- Hip strength
- Balance
- Functional movement patterns
Our goal is not only to help your ankle feel better.
Our goal is to help you return stronger, move confidently, and reduce the chance of future injuries.
Key Takeaways
Most ankle sprains recover well with appropriate rehabilitation.
Early movement and progressive exercise are important for recovery.
Strength and balance training reduce the risk of recurring ankle injuries.
Pain improvement does not always mean complete recovery.
Physiotherapy helps restore mobility, stability, and confidence.
References
- Martin RL, et al. Ankle Stability and Movement Coordination Impairments: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health. Journal of Orthopaedic & Sports Physical Therapy.
- Dubois B, Esculier JF. Soft tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine.
- van Rijn RM, et al. What is the clinical course of acute ankle sprains? British Journal of General Practice.
- Gribble PA, et al. Selection criteria for patients with chronic ankle instability. Journal of Athletic Training.
- College of Physiotherapists of Ontario. Evidence-Informed Practice Standard.