A bad step off a kerb, a jump on the padel court or a misstep on the pitch: that is how most ankle sprains start. It is the most common sports injury and, although it is often played down, poor recovery is the main reason it happens again.
What an ankle sprain is
A sprain is an injury to the ligaments that stabilise a joint. In the ankle the most common mechanism is inversion: the foot rolls inwards and the ligaments on the outside are damaged, especially the anterior talofibular ligament.
Sprains are graded by severity:
- Grade I: the ligament is stretched, with mild pain and swelling.
- Grade II: partial tear, with obvious swelling and bruising and difficulty bearing weight.
- Grade III: complete tear, with major swelling and instability.
What to do in the first 48 hours
- Protect the ankle and avoid activities that cause sharp pain.
- Elevate the foot above heart level whenever you can.
- Compress with an elastic bandage that is not too tight.
- Bear weight as soon as pain allows. We now know that complete immobilisation slows recovery in most sprains.
- Ice can ease pain, applied for 10 to 15 minutes with a cloth between the ice and the skin.
Go to A&E if you cannot take four steps in a row, if there is very sharp pain when pressing on the bone or if the foot looks deformed, as there may be a fracture.
Recovery: beyond the pain going away
The most common mistake is to consider the sprain healed once the pain goes. Ligaments take weeks to regain their strength and the injury also disrupts proprioception: the ankle’s ability to “know” where it is and react in time.
A good physiotherapy programme includes:
- Restoring mobility, especially ankle dorsiflexion.
- Strengthening the peroneal muscles, the calf and the foot muscles.
- Balance and proprioception exercises, from easier to harder.
- Sport-specific work: jumps, changes of direction and running.
Balance exercises you can start at home
- Stand on the injured leg for 30 seconds, first with support and then without.
- Repeat with your eyes closed once you have good control.
- Progress to unstable surfaces such as a cushion and add arm movements or ball throws.
How long does an ankle sprain take to heal?
A mild sprain may allow a return to activity in two to three weeks; a moderate one in four to six; and a severe one may need three months or more. More important than the calendar is passing strength and balance tests before returning to competition.
How to stop it happening again
Up to a third of people who sprain their ankle end up with ongoing discomfort or repeat sprains. Keeping up balance exercises two or three times a week after discharge is one of the most effective ways to prevent it. If you play sport, also check our injury prevention tips.
Ankle sprain rehabilitation in Gines
If you have rolled your ankle or feel it often “gives way”, we help you recover fully and return to your sport safely. At Therapeía Fisioterapia we see patients at Avenida de Europa 3G in Gines (Seville), just minutes from Bormujos, Espartinas, Castilleja de la Cuesta, Valencina and the rest of the Aljarafe area. After a full assessment we design a sports physiotherapy plan tailored to you. You can meet our physiotherapy team or book an appointment by calling +34 624 244 420.
For more information from a reliable source, see MedlinePlus, the U.S. National Library of Medicine health encyclopedia, on sprains and strains.
Frequently asked questions about ankle sprains
Is ice or heat better for an ankle sprain?
In the first few days ice helps control pain. Heat is better for later stages, once swelling has gone down.
Should an ankle sprain be immobilised?
In most mild and moderate sprains, no. Gradual weight-bearing and early movement speed up recovery. Severe sprains may need a brace for a few days.
Why do I keep rolling my ankle?
It is usually due to a previous sprain that did not fully recover, leaving weakness and poor proprioception. It can be corrected with a specific strength and balance programme.
