Ankle sprains are one of the most common musculoskeletal injuries, especially among athletes and active individuals. In fact, studies suggest that 1 in 4 people who engage in sports or regular exercise will experience an ankle sprain at some point. But while the injury is common, it’s also widely misunderstood and often mistreated – leading to chronic issues and recurring pain.
In this comprehensive guide, we’ll walk you through what an ankle sprain is, why it happens, how to properly manage it based on severity, and most importantly – how to recover fully and prevent future injuries.
What is an Ankle Sprain?
An ankle sprain occurs when one or more ligaments in the ankle are overstretched or torn due to excessive force or movement. Ligaments are tough bands of connective tissue that provide stability to joints by connecting bones together. When these ligaments are pushed beyond their normal range, they can become damaged – resulting in pain, swelling, instability, and loss of function.
Think of your ankle like a car equipped with a seatbelt. The ligaments act as the “seatbelt,” providing restraint and support during sudden movements. However, just like a seatbelt can snap in a high-impact collision, your ankle ligaments can tear if the joint moves too forcefully or suddenly – often when you’re least expecting it.
Common Causes of Ankle Sprains
Ankle sprains can happen to anyone, from elite athletes to casual walkers. The most frequent causes include:
- Twisting the ankle during sports (e.g., landing awkwardly from a jump or sudden directional changes)
- Walking or running on uneven surfaces
- Wearing inappropriate footwear (e.g., high heels or shoes with poor support)
- Sudden trauma like slipping on a wet surface or mis-stepping off a curb
- Weak ankle muscles or poor balance increasing the risk of instability
Symptoms of an Ankle Sprain
The symptoms of an ankle sprain can vary based on its severity, but the most common signs include:
- Pain, especially when bearing weight
- Swelling around the ankle joint
- Bruising or discoloration
- Tenderness to touch
- Restricted range of motion
- A popping sound or sensation at the time of injury
- Instability or weakness in the ankle
If left untreated, even a minor sprain can lead to persistent pain, instability, and a higher risk of re-injury.
The Three Grades of Ankle Sprains
Not all ankle sprains are the same. They are typically categorised into three grades, depending on the extent of ligament damage:
Grade 1: Mild (Microscopic Tear)
- Slight overstretching of the ligament
- Minimal swelling and tenderness
- Little to no joint instability
- Recovery time: 1–2 weeks with proper rest and rehabilitation
Grade 2: Moderate (Partial Tear)
- Partial tearing of the ligament
- Moderate swelling, bruising, and pain
- Noticeable joint instability
- Difficulty walking or bearing weight
- Recovery time: 3–6 weeks with structured rehab
Grade 3: Severe (Complete Tear)
- Complete rupture of one or more ligaments
- Severe swelling, bruising, and pain
- Marked joint instability
- Inability to walk without significant pain or support
- May require immobilisation, bracing, or even surgery
- Recovery time: 6 weeks to several months depending on treatment
Diagnosing an Ankle Sprain
Accurate diagnosis is essential to ensure the right treatment plan and full recovery. In many cases, ankle sprains are misdiagnosed as fractures or vice versa, particularly in acute or high-pain situations.
A qualified physiotherapist or medical professional will typically assess:
- The mechanism of injury (how it happened)
- Swelling and bruising patterns
- Palpation and ligament testing
- Functional movement and range of motion
- In some cases, imaging such as X-rays or MRIs may be required to rule out fractures or assess ligament damage
Effective Treatment Options for Ankle Sprains
Treatment depends on the severity of the injury but generally follows the POLICE principle:
P – Protect
Avoid further injury using bracing or taping if necessary, especially in moderate to severe cases.
OL – Optimal Loading
Unlike the older RICE method, current best practice encourages gentle movement and loading rather than complete rest. This helps maintain strength and promote healing.
I – Ice
Apply ice packs for 15–20 minutes every 2–3 hours during the first 48 hours to reduce swelling and pain.
C – Compression
Use compression bandages to limit swelling and support the joint.
E – Elevation
Keep the ankle raised above heart level whenever possible to minimise swelling.
Rehabilitation and Physiotherapy
Rehabilitation is a critical phase of ankle sprain recovery and is often the most overlooked. Many people stop treatment as soon as pain subsides, but failing to restore full strength, flexibility, and proprioception (joint awareness) can lead to repeated sprains or long-term dysfunction.
An evidence-based rehab program includes:
- Strengthening exercises for the ankle, foot, and surrounding muscles
- Balance and proprioception drills (e.g., single-leg stands, wobble boards)
- Mobility work to restore joint range and movement patterns
- Gradual return to activity under professional supervision
Why Do Some Ankle Sprains Take Longer to Heal?
While mild ankle sprains often resolve quickly, others may take longer due to:
- Misdiagnosis or incorrect grading
- Inadequate rest or premature return to sport
- Pre-existing ankle instability or poor mechanics
- Other underlying conditions (e.g., fractures, joint impingement, tendon damage)
If your ankle sprain isn’t improving within the expected timeframe, it’s essential to seek professional assessment. Persistent pain, swelling, or instability could indicate a more serious issue.
When to See a Physiotherapist
If you’ve recently suffered an ankle injury, especially with swelling, bruising, or difficulty walking, it’s best to consult a physiotherapist. Early intervention can prevent complications and speed up your recovery.
At Logan Physio, our experienced team can help you:
- Accurately diagnose the severity of your ankle sprain
- Create a personalised treatment and rehab plan
- Guide your return to sport or activity safely
- Reduce your risk of re-injury
Preventing Future Ankle Sprains
Once you’ve had one ankle sprain, the likelihood of experiencing another increases unless steps are taken to restore full function. To protect your ankles long-term:
- Warm up properly before exercise
- Strengthen ankle and calf muscles
- Improve balance and proprioception
- Wear supportive footwear
- Consider taping or bracing if you’re returning to sport after injury
Final Thoughts
Ankle sprains may be common, but they shouldn’t be taken lightly. Whether you’ve suffered a mild twist or a severe ligament rupture, timely diagnosis, effective treatment, and guided rehabilitation are key to a full recovery.
If you’re struggling with ankle pain, instability, or a lingering injury that’s affecting your daily life or performance, our team at Logan Physio is here to help you get back on your feet—stronger and more stable than before.
📅 Book your appointment today at Logan Physio and take the first step toward pain-free movement and injury prevention.
