What Is an Ankle Sprain?

An ankle sprain occurs when one or more ligaments around the ankle are stretched beyond their normal capacity and become injured.

The most common type is a lateral ankle sprain, which affects the ligaments on the outside of the ankle. It commonly happens when the foot rolls inward while the ankle moves outward.

An ankle sprain can involve:

• Stretching of the ligament
• Partial tearing of ligament fibres
• More significant ligament tearing
• Swelling and bruising
• Reduced ankle movement
• Pain with weight-bearing
• Reduced strength and balance
• A feeling of ankle instability

The severity of an ankle sprain can vary considerably from one person to another.

Common Causes of Ankle Sprains

Ankle sprains can occur when sudden forces or unexpected movements place more stress on the ankle than the ligaments can tolerate.

Common situations include:

• Landing awkwardly after jumping
• Running on uneven surfaces
• Quickly changing direction during sport
• Stepping off a curb unexpectedly
• Stepping into a hole or uneven surface
• Rolling the ankle while walking or running
• Landing on another person’s foot
• Falling or stumbling
• Sudden twisting of the ankle

Sports such as basketball, soccer, volleyball, tennis, and other activities involving running, jumping, and rapid changes of direction can increase the opportunity for ankle injuries so Ankle Sprain Physiotherapy Newmarket.

Ankle Sprain Symptoms

Symptoms depend on the severity of the injury and the structures involved.

Common symptoms include:

• Ankle pain
• Tenderness around the injured area
• Swelling
• Bruising
• Difficulty walking
• Pain with weight-bearing
• Reduced ankle movement
• Stiffness
• Weakness
• Difficulty running or jumping
• A feeling that the ankle is unstable or “giving way”

Swelling and bruising can develop shortly after the injury, although the amount of swelling does not always indicate the exact severity of the ligament injury.

Where Does an Ankle Sprain Hurt?

The location of pain can provide useful information, but pain location alone cannot confirm the diagnosis.

Pain on the Outside of the Ankle

Pain on the outside of the ankle is common with a lateral ankle sprain involving the outer ankle ligaments.

Pain on the Inside of the Ankle

Pain on the inside of the ankle can involve different structures, including the deltoid ligament, and should be assessed rather than automatically assumed to be a routine ankle sprain.

Pain Above the Ankle

Pain above the ankle can occur with a high ankle sprain, which involves the syndesmotic ligaments between the tibia and fibula.

High ankle sprains can require a different rehabilitation approach and may take longer to recover than some uncomplicated lateral ankle sprains.

Pain at the Back of the Ankle

Pain around the back of the ankle may involve the Achilles tendon or other structures rather than a typical ankle ligament sprain.

The Grades of Ankle Sprains

Ankle sprains are commonly described according to the severity of ligament damage.

Grade 1 Ankle Sprain

A Grade 1 sprain generally involves relatively minor stretching or damage to the ligament.

Possible symptoms include:

• Mild pain
• Mild tenderness
• Limited swelling
• Minimal loss of function
• Little or no instability
• Walking may still be possible

Recovery is generally quicker than with more severe ligament injuries, although rehabilitation needs vary.

Grade 2 Ankle Sprain

A Grade 2 sprain generally involves a partial tear of a ligament.

Symptoms may include:

• Moderate pain
• More noticeable swelling
• Bruising
• Difficulty walking
• Reduced ankle movement
• Some instability
• Pain with weight-bearing

A structured rehabilitation program can help restore mobility, strength, balance, and function.

Grade 3 Ankle Sprain

A Grade 3 sprain represents a severe ligament injury, which may involve a complete tear.

Possible symptoms include:

• Significant pain
• Marked swelling
• Extensive bruising
• Significant difficulty walking
• Substantial loss of function
• Greater ankle instability

A severe ankle injury should be medically assessed to determine the extent of the injury and whether additional investigation or protection is required.

Ankle Sprain vs Ankle Fracture

A severe ankle sprain and an ankle fracture can sometimes produce similar symptoms.

It is important not to assume that every painful or swollen ankle is simply a sprain.

Medical assessment may be appropriate if you have:

• Significant difficulty or inability to bear weight
• Severe pain
• Significant tenderness over the ankle bones
• Significant swelling
• Obvious deformity
• A crack or unusual sensation at the time of injury
• Numbness or unusual sensation
• A foot that becomes unusually cold or changes colour

Clinical assessment may include the use of the Ottawa Ankle Rules to help determine whether an X-ray may be appropriate.

If you are unable to walk or the ankle appears deformed, seek appropriate medical assessment.

What Should You Do Immediately After an Ankle Sprain?

The first few days after an ankle injury are often focused on protecting the ankle, controlling symptoms, and maintaining appropriate movement.

Depending on the severity of the injury, early management may include:

Protect

Protect the ankle from movements or activities that could aggravate the injury. An appropriate brace, support, or supportive footwear may be recommended depending on the injury.

Optimal Loading

Complete rest is not always necessary. Appropriate, gradual movement and weight-bearing can be introduced according to the severity of the injury and your symptoms.

Ice

Cold therapy can provide temporary relief from pain and may help with swelling. Avoid placing ice directly on the skin.

Compression

Appropriate compression may help manage swelling and provide additional support.

Elevation

Elevating the ankle while resting can help manage swelling.

The appropriate combination of protection, movement, and loading depends on the injury and should be adjusted as recovery progresses.

Ankle Sprain Rehabilitation

Recovering from an ankle sprain involves more than waiting for the pain to disappear.

A structured rehabilitation program may gradually address:

Pain & Swelling → Mobility → Strength → Balance → Functional Movement → Return to Activity

The exact progression depends on the severity of the injury and the individual’s goals.

Phase 1: Pain and Swelling Management

Early rehabilitation may focus on:

• Managing pain
• Controlling swelling
• Protecting the injured tissues
• Maintaining comfortable ankle movement
• Gradually restoring weight-bearing

Gentle ankle movements may be introduced when appropriate.

Examples can include ankle pumps and other comfortable range-of-motion exercises.

Phase 2: Restoring Ankle Mobility

An ankle can become stiff following an injury.

Rehabilitation may include exercises designed to gradually restore:

• Ankle dorsiflexion
• Ankle plantarflexion
• Comfortable ankle rotation
• Calf flexibility
• Functional ankle movement

Manual therapy may also be considered where clinically appropriate.

Phase 3: Progressive Strengthening

An ankle sprain can temporarily reduce the strength and control of the muscles around the ankle and foot.

Strengthening may include:

• Resistance-band exercises
• Calf raises
• Foot and ankle strengthening
• Single-leg strengthening
• Step-ups
• Functional lower-limb exercises

Exercise difficulty can gradually increase as pain and weight-bearing tolerance improve.

Phase 4: Balance and Proprioception Training

Balance training is an important component of ankle rehabilitation.

An ankle injury can affect the body’s ability to sense joint position and respond effectively to changes in the surface or movement.

Exercises may progress from:

• Double-leg balance
• Single-leg standing
• Reaching exercises
• Dynamic balance
• Unstable-surface exercises
• Functional balance activities

The level of difficulty should be appropriate for the person’s current ability.

Phase 5: Return to Running, Agility and Sport

Walking without significant pain does not necessarily mean the ankle is ready for sport.

For active individuals and athletes, later-stage rehabilitation may include:

• Jogging
• Running
• Hopping
• Jumping
• Landing exercises
• Acceleration and deceleration
• Direction changes
• Cutting movements
• Sport-specific drills

The goal is to gradually expose the ankle to the physical demands required for the individual’s activity.

Ankle Sprain Exercises

Exercises should be selected according to the stage and severity of the injury.

Common rehabilitation exercises may include:

Ankle Pumps

Move the foot gently up and down through a comfortable range.

Ankle Circles

Perform controlled circular movements with the ankle.

Resistance-Band Exercises

Resistance can gradually be introduced to strengthen the muscles responsible for controlling ankle movement.

Calf Raises

Raise the heels while maintaining controlled ankle alignment.

Single-Leg Balance

Stand on the injured leg while maintaining balance. Use a wall or stable surface for support when necessary.

Step-Ups

Step exercises can gradually develop lower-limb strength and control.

Hopping and Jumping

Later-stage rehabilitation may include hopping and jumping when appropriate for the individual’s recovery and activity goals.

Do not force an exercise that causes significant pain or worsening symptoms.

How Long Does an Ankle Sprain Take to Heal?

Recovery time varies depending on the severity of the injury.

Many mild ankle sprains improve substantially within a few weeks, while more significant ligament injuries can require a longer period of rehabilitation.

Recovery can be influenced by:

• Severity of ligament injury
• Amount of swelling
• Pain
• Ability to bear weight
• Ankle mobility
• Muscle strength
• Balance
• Previous ankle injuries
• Rehabilitation progression
• Work and sporting demands

There is no single recovery timeline that applies to every ankle sprain.

Why Does My Ankle Still Hurt After a Sprain?

Some people continue to experience ankle symptoms after the initial injury.

Possible reasons include:

• Persistent swelling
• Reduced ankle mobility
• Reduced muscle strength
• Balance deficits
• Persistent ligament instability
• Tendon irritation
• Joint stiffness
• An associated injury
• Incomplete rehabilitation

If pain, stiffness, weakness, or instability continues, reassessment can help identify what may be contributing to the ongoing symptoms.

Chronic Ankle Instability

Some people experience repeated ankle sprains or a feeling that their ankle is “giving way” after an earlier injury.

This can be associated with chronic ankle instability.

Possible signs include:

• Repeated ankle sprains
• The ankle giving way during activity
• Difficulty walking on uneven surfaces
• Reduced confidence in the ankle
• Persistent stiffness
• Ongoing discomfort
• Difficulty returning to running or sport

Physiotherapy rehabilitation may address:

• Ankle strength
• Balance
• Coordination
• Joint mobility
• Single-leg control
• Functional movement
• Sport-specific demands

Can Physiotherapy Help an Ankle Sprain?

Physiotherapy can help address pain, stiffness, weakness, balance problems, and functional limitations following an ankle sprain.

A physiotherapy rehabilitation program may include:

• Clinical assessment
• Education
• Pain and swelling management
• Mobility exercises
• Strengthening
• Balance training
• Functional exercises
• Running progression
• Sport-specific rehabilitation
• Home exercise guidance

Treatment is adjusted according to the individual’s injury, symptoms, goals, and progress.

What Happens During an Ankle Physiotherapy Assessment?

At RehabDNA Physiotherapy, your assessment may include discussion of:

• How the injury occurred
• When the injury happened
• Your current pain
• Swelling and bruising
• Ability to walk
• Previous ankle injuries
• Work and activity requirements
• Sporting goals

Your physiotherapist may assess:

• Ankle range of motion
• Strength
• Balance
• Walking pattern
• Functional movement
• Tenderness
• Swelling
• Single-leg control

The assessment findings help guide an individualized rehabilitation plan.

When Should You See a Physiotherapist for an Ankle Sprain?

Consider a physiotherapy assessment if:

• Ankle pain continues after the initial injury
• Swelling remains
• Walking is still difficult
• The ankle feels unstable
• You cannot return to running or sport
• Your ankle repeatedly gives way
• You have had multiple ankle sprains
• The ankle remains stiff
• You are unsure how to progress your exercises
• You want structured rehabilitation after a sports injury

When Should You Seek Medical Assessment?

An ankle injury should be medically assessed when there are signs of a potentially more serious injury.

Seek prompt medical attention if:

• You cannot bear weight
• The ankle or foot looks deformed
• You experience severe pain
• There is significant swelling
• You heard a crack during the injury
• You develop numbness or significant loss of sensation
• The foot becomes unusually cold or changes colour
• Symptoms are severe or worsening

Ankle Sprains in Runners and Athletes

Running and sport place additional demands on the ankle.

After an ankle sprain, being able to walk does not necessarily mean the ankle is ready for:

• Sprinting
• Jumping
• Cutting
• Rapid direction changes
• Uneven surfaces
• Competitive sport

A progressive rehabilitation program can gradually reintroduce these demands.

For athletes, rehabilitation should reflect the movement and physical requirements of their particular sport.

Ankle Sprain and Return to Running

Return to running should be gradual rather than based only on the number of days since the injury.

Before progressing to running, important considerations can include:

• Comfortable walking
• Appropriate ankle range of motion
• Adequate strength
• Good single-leg control
• Ability to perform relevant functional exercises
• No significant increase in pain or swelling after activity

Running can then be gradually progressed from easier activity toward normal training.

Can You Prevent Another Ankle Sprain?

No rehabilitation program can guarantee that another ankle sprain will never occur.

However, rehabilitation can address factors that may contribute to ankle problems, including:

• Reduced strength
• Poor balance
• Reduced coordination
• Limited ankle mobility
• Reduced single-leg control
• Difficulty controlling the ankle during dynamic movements

For people with previous or recurrent ankle sprains, strength and balance training can form an important part of rehabilitation.

Ankle Sprain Physiotherapy in Newmarket

An ankle sprain can affect walking, work, exercise, running, and sport. If your ankle remains painful, stiff, weak, or unstable after an injury, physiotherapy assessment can help identify the factors affecting your recovery and guide an appropriate rehabilitation plan.

At RehabDNA Physiotherapy, our approach follows:

Assess → Identify → Plan → Treat → Progress → Return

RehabDNA Physiotherapy

455 Harry Walker Pkwy S, Unit 7
Newmarket, ON L3Y 8T3, Canada

Phone: +1 (905) 509 8469

Email: Info@RehabDNA.com

Website: https://rehabdna.com/

FAQ About Ankle Sprain Injury