An ankle sprain is one of the most common musculoskeletal and sports injuries. It typically occurs when the ankle is forced beyond its normal range, stretching or tearing one or more of the ligaments that help stabilise the joint.
Although many ankle sprains improve well, inadequate rehabilitation can leave ongoing pain, weakness, reduced balance or a feeling that the ankle is unstable. At YOS Health London Bridge, physiotherapy rehabilitation focuses on restoring movement, strength, balance and confidence before a gradual return to normal activity or sport.
What is an Ankle Sprain?
An ankle sprain occurs when one or more ligaments around the ankle are stretched beyond their normal capacity. Ligaments are strong bands of connective tissue that help control excessive joint movement.
The most common type is a lateral ankle sprain, which affects ligaments on the outside of the ankle. It often occurs when the foot rolls inwards while the ankle moves into inversion.
Less commonly, an injury can involve the ligaments connecting the lower leg bones above the ankle. This is often referred to as a high ankle sprain or syndesmotic injury and can require a different rehabilitation approach.
What Causes an Ankle Sprain?
Ankle sprains can happen during everyday activities or sport. Common situations include:
- Landing awkwardly after a jump
- Rolling the ankle while running
- Sudden changes of direction
- Stepping onto an uneven surface
- Contact or collision during sport
- Tripping or losing balance
- Returning to sport without adequate ankle conditioning
A previous ankle sprain is an important risk factor for another injury. Persistent weakness, reduced balance or incomplete rehabilitation can affect how well the ankle responds to unexpected movements.
Ankle Sprain Symptoms
Symptoms vary according to the severity and structures involved. Common symptoms include:
- Pain around the ankle, particularly after a twisting injury
- Swelling
- Bruising
- Tenderness around the injured ligament
- Difficulty putting weight through the foot
- Reduced ankle movement
- Weakness or reduced confidence
- A feeling that the ankle may give way
More severe sprains may cause substantial swelling, bruising and difficulty walking. Similar symptoms can also occur with fractures and other injuries, so significant or persistent symptoms should be assessed appropriately.
How Severe is an Ankle Sprain?
Ankle sprains are often described according to the extent of ligament injury:
Grade 1
A mild sprain generally involves stretching or minor damage to ligament fibres. There may be local tenderness and swelling, but walking is often possible.
Grade 2
A moderate sprain involves greater ligament damage and may cause more pain, swelling, bruising and difficulty walking.
Grade 3
A severe sprain involves substantial or complete ligament disruption. The ankle may be significantly swollen or unstable and weight-bearing can be difficult.
These grades are useful descriptions, but recovery should be guided by symptoms and functional progress rather than a grade alone.
When Should an Ankle Sprain Be Assessed?
Medical or physiotherapy assessment is particularly important if you cannot comfortably bear weight, there is marked swelling or deformity, pain is severe, symptoms are not improving, or there is concern about a fracture or significant ligament injury.
Following an acute ankle injury, a clinician may use the history and physical examination to determine whether further investigation is appropriate.
Ankle Sprain Recovery Timeline
Recovery varies according to the severity of the sprain, the structures involved, previous ankle problems and the demands placed on the ankle.
Early Stage: First Few Days
The initial focus is on protecting the ankle from excessive aggravation while maintaining comfortable movement where appropriate. Swelling and pain may be more prominent during this period.
Depending on the injury, you may be advised to use support such as a brace or temporary reduction in weight-bearing activity.
Early Rehabilitation: First 1–2 Weeks
As symptoms allow, rehabilitation can begin to restore ankle movement, walking ability and basic muscle activation. Gentle range-of-motion exercises and progressive weight-bearing can be introduced where appropriate.
Strength and Balance Phase
Once basic movement is improving, the focus progresses towards calf, ankle and lower-limb strengthening and balance. Single-leg control becomes particularly important for people returning to running and sport.
Running and Impact Phase
For active people, rehabilitation eventually needs to introduce impact, hopping, running and changes of direction. These should be progressed gradually according to capacity.
Return-to-Sport Phase
The final stage involves exposing the ankle to the specific demands of the person's sport, including acceleration, deceleration, jumping, landing and changes of direction where relevant.
Physiotherapy Treatment for an Ankle Sprain
1. Pain and Swelling Management
Early treatment may focus on managing pain and swelling while maintaining appropriate movement and activity. Your physiotherapist can advise on weight-bearing, support and activity modification according to the injury.
2. Restoring Ankle Movement
Ankle stiffness is common after a sprain. Rehabilitation may include controlled ankle movements and exercises designed to gradually restore the range needed for walking, squatting, running and sport.
3. Progressive Strengthening
The calf, ankle and surrounding lower-limb muscles need to regain strength after injury. Exercises are progressively loaded according to symptoms and functional goals.
4. Balance and Proprioception
Balance exercises challenge the ankle's ability to respond to changes in position. This is particularly important after a lateral ankle sprain and can help prepare the ankle for uneven surfaces and sporting movements.
5. Movement and Technique Assessment
Your physiotherapist may assess single-leg control, lower-limb movement and the way you absorb and produce force. This can identify areas that may need attention before returning to higher-level activity.
6. Return-to-Sport Rehabilitation
Sport-specific rehabilitation progressively introduces the movements and intensity required for your activity rather than moving directly from basic exercises to full competition.
Ankle Sprain Rehabilitation Exercises
The appropriate exercises depend on the stage of recovery. Common rehabilitation exercises may include:
Ankle Range-of-Motion Exercises
Gentle ankle movements can help restore mobility after injury. The range should be comfortable and progressed gradually.
Calf Raises
Calf raises strengthen the muscles responsible for pushing off the ground. They can progress from double-leg to single-leg exercises and then to more demanding variations.
Resistance-Band Exercises
Resistance-band exercises can target ankle inversion, eversion, dorsiflexion and plantarflexion. They provide a controlled way to rebuild ankle strength.
Single-Leg Balance
Standing on one leg challenges balance and ankle control. Difficulty can be progressed by changing the surface or adding controlled movement when appropriate.
Step-Ups
Step-ups introduce functional weight-bearing and can help rebuild lower-limb strength and confidence.
Hopping and Landing Drills
Later-stage rehabilitation may include hopping, landing and repeated impact exercises. These should be introduced only when the ankle has sufficient strength and control.
Running and Agility Drills
For athletes, running, acceleration, deceleration and changes of direction should be progressively introduced before returning to full training.
Exercise progression should be individualised. An exercise that is appropriate later in recovery may be too demanding during the early stages of a significant sprain.
How Long Does an Ankle Sprain Take to Heal?
There is no universal recovery time. Many uncomplicated ankle sprains improve substantially within the first few weeks, but complete recovery can take longer depending on the severity of the injury and the demands placed on the ankle.
Being able to walk without significant pain does not necessarily mean the ankle is ready for running, jumping or competitive sport. Strength, balance and impact tolerance may continue to require rehabilitation after everyday symptoms have improved.
Returning to Running After an Ankle Sprain
Running should be reintroduced once the ankle has adequate movement, strength and functional tolerance. A gradual progression may include:
- Comfortable walking and daily activity
- Calf and ankle strengthening
- Single-leg balance and control
- Low-level hopping and impact
- Easy jogging
- Progressive running volume
- Faster running and acceleration
- Changes of direction and sport-specific drills
The response of the ankle during activity and over the following day should be considered when progressing training.
Returning to Sport After an Ankle Sprain
A safe return to sport involves more than being pain-free. Depending on the sport, the ankle may need to tolerate repeated jumping, landing, sprinting, cutting and contact.
Before full return, useful functional markers can include:
- Near-normal ankle movement
- Good single-leg balance and control
- Restored calf and ankle strength
- Ability to hop and land confidently
- Ability to run and change direction without significant symptoms
- Completion of sport-specific drills
- Confidence in the injured ankle
Can an Ankle Sprain Cause Long-Term Problems?
Most ankle sprains recover well, but some people develop persistent symptoms. These can include recurrent sprains, chronic ankle instability, ongoing pain, stiffness or reduced confidence.
Incomplete rehabilitation can contribute to ongoing functional deficits. This is why restoring strength and balance can be important even after pain and swelling have improved.
How Can Future Ankle Sprains Be Prevented?
- Complete rehabilitation after an ankle injury rather than returning as soon as pain settles
- Maintain ankle and calf strength
- Include balance and single-leg control exercises
- Progressively expose the ankle to running, jumping and changes of direction
- Use appropriate sport-specific conditioning
- Pay attention to recurring feelings of instability
- Consider appropriate external ankle support when advised for higher-risk activities
When Should You See a Physiotherapist?
Consider physiotherapy if ankle pain or stiffness persists, you are struggling to return to running or sport, the ankle repeatedly gives way, or you are unsure how to progress rehabilitation after a sprain.
A physiotherapy assessment can help identify remaining deficits in movement, strength, balance and load tolerance and provide a structured plan for recovery.
Why Choose YOS Health London Bridge?
At YOS Health London Bridge, physiotherapy for ankle and sports injuries can combine clinical assessment, strength testing, movement analysis and progressive rehabilitation.
Your programme can be tailored to your everyday activities, running requirements or sporting demands. Rehabilitation may include mobility work, strengthening, balance training, movement retraining and a structured return-to-sport progression.
The aim is to restore the ankle's capacity and confidence so you can return to the activities that matter to you.
A personalised assessment can help determine your current stage of recovery and establish the right progression towards normal activity, running or sport.
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Frequently Asked Questions
How long does an ankle sprain take to recover?
Recovery depends on the severity of the sprain and the individual's activity demands. Many uncomplicated sprains improve considerably within a few weeks, but strength, balance and sport-specific recovery can take longer.
Should I walk on a sprained ankle?
Weight-bearing depends on the severity of the injury. For many sprains, progressive weight-bearing is part of rehabilitation, but significant pain or inability to bear weight should be assessed by a healthcare professional.
When can I run after an ankle sprain?
Running should usually be introduced once walking, ankle movement, strength and basic single-leg control have sufficiently recovered. Running volume and speed should then be increased progressively.
Why does my ankle still feel unstable after a sprain?
Persistent instability can be associated with reduced strength, balance or proprioception following an injury. A structured rehabilitation programme can assess and address these factors.
Do ankle sprains need physiotherapy?
Not every mild sprain requires formal physiotherapy, but assessment can be particularly useful for more significant injuries, persistent symptoms, recurrent sprains or people who need to return to running and sport.
Can I prevent another ankle sprain?
Risk cannot be eliminated completely, but maintaining strength, balance and sport-specific ankle capacity and completing rehabilitation after an injury can help reduce the risk of recurrence.