Ankle sprain treatment
Learn how to effectively rehabilitate your twisted ankle starting from day zero

You've twisted your ankle and need ankle sprain treatment straight away - well you're in the right place.

This page is all about how to rehabilitate and treat your sprained ankle starting from the moment of injury, through the next 6-10 weeks and then well into the future.

This page covers:

- immediate ankle sprain treatment,

- basic ankle rehabilitation,

- advanced ankle stabilisation and strengthening exercises specific for ankle sprains

- what NOT to do.

Video

Immediate ankle sprain treatment

You've probably heard it before, but what you need is PRICE. 

Price stands for

First 1-72 hours

Protection

This is day 1, ground zero, you've got to PROTECT your ankle. This means STOP weight bearing on the joint, if you need to move around use a crutch and keep your foot off the ground.  Keep you ankle in a safe place, don't let it be kicked, don't let it be bashed about. Even a heavy pillow can cause agony if falls onto the ankle so keep it safe!

Rest

Rest is crucial for ankle sprain treatment. While you may want to get up and about as soon as possible you've got to give yourself time.

Depending on the severity of the ankle sprain, you need to avoid all weight bearing for at leas the first three days. Wait until the pain has started to subside and the swelling has gone down.

Ice

Ice will be your new best friend in your efforts to reduce your ankle swelling. Using a bag of peas is pretty handy, otherwise an special ice pack is ideal. Apply the ice over the side and top of the ankle where the pain is, leave it there for 5-10 minutes and then remove it for 5 to ten minutes. Repeat for as long as you like. Ice can help to reduce the swelling and the pain in these initial stages.

Compression

Applying a bandage over the ankle offers a gentle amount of compression which can help with swelling and pain but can also provide a degree of stability to what is now essentially an unstable joint. Try to avoid leaving the compression bandage on too tight and don't leave it on for longer than 2 hours in any 3 hour period.

Elevation

Elevation is an important part of ankle sprain treatment, helping to reduce any discomfort associated with increased swelling and inflammation around the ankle. Keep your ankle up on a chair or table at about 45 degrees. Adjust this level if you start getting back hip, or knee pain.

Weeks 1-2: Restoring movement and mobility

After the worst of the swelling and pain has passed and you have successfully carried out PRICE, you are in the position to begin restoring movement to your ankle.

Gentle ankle mobility exercises are the way to do this, we have already put together a quick and easy ankle mobility video and page so you can see these exercises in more detail, but for now here is what you need to know:

Ankle Mobility Exercises

Ankle mobility exercises are fundamental for ankle sprain treatment for the following reasons:

- Reduce swelling, improve blood supply, flush out waste from around you joint

- Restrict further damage due to lack of mobility

- Engage and gently stretch muscles around the ankle

- Improve fluid dynamics within the joint to help protect cartilage

Please be aware! While some minor discomfort is to be expected, if you're experiencing pain during these exercises the chances are you are pushing too hard too soon.

Check out our full guide on ankle mobility exercises for more information.

Three exercises, three times per day

Gently take your ankle through these three main types of movement, repeating each of the three exercsies 10-15 times through, 2-3 times per day.

- Dorsi-flexion and extension (up and down)

- Inversion / eversion (in and out)

- Circumduction (round and round)

Weeks 2-4: Making progress with proprioception

By now the worst of the swelling and bruising should have calmed right down along with the worst of the pain. Weight bearing should now be possible even if you are limping a little bit. If weight bearing is still difficult then you may need to wait a little longer.

NOTE: Throughout weeks 2-4 of your ankle sprain treatment and rehabilitation it is important that you maintain the ankle mobility exercises you've been doing above.

Proprioception

Proprio-what? Proprioception is a fancy term given to your sense of balance. it refers to the ability of the brain to know where any particular body part is and what its doing even if it can't see it.

When an ankle is sprained, this sense is often impaired or even lost and it is very important that you work to restore it. Why? Because without the redevelopment of this sense, your chances of re-injury, or re-spraining your ankle are high.

The first two stages of ankle sprain balance exercises

Beginner

Begin by standing on one leg, eyes open. Be sure to have something nearby to grab onto in case you need it.

Intermediate

Once you've mastered the beginner, move onto the intermediate stage where you tip your body forwards.

Using balance to re-train you ankle

If you can do so without too much discomfort, stand on one leg (obviously the affected side). If it hurts, you are doing it too soon and you need to be patient and come back next week.

Stand on one leg for approximately 20-30 seconds, 3 times per day. You may need to have something to support you to start with, that's no problem, it is important that you ease yourself into this.

NOTE: The important thing to note during this exercise is that you're actually developing your sense of balance through the whole leg, pelvis and lower back while you're doing this exercise!

Weeks 4-6: Getting ready to strengthen

By now you're ankle should be in full recovery mode and your able to get around now problem, without a crutch. Great! You are ready for the next phase: strengthening.

This whole ankle sprain drama has left the muscles that support and control your ankle disused and weak meaning that they are going to struggle to do there job properly. Furthermore, if you want to stop this from happening again, these structures need to be stronger, and your ankle even more stable than it was before.

NOTE: Throughout weeks 4-6, continue to do the mobility and stability exercises from the first 4 weeks.

Strengthening the ankle

Ankle strengthening exercises for a sprained ankle constitute an extremely important part of ankle sprain treatment. The main parts to strengthen are the muscles of the lower leg especially:

- Gastrocnemius (calf)

- Tibialis anterior and posterior (shin)

- Peroneal muscles (outside of lower leg)

Through strengthening these muscles, the smaller muscles of the foot and ankle will also be activated, so we won't worry too much about those for the time being.

Three simple ankle strengthening exercises for ankle sprain treatment

The three exercises that are going to help you the most are as follows:

- Standing calf raises

- Foot lift

- Ankle eversion and ankle inversion 

- Ankle dorsiflexion and plantarflexion

For the complete, guide check out our page on ankle strengthening exercises.

Returning to proprioception...

Those exercises you've been doing on a daily basis for balance can now be stepped up. Follow the same process as before but this time, once in position, close your eyes.

Taking away your vision forces the brain to rely on, and therefore develop, your sense of proprioception, further improving ankle function and stability.

Advanced Continuing the balance exercises now with your eyes closed is crucial for rebuilding ankle balance and stability.

Super advanced If you feel up to it you can repeat the three stages above but this time using a wobble board to increase difficulty.

Week 6 and beyond: Stability, stability, stability

By now your ankle should be returning to normal and you should be able to get around with no real issues. The stability phase of ankle sprain rehab is the most crucial!#

It ties in all of the previous phases into one action ensuring that no aspect of your rehabilitation is forgotten. This phase brings it all together meaning full ankle control, full ankle strength and full ankle proprioception.

For this phase we recommend you check out our full guide to advanced ankle stability exercises. Some of them you will recognise from above but most will be new.

And that's it! Your ankle sprain is now fully rehabilitated and stronger than ever!

AUTHORS AND CREATORS

This page was written and composed by experts in their fields;

OLIVER WAKEFIELD M.ost
REGISTERED OSTEOPATH

Oliver is a registered Osteopath in the UK with a particular interest in sports and rehabilitation - he practises in Devon, Southwest England.

LOUISE PRATLEY M.ost
REGISTERED OSTEOPATH

Louise is a registered Osteopath, fitness model and enthusiast as well as a business and social influencer. She also practises as an Osteopath in Devon, UK.

Oliver and Louise specialise in helping people get over their pain and get back to living the lives they want to be living - follow this link to find out more about us.

We welcome any one who wants to get in touch with us here at the OFC for any reason - please use the form on our contact us page.

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All the information and advice in this website should be followed with common sense and expert help - follow this link for our full disclaimer.

We hoped you enjoyed this page about ankle sprain treatment. Follow this link to learn more about ankle exercises or return to the Osteo fitness collective homepage.

The information and rehabilitation advice on this page was formed alongside ankle sprain guidance from NICE, the national institute for clinical guidance.