Understanding Ankle Sprains: Physiotherapy Rehabilitation for a Speedy Recovery

by | Feb 24, 2024 | Injuries & rehabilitation

A man helping a woman with a sprain ankle in a park

Ankle sprains are among the most common musculoskeletal injuries, frequently occurring during physical activities, sports, or even day-to-day tasks. They happen when the ankle ligaments stretch beyond their normal range, typically due to sudden twists or turns. This can lead to pain, swelling, and difficulties bearing weight on the affected ankle. Unfortunately, these injuries often lead to reduced ankle stability and increased vulnerability to future injury, as the ligaments tend to heal in a ‘stretched state.

Understanding the significance of accurate diagnosis and comprehensive rehabilitation is vital for achieving a swift and complete recovery.

Diagnosis of Ankle Sprains

To accurately diagnose an ankle sprain, physiotherapists consider a variety of factors. They evaluate the level of pain, swelling, and bruising, carefully examining the ankle’s range of motion and stability. Special tests like the anterior drawer test, talar tilt test, and squeeze test, are conducted to assess the integrity of the ligaments and identify the severity of the injury. In some cases, diagnostic tools such as X-rays, ultrasounds, or MRIs may be used to confirm the diagnosis and rule out potential fractures or other associated damage. 

Ankle sprains are categorised into three grades based on severity:

  • Grade 1: Slight stretching and microscopic tears in the ligament causing mild tenderness and minimal swelling.
  • Grade 2: Partial tearing of the ligament fibers, leading to moderate pain, swelling, and some instability in the joint.
  • Grade 3: Refers to complete tearing or rupture of the ligament, resulting in severe pain, significant swelling, and considerable instability in the joint.

Physiotherapy Rehabilitation

The management and healing timeline of an ankle sprain can vary depending on its severity. In more severe cases, recommendations may include the use of a brace, rest, and possibly even surgical intervention. The typical rehabilitation protocol however remains as follows:

1. Acute phase of rehabilitation (First few days after injury)

During the initial phase following an injury, the body initiates the inflammatory response, leading to heightened swelling and pain. This period is often marked by challenges in movement and walking. Implementing the P.O.L.I.C.E principles during this phase aids in reducing swelling and gradually reintroducing movement:

P – Protection
OL – Optimal Loading
I – Ice
C – Compression
E – Elevation

2. Sub-acute phase of rehabilitation 

After the initial phase of swelling and inflammation has subsided, engaging in active movement becomes crucial.

In the early stages of ankle rehabilitation, the primary goal is to restore ankle mobility and function. This is achieved by enhancing range of motion and strength without causing a flare-up or worsening the pain.

3. Intermediate phase of rehabilitation 

In the intermediate phase of ankle sprain rehabilitation, the main objective is to gradually enhance the strength of the muscles around the ankle. This phase also involves retraining balance and proprioception to enhance stability and minimize the risk of re-injury. Additionally, this stage addresses factors such as hip control, alignment, and other compensatory mechanisms.

4. End phase of rehabilitation 

In the end stages of ankle sprain rehabilitation, the main aim is to restore complete function and flexibility in the ankle joint. This phase incorporates advanced dynamic exercises to enhance strength, agility, and balance, facilitating a secure return to regular activities and sports. 

Considering that various sports have distinct requirements, it is crucial to customise the exercises according to the specific needs and sporting demands of each patient.


Ankle sprains can be debilitating, but with the right diagnosis and physiotherapy approach, individuals can recover fully and regain their active lifestyles. A structured rehabilitation program, tailored to the individual’s specific needs, not only promotes healing but also helps in preventing future injuries.

Struggling with recurrent ankle injuries and lingering pain, contact us today for an appointment. You can also head over to our Instagram page for some exercises you can use during each of these phases. 

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