top of page
Search

Ankle Sprains: Causes, Symptoms and Treatment Options

  • Writer: Daniel Taylor
    Daniel Taylor
  • Jul 9
  • 4 min read

An ankle sprain is one of the most common musculoskeletal injuries seen in both active individuals and the general population. It occurs when one or more of the ligaments surrounding the ankle are overstretched or torn, usually following a twisting injury. Although many ankle sprains improve naturally, recovery can often take longer than people expect, and inadequate rehabilitation can lead to persistent pain, weakness, instability, and recurrent sprains.

What Causes an Ankle Sprain?

The majority of ankle sprains occur when the foot rolls inwards (known as an inversion injury), placing excessive stress on the ligaments located on the outside of the ankle.

Common causes include:

  • Stepping awkwardly off a curb or step

  • Sports involving running, jumping, or sudden changes of direction

  • Walking or running on uneven ground

  • Slipping or tripping

  • Previous ankle injuries resulting in instability

The most commonly injured ligament is the Anterior Talofibular Ligament (ATFL), although more severe injuries may also involve the Calcaneofibular Ligament (CFL) and other supporting structures.

Common Symptoms

Symptoms can vary depending on the severity of the injury but commonly include:

  • Pain around the outside of the ankle

  • Swelling

  • Bruising

  • Difficulty walking

  • Reduced ankle movement

  • Tenderness when touching the injured ligaments

  • A feeling of instability or weakness

In more severe cases, individuals may hear or feel a "pop" at the time of injury.

Understanding Ankle Sprain Grades

Grade 1 (Mild)

  • Ligament overstretching without significant tearing

  • Mild swelling and discomfort

  • Able to walk with minimal difficulty

  • Recovery typically 2–6 weeks

Grade 2 (Moderate)

  • Partial ligament tear

  • Moderate swelling and bruising

  • Painful walking

  • Recovery typically 6–12 weeks

Grade 3 (Severe)

  • Complete ligament rupture

  • Significant swelling and bruising

  • Difficulty weight bearing

  • Recovery often 3–6 months or longer

Even seemingly minor sprains can take several months before the ankle feels completely normal again.

Early Treatment: The RICE Principle

In the early stages, treatment focuses on reducing pain and inflammation.

Rest

Avoid activities that aggravate symptoms. Complete immobilisation is rarely necessary, but reducing excessive loading can help the healing process.

Ice

Apply an ice pack wrapped in a towel for 15–20 minutes every 2–3 hours during the first few days after injury.

Alternatively you can purchase this sytlish comfortable ossur ankle cold press

ossur ankle cold press for ankle injuries












Compression

Compression bandages or ankle supports can help control swelling and provide additional support.

Elevation

Keeping the ankle elevated above heart level can help reduce swelling, particularly during the first 48–72 hours.

Pain Relief

Over-the-counter medications may help manage symptoms:

  • Paracetamol

  • Ibuprofen (if appropriate)

  • Anti-inflammatory gels

Always follow the manufacturer's instructions and consult a healthcare professional if unsure whether these medications are suitable for you.

Early Exercises

Early movement is important to prevent stiffness and maintain ankle mobility.

Simple exercises may include:

Ankle Pumps

Move the foot up and down repeatedly.

Ankle Circles

Slowly rotate the ankle clockwise and anticlockwise.

Alphabet Exercise

Use your foot to "draw" letters of the alphabet in the air.

These exercises should remain within a comfortable range and not significantly increase pain.

Ankle Bracing

If you are struggling with pain and confidence an ankle support may benefit you. We recommend purchasing an ossur formfit pro ankle support

ossur ankle support for ankle sprains














Progressing Your Rehabilitation

Once the initial pain and swelling begin to settle, usually around weeks 3–4, rehabilitation should progress to strengthening and balance exercises.

Useful exercises include:

  • Calf raises

  • Resistance band strengthening

  • Single-leg balance exercises

  • Heel-to-toe walking

  • Controlled hopping and jumping drills (later stages)

I have created a video demonstrating some useful intermediate rehabilitation exercises:

📹 YouTube Rehabilitation Video

Why Do Some Ankle Sprains Fail to Recover?

Whilst most ankle sprains settle naturally over approximately 12 weeks, some patients continue to experience:

  • Persistent pain

  • Recurrent swelling

  • Ankle instability

  • Repeated sprains

  • Reduced confidence during walking or sport

This commonly occurs due to:

  • Scar tissue formation

  • Poor ligament healing

  • Muscle weakness

  • Reduced balance and proprioception

  • Returning to activity too quickly

If recovery is progressing slowly, a course of physiotherapy can be highly beneficial.

At Elite Joint Solutions, treatment is tailored to the individual and commonly includes:

Manual Therapy

Manual therapy involves working directly into the injured ligaments, tendons, and surrounding soft tissues.

Potential benefits include:

  • Improving tissue mobility

  • Breaking down excessive scar tissue

  • Improving collagen alignment during healing

  • Reducing stiffness

  • Improving ankle movement

Many patients notice improvements after several sessions, although treatment can occasionally be uncomfortable due to the nature of the injured tissues.

Rehabilitation Progression

We will also review and progress your exercise programme to ensure you are:

  • Restoring strength

  • Improving balance

  • Reducing reinjury risk

  • Returning safely to sport and normal activities

Most patients require approximately 4–6 physiotherapy sessions, although this varies depending on injury severity.

Dry Needling for Ankle Sprains

In selected cases, dry needling may be incorporated into treatment.

Dry needling is thought to:

  • Stimulate local blood flow

  • Promote tissue healing

  • Reduce muscle tension

  • Improve tissue mobility

  • Help break down adhesions within the healing tissues

It is commonly used alongside physiotherapy rather than as a standalone treatment.

Injection Therapy for Persistent Symptoms

For patients whose recovery has plateaued despite appropriate rehabilitation, injection therapy may be considered.

Depending on the structures involved, treatment options may include:

  • Corticosteroid injections (for persistent inflammation)

  • Hyaluronic acid injections (in selected cases involving joint irritation)

  • Other regenerative injection options where appropriate

Injection therapy is usually considered only after a thorough assessment and when conservative treatments have not achieved satisfactory results.

When Should You Seek Professional Advice?

You should consider seeking assessment if:

  • Pain remains significant after several weeks

  • Swelling persists

  • The ankle repeatedly "gives way"

  • You are unable to return to work or sport

  • Symptoms are worsening rather than improving

  • You cannot comfortably bear weight

Contact our experts today Home


References

  1. National Institute for Health and Care Excellence – Management of ankle injuries.

  2. British Journal of Sports Medicine – Clinical guidelines for ankle sprain rehabilitation.

  3. Journal of Orthopaedic & Sports Physical Therapy – Clinical Practice Guidelines for Lateral Ankle Sprains.

  4. American Academy of Orthopaedic Surgeons – Ankle Sprain Rehabilitation Guidance.

Comments

bottom of page