Ankle Sprain

What is a Sprain?

Ankle sprains most commonly occur when the foot is forcibly rolled inwards whilst weight bearing which overstretches the outside of the joint to the point where tissue damage to a ligament occurs. Ligaments are strong bands of connective tissue. They run from bone to bone over a joint and often blend in with the capsule of that joint.  An ankle sprain injury sets off an inflammatory reaction leading to pain and swelling and consequently joint stiffness. After day 5 the inflammatory reaction begins to slow and your body will begin to lay down new scar tissue.

Grades of Sprain

  • First Degree = minor tearing with local tenderness over the ligament
  • Second Degree = more extensive ligament tearing with associated swelling, bruising, loss of joint mobility
  • Third Degree = complete ligament rupture with intense pain and joint instability. May require surgery.

(Grades 2 and 3 commonly occur with associated fractures so Xray/MRI/CT may be required)


Acute management of an ankle sprain involves the R.I.C.E.R concept of REST, ICE, COMPRESSION, ELEVATION and REFERRAL to a physiotherapist or doctor if required.

Initial physiotherapy goals are to restore joint movement and muscle strength as well as balance.  Your ligaments contain tiny receptors which are disrupted with injury and your muscles need to learn to adapt to this change otherwise the risk of re-injury is high.  In addition, if you do not regain full ankle movement, you will have difficulty walking downstairs or hills which can lead to knee and hip problems later on.

At Focus Physiotherapy we use a variety of hands-on techniques to restore ankle joint movement.  You can also download Physiapp on your phone before your first appointment to receive your individualised balance and strengthening program.

A gradual loading of the joint is vital when it comes to returning to sport.

First degree ankle sprains tend to bounce back within a few weeks and usually do not require physiotherapy.

Second degree ankle sprains can take 4-6 weeks minimum to return to light sport depending on your level and type of sport.

Third degree ankle sprains require a prolonged period of rehabilitation.   Depending on your goals in life, you may require the skills and opinion of an orthopaedic specialist as chronic joint instability can lead to osteoarthritis in the long term. Of course the goal is to avoid the need for surgery in the first place.


Advanced exercises

Once you have met our initial physiotherapy goals, you can commence our advanced ankle sprain program.   We often recommend taping or bracing to help prevent re-injury during this transition phase as well as on return to sport.

  • Ladder drills
  • Interval running (acceleration/deceleration/straight line/changing direction)
  • Plyometric Drills (explosive strength/power drills eg. box jumps, bounding, burpees)
  • Sport specific drills (eg. ball handling skills at 50% pace if returning to rugby)
  • Hill/stair running
  • Running on a variety of surfaces (bush track, road, grass)

In summary, at Focus Physiotherapy our ultimate goal is to return you to your chosen sport without pain or loss of athletic performance.

For more information on the conditions we treat and services we offer, or to book an appointment please call 9939 0157 or email us at

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