Ankle Sprains

This page has been designed to provide you with the right information about ankle sprains and how to manage them from a physiotherapy point of view.

What is an ankle sprain?

An ankle sprain is an injury that can happen when your ankle is forced into a position that puts stress and strain through the ligaments (as well as other structures), to the point that they are upset.

How would you sprain an ankle?

The most common way to sprain an ankle is by ‘turning or rolling’ your ankle. This normally happens whilst walking or running, as your foot goes underneath yourself and your body weight pushes down on the ankle/foot, causing the injury.

What are the symptoms of an ankle sprain?

This is a really important question and it is useful for you to know what is normal after spraining your ankle as it can sometimes be a worrying time. We’ve broken the answer down into things that are found most common:

First and foremost, ankle sprains can be really sore. As you might expect, the discomfort you get from an ankle sprain can be different from person to person. Sometimes they can be very sore and sometimes they may only hurt a little. It is very normal for your ankle to be sore after a sprain and it is just as normal for that soreness to still be there for a while afterwards (maybe into a few weeks afterwards).

After an ankle sprain, it is very likely your ankle will swell. This is your body’s way of starting the healing process. The swelling helps to ‘stiffen’ your ankle temporarily and helps keep all of the ‘healing cells’ where they need to be to help your ankle recover. Interestingly, you might find the swelling lasts for a long time and it may even still be there when the pain has settled and you are feeling better, but this doesn’t necessarily mean anything is wrong, it is just what seems to happen.

Whilst your ankle is sore and swollen, you can expect to find that moving your ankle will be difficult. Again, this is normal and will actually help the early stages of your healing. It is important to get your ankle moving as soon as you feel that you can, as this will make sure your recovery is started nice and early.

For all the reasons listed in the other sections, walking after an ankle sprain can be difficult. It may be sore to use your foot or you may feel worried about taking weight through it but as things settle, it is likely that this will ease and return to what is normal for you.

After any type of injury, including ankle sprains, it is important to recognise that sometimes there can be an emotional part to the injury and your recovery. After an ankle sprain, you might not feel confident to use your foot or may feel that it will let you down or that you might injure it again. By accepting that this might be something worth working on as part of your rehabilitation, you might find that you get a better overall outcome.

Are there different types of ankle sprains?

Yes, there are.

Ankle sprains can be graded dependent on their severity and the symptoms you may get.

Grade 1: Mild - Little swelling and tenderness with minimal impact on function. Minimal, if any, bruising.

Grade 2: Moderate – Moderate swelling, pain and some difficulties with normal function (like walking). Bruising may be present and may extend down to the toes.

Grade 3: Severe – Complete rupture, large swelling, lots of tenderness and very limited function. Bruising very likely.

You mentioned ligaments - what are they?

This is a good question and it’s important to know.

A ligament is a structure that you find around joints that gives joint support and helps with stability. They are naturally quite flexible to allow normal movement of the joint. They can get upset if they are stretched too far and this is what often happens with an ankle sprain.

Does it matter which type of sprain I’ve got?

No, not really. Most ankle sprains will be either a grade 1 or 2, but regardless of that, most people will find the advice and exercises laid out on this page are helpful for recovery.

What should I do to help my ankle?

If you have recently upset your ankle, try not to worry.

Follow the new way of managing acute (early) muscle and joint injuries using the POLICE principle.

This means looking after the injured body part by stopping playing or taking some weight off it.

This means working the body part within what is comfortable. This would include walking on it or moving it as much or as far as is comfortable/manageable.

Ice can act as a good distraction and therefore is good as pain relief in the early stages of an injury.

Applying a Tubigrip or bandaging the area may help with the swelling in the early stages. It will also reassure you that the body part feels suitably supported.

Gravity can help with fluid drainage and as such can help with swelling, as long as your heel is above the height of your knee.

Could my ankle be broken?

Your ankle is strong and robust and is not easily damaged. After ‘rolling’ or ‘turning’ your ankle, the most likely thing to happen is that you will sprain the ligaments and therefore it will be a simple ankle sprain. However, it is obviously possible to break your ankle if the force is strong enough or if you have a pre-existing medical issue, like osteoporosis.

If your ankle is significantly swollen, very painful and you simply cannot take any meaningful weight through your foot since the injury and it is not getting better, you may want to discuss this with either your GP, your physio or seek help via A&E.

Can ankle sprains be managed without surgery?

Yes, indeed. Most ankle sprains recover very well with time and some gentle exercises and rarely require surgery.

I’ve been to hospital to get checked and they said “soft tissue injury”, is that the same?

In essence, it is the same thing. The term ‘soft tissue’ is a general term for muscles, ligaments and tendons. An ankle sprain is a soft tissue injury.

I’ve been given crutches and an ankle brace. What do I do with them?

If you have had to seek some help from A&E following your ankle sprain, you may have been given some crutches and an ankle brace to help you for the first few days.

Crutches:

If you need some help with how to use your crutches, please visit our Walking Aids page here: Walking Aids

It is important to take as much weight through your foot as possible, as early as possible, as it will help your recovery. It might be sore but it is the right thing to do.

Brace:

The ankle brace you may have been given is not something that is given out routinely. Your ankle might feel a little better in the brace, however, normal movement is key to helping your ankle calm down, which the brace doesn’t allow for. If you do want to use the brace, use it sparingly and stop using it as soon as you feel you can.

Ok, what can I do to help my ankle get better?

Any type of pain, no matter where it is, is unpleasant and can sometimes become a bit concerning. This page should provide you with information and reassurance that even if it’s rather sore, your ankle is an amazingly strong and robust piece of kit and most ankle sprains are nothing to worry about. Ankle sprains will normally calm down with the right amount of time and a few things to help it along the way.

Your foot is designed to be walked on, therefore, it is important to try and get some weight going through it as soon as you can. It is likely to be sore, but you will not make it worse by using it. In fact, it will help your ankle start to get better more effectively. You may need to take more breaks or choose different shoes to help you succeed in taking weight through your foot comfortably in the first stages, but it is something that improves relatively quickly for most people.

One of the best things for most aches and pains is normal, confident movement. Your ankle will be sore, stiff and swollen after an ankle sprain and it might feel like the last thing you might want to do is to move it, but movement is the best medicine for your ankle. Us physios like to say "motion is lotion!". When you are ready, try moving your ankle as far as you are comfortable as regularly as you can. You will not injure your ankle or upset the healing process by moving it.

We have a selection of exercises to help you get moving at the bottom of this page.

Once you have started to take weight on your foot and are starting to feel the movement coming back, you might want to add some other exercises into your rehabilitation to help you make the best recovery.

Working on the strength and balance of your ankle is normally key to helping you get a good outcome after an ankle sprain. We have a selection of exercises at the bottom of this page to provide you with some ideas.

Is there anything else I can do?

As mentioned previously, ankle sprains can be sore. Some people will choose to manage this pain with pain relief, whereas others may choose to avoid medication. If you need pain relief and either don’t have any or what you have isn’t working, please speak with your GP or pharmacist. Applying something cold to your ankle may also be useful in helping with some of the pain (do remember to wrap your frozen peas in a towel before applying them to your skin to avoid cold burns).

Getting your ankle moving is key to getting a good result after an ankle sprain and helping to reduce any swelling. Some people may find resting their foot on a stool or chair useful to help with the swelling.

As mentioned previously, getting your ankle moving as soon as you can is important to getting a good outcome after your ankle sprain. It is likely to be sore and difficult to move your ankle to begin with, but you will not injure your ankle again by moving it. Anything is better than nothing when it comes to movement and we have provided some ideas for exercises at the bottom of this page.

Just like getting your ankle moving early, getting some weight going through your ankle as soon as you can is again, really important for a good recovery. It is very likely to be sore and difficult to walk to begin with, but it is some of the best medicine for your ankle.

It sometimes takes a bit of time to remember how to walk normally and to trust your ankle again.

If you need to, try these simple tips to help you get walking again.

Don’t overthink it (thinking too much about what you’re ‘meant to do’ will often make you walk stiffly and slightly robotic!).
Try to take the same length steps with each foot (make sure you step past with each foot).
Think ‘heel toe’ (as you step, make sure your heel hits the floor first and your toe comes off last).

Is there anything I should look out for?

As mentioned before, most ankle sprains will get better with time and sometimes some gentle exercises. If your ankle is showing no signs of progress, is still considerably swollen, is still really painful and most importantly, you simply cannot put any weight on it, then you should discuss this with your physio or GP or seek help from A&E, as they may need to exclude a fracture/break.

What exercises should I be doing to start with?

In the earliest stages of your recovery i.e. within the first two weeks, it is recommended that you simply try to gently move the ankle as well as you can and as far as is comfortable. We have provided a selection of suitable exercises below.

Can I do any other type of exercise to help my ankle?

Yes, you can do anything that you like. You may find certain types of exercises easier than others after an ankle sprain, but there are no limitations in what you can do. Often, people find exercises like swimming or cycling easiest to start with.

Frequently asked questions

Q: When can I get back to sport?

A: This will be dictated by your ankle and your sport. Most people will find their ankle feels better after a few weeks. By working on the movement, strength and balance exercises, as well as being patient, you may find that going back to most sports by about 6-8 weeks will be successful (this can be very variable).

Q: My ankle feels tight and a bit strange. Is that normal?

A: It is not unusual to find that your ankle feels strange after a sprain. It is normal to feel tight, stiff or even a bit loose after a sprain, but these things often ease with time and some gentle exercises.

Q: My ankle is still swollen after all this time. Is this normal?

A: Swelling can sometimes be the last thing to ease after injuries. It can sometimes hang around for weeks into months after the injury, however, if you are feeling better, moving better and doing more, it is not something you should be worried about.

Q: I’ve finished with my crutches, what should I do with them?

A: If you have been loaned the crutches from the James Paget University Hospital, you should call the following numbers to arrange for collection:

For patients in Suffolk please call 01502 470360

For patients in Norfolk please call 0300 1000716

If you have been loaned the crutches from East Coast Community Healthcare, you can return these to the physiotherapy clinic. To find out which clinics can accept returns, please call 01493 809977.