Rehab Library · Hips, knees & feet
Ankle Sprain Rehab Guide
A general guide from the first few days after a sprain through to balance, strength and getting back to sport. Use it alongside the advice from your treating practitioner.
← Back to Rehab LibraryAbout ankle sprains
Understanding ankle sprains
An ankle sprain happens when the ligaments that support the ankle are stretched or torn, most often when the foot rolls inwards. Swelling, bruising and pain are common in the first few days.
Most ankle sprains improve well over a few weeks with early, gradual movement and balance training. Ankles that aren't fully rehabilitated are more likely to be sprained again, so the later phases are just as important as the first.
What usually helps
• Protecting the ankle for the first few days, then getting it moving as soon as you comfortably can.
• Walking on it as pain allows, rather than staying off it completely.
• Raising it to help with swelling early on.
• Balance training, which can help reduce the chance of another sprain.
• A brace or tape when returning to sport, if your practitioner recommends it.
Before you start
This guide is general information. If you couldn't walk four steps straight after the injury, or you have tenderness over the ankle bones, have it checked by a doctor, as an X-ray may be needed. Follow the specific program your practitioner gives you.
A simple pain guide
Some discomfort during exercise is common as your ankle heals. As a general guide, keep pain at or below about 3 out of 10 during exercise, and pain and swelling should settle back to your usual level by the next morning.
If they don't, ease back and let your practitioner know.
Phase 1
The first few days
Early on, the aim is to calm the swelling and keep your ankle gently moving. Little and often, a few times a day.
1
Raise and rest
15–20 minutes, several times a day
Lie down with your ankle raised on pillows, above the level of your heart, to help reduce swelling. A cold pack wrapped in a cloth for 10–15 minutes may also feel soothing.
2
Ankle pumps
20 repetitions, a few times a day
Sitting or lying down, slowly point your foot down and then pull it back up towards you, within a comfortable range.
3
Ankle alphabet
Once or twice through
With your foot raised, slowly “draw” the letters of the alphabet in the air with your big toe.
4
Walk as comfort allows
Through the day
Start putting weight through your foot and walking short distances as soon as you comfortably can, in supportive shoes. Crutches may help for the first day or two if needed.
Phase 2
Build strength and balance
As walking becomes more comfortable, the focus moves to strength and balance. These can be done most days.
1
Band ankle movements
3 sets of 10–15 each direction
Sit with your leg straight and a resistance band around your foot. Slowly push your foot down, then out to the side and in, against the band.
2
Calf raises
3 sets of 12
Holding onto a bench, rise onto your toes on both feet, then lower slowly. Progress to one foot as it gets easier.
3
Single-leg balance
3 holds of 30 seconds each side
Stand on your injured leg near a bench for support and hold your balance. As it gets easier, try with your eyes closed, or standing on a cushion.
4
Calf stretch
3 holds of 30 seconds
Stand facing a wall with your injured leg behind you, heel down and knee straight. Lean forward until you feel a stretch in your calf.
Phase 3
Return to sport and activity
The final stage prepares your ankle for quicker, more demanding movements, so you can get back to sport and activity with confidence.
1
Balance and reach
3 sets of 8 each side
Balance on one leg and slowly reach your other foot forwards, out to the side and behind you, then return.
2
Hopping
3 sets of 10
Once you can balance and do calf raises on one leg comfortably, practise small hops on both feet, then on your injured leg, landing softly.
3
Side-to-side steps
3 sets of 30 seconds
Step or shuffle side to side, then progress to quicker changes of direction as your confidence grows.
4
Return to sport
Build up over a few weeks
Gradually return to running, jumping and sport-specific drills before going back to full training and games.
Everyday tips
• Wear supportive, well-fitting shoes while it heals.
• Take care on uneven ground, and avoid high heels for the first few weeks.
• Keep up your balance exercises even after the pain settles.
• Consider a brace or tape for sport in the first few months, as your practitioner advises.
• Build up running and sport gradually.
When to seek prompt medical review
• You couldn't take four steps straight after the injury, or still can't. See a doctor, as an X-ray may be needed.
• Tenderness on the bony bumps of the ankle, or along the outer edge of the foot.
• Your ankle or foot looks deformed, or feels cold, pale or numb.
• Calf pain, swelling or redness. Seek urgent medical care.
• Pain and swelling that are getting worse after a few days, rather than better.
• Fever, or the ankle becomes hot and red without an injury.
This resource is general information only and is not a substitute for individual assessment and advice. Prepared by Dr Emma Cormack (Chiropractor), Vital Chiropractic, Mona Vale.
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