Understanding and Managing Ankle Sprains

Ankle sprains are one of the most common musculoskeletal injuries, often occurring during physical activities, sports, or even daily tasks. They occur when the ligaments connecting the bones of the ankle joint are stretched or torn due to an excessive force or twisting motion. In this blog, we’ll delve into what ankle sprains are, the different grades of sprains, how they happen, their treatment options, and effective prevention strategies.

Ankle Sprains: An Overview

Ankle sprains can range in severity from mild to severe, and they are typically classified into three grades based on the extent of ligament damage:

Grade 1 Ankle Sprain: This is a mild sprain where the ligaments are stretched, but not torn. There might be slight discomfort, swelling, and minimal loss of function. Most people can still bear weight on the affected ankle.

Grade 2 Ankle Sprain: In a grade 2 sprain, one or more ligaments are partially torn. This leads to moderate pain, swelling, bruising, and difficulty bearing weight. The joint might feel unstable, and there could be some loss of motion.

Grade 3 Ankle Sprain: A grade 3 sprain is the most severe, involving a complete tear of one or more ligaments. It causes significant pain, swelling, bruising, and difficulty or inability to bear weight. The joint may feel very unstable, and there can be substantial loss of function.


How Ankle Sprains Happen

Ankle sprains most commonly occur due to sudden twists or rolls of the ankle. This can happen during various activities such as running, jumping, or simply stepping onto an uneven surface. The ligaments on the outer side of the ankle are the most commonly affected, these include the ATFL, CFL and PTFL. The ATFL is the most commonly injured.

Treating Ankle Sprains

P.O.L.I.C.E Method
  • Protect: important to avoid further tissue damage, but doesn’t necessarily mean complete rest.
  • Optimal Loading:this helps to stimulate the healing process, which is done using crutches, braces or boots as needed, the right amount of loading is key to assisting the healing process
  • Ice: Applying ice to the area helps reduce swelling and pain. Use ice packs for 20 minutes on 20min off 20min for an hour.
  • Compression: Wrapping the ankle with an elastic bandage helps control swelling.
  • Elevation: Elevate the ankle above heart level to assist with venous return.

Pain Relief and Support: Over-the-counter pain relievers and anti-inflammatory medications can provide relief. Wearing a brace, splint, or using crutches might be necessary depending on the severity of the sprain.

Physical Therapy: Physiotherapy plays a crucial role in ankle sprain recovery. A physiotherapist will guide you through exercises that improve flexibility, strength, balance, and stability. They will also help you regain normal range of motion.

Grade 3 Sprains and Surgery: In some cases, especially with severe grade 3 sprains, surgery may be required to repair the torn ligaments. Rehabilitation is vital after surgery to regain full function.

The Latest Research on Recovery and Treatment

Ankle sprain recovery and treatment have been extensively researched in the field of sports medicine and physiotherapy. Below are some key findings from recent research studies that provide insights into effective recovery strategies for ankle sprains:

Early Mobilisation and Weight-Bearing:
Research has shown that early mobilisation and controlled weight-bearing can lead to faster recovery and improved functional outcomes for mild to moderate ankle sprains. Gradually introducing weight-bearing activities helps stimulate tissue healing and prevents stiffness.
Functional Rehabilitation Exercises:
Incorporating functional exercises that mimic real-life movements has been found to be more effective than traditional rehabilitation methods. These exercises improve proprioception, strength, and balance, reducing the risk of re-injury.
Manual Therapy Techniques:
Manual therapy techniques provided by physiotherapists, such as joint mobilisations and soft tissue techniques, can help improve joint range of motion, reduce pain, and enhance tissue healing.
Bracing vs. Taping:
Research comparing ankle bracing and taping has shown that both can provide support during recovery. Bracing is often preferred due to its ease of use and consistent support, while taping requires skill and may need frequent reapplication.
Neuromuscular Training:
Neuromuscular training focuses on enhancing neuromuscular control and proprioception. Studies suggest that incorporating these training strategies into rehabilitation programs can significantly reduce the risk of recurrent ankle sprains.
Gait Analysis:
Analysing gait patterns during recovery can identify any compensatory movements that might delay healing or lead to secondary issues. Addressing these gait abnormalities can contribute to a smoother recovery process.
Psychological Factors:
Research has highlighted the role of psychological factors, such as fear of re-injury, in ankle sprain recovery. Addressing these factors through education, counselling, and gradual exposure to activities can improve overall recovery outcomes.
Individualised Treatment Plans:
Personalised treatment plans tailored to the specific needs of the patient are crucial. Factors like age, fitness level, severity of injury, and previous history of ankle sprains should all be considered. Everyone has a different return to activity goal and treatment plans should be individualised for this
Recovery Timeframes:
The recovery timeframe varies depending on the severity of the ankle sprain. While mild sprains may recover within a few weeks, more severe sprains can take several months. Returning to sports or high-impact activities should only be done under professional guidance.

It’s important to note that ankle sprain treatment and recovery are highly individualised. Consulting a qualified physiotherapist or healthcare professional is essential for accurate diagnosis, appropriate treatment planning, and monitoring progress. Staying patient, adhering to the prescribed rehabilitation plan, and gradually returning to activities can lead to a successful and sustainable recovery from ankle sprains.

Preventing Ankle Sprains

Ankle sprains have one of the highest re-injury rates amongst common joint sprains. This is mostly because of poor rehabilitation, once the pain has settled most people think they can just continue on with activity, but this only increases their chance of re-injury due to their lack of strength and proprioception around the ankle joint that was lost with the initial injury.

Warm-Up: Prior to any physical activity, perform a proper warm-up that includes gentle stretches and movements to prepare the ankle joints and surrounding muscles.

Strengthening Exercises: Incorporate exercises that focus on ankle stability and strength, such as calf raises and balance exercises.

Proper Footwear: Wear appropriate shoes that provide ankle support and cushioning for the activities you’re engaging in.

Mind Your Terrain: Be aware when walking or exercising on uneven surfaces. Watch out for obstacles that could cause you to twist your ankle.

Listen to Your Body: If you feel discomfort or strain in your ankles during any activity, take a break and assess the situation.


Ankle sprains are common injuries that can range from mild to severe. Understanding their grades, causes, and treatment options is essential for a successful recovery. By following proper prevention techniques, you can significantly reduce the risk of ankle sprains and continue to enjoy an active and healthy lifestyle. If you do experience an ankle sprain, consulting a physiotherapist or healthcare professional is recommended to ensure proper diagnosis, treatment, and rehabilitation as well as a reduction of risk of re-injury.

  By Caitlan Skillicorn, Senior Physiotherapist Healthfix North Sydney