Ankle sprains are one of the most common injuries, affecting people of all ages and activity levels. It is an injury that occurs when you roll, twist or turn your ankle causing the ligaments to stretch or tear. Ligaments are the tough bands of tissue that attach our bones together, providing stability to our joints.
The most common type is called a lateral ankle sprain, which makes up around 85% of ankle sprains. This affects the ligaments on the outside of the ankle and is usually caused by rolling the ankle inwards. Medial or high ankle sprains are characterised by injury to the ligaments on the inside or upper part of the ankle. These are less common but are usually more debilitating than lateral ankle sprains.
What are the symptoms?
Signs and symptoms vary depending on the severity of the injury but include:
· Pain (especially when weight bearing)
· Tenderness
· Swelling
· Bruising
· Reduced range of motion
· Instability
· ‘Popping’ sound at time of injury
Are there any risk factors?
There are some factors that can increase your risk of a sprained ankle including:
Sports participation – Ankle sprains are a common sports injury especially in those that involve running, jumping, and sudden changes in direction.
Surfaces – Walking or running on uneven surfaces or poor field conditions may increase the risk.
Prior ankle injury – If you’ve sprained your ankle before, you’re more likely to sprain it again.
Poor physical condition – Poor strength or flexibility in the ankles may increase your risk.
Improper shoes – Shoes that don’t fit properly or wearing high-heeled shoes make ankles more vulnerable to injury.
What should I do if I get an ankle sprain?
RICER protocol is suggested for treatment of a sprained ankle:
Rest or reduce activity (however gentle ankle movements are recommended when you feel able to do so).
Ice therapy (can be applied for 20 minutes every 2-3 hours for the first 24 hours).
Compress the injured ankle using tape or a bandage.
Elevate the ankle (above the heart if possible).
Refer – you should seek medical attention to determine if medical imaging is needed.
You should also avoid HARM – Heat, Alcohol, Running/exercise and Massage, in the first 48 hours to prevent further swelling. You should also call your physiotherapist as soon as you can.
The Role of Physiotherapy in Recovery
While many sprains are mild and can be managed with basic care, more severe cases can lead to long-term instability, pain, and difficulty returning to normal activities. When it comes to ankle sprains, proper rehabilitation is key to recovery and preventing long-term issues.
Physiotherapy is one of the most effective treatment methods for sprained ankles. Here’s how physiotherapy can help:
Restoring Range of Motion – Physios can use specific stretches and exercises to gradually improve flexibility, allowing the ankle to move normally again.
Strengthening the Muscles Around the Ankle - Physios help guide patients through exercises designed to strengthen the muscles around the ankle joint to prevent instability and re-injury.
Balance and Proprioception Training - Physiotherapists incorporate balance and proprioceptive exercises to retrain the brain and body to respond to changes in terrain, thereby improving stability.
Preventing Future Injuries - Physios help to prevent recurrence by addressing any weaknesses, imbalances, or poor movement patterns. They often provide education on proper footwear, taping techniques, and modification of activities to reduce strain on the ankle.
Gradual Return to Activity - Physios will develop a customised rehabilitation program that considers the severity of the injury, the patient’s fitness level, and their activity goals. This ensures that individuals can safely return to their normal routine without risking re-injury.
Conclusion
Ankle sprains can be painful and disruptive, but with the right care, most people can recover fully and return to their usual activities. Physiotherapy is a vital part of that recovery process, helping to manage pain, restore mobility, strengthen the ankle, and prevent future injuries. If you’ve experienced an ankle sprain, working with a physiotherapist can greatly improve your outcomes and ensure you get back on your feet safely and effectively.
Return to sport testing
Here at our clinic, we have access to state-of-the-art technology that is used worldwide to measure an individual’s precise ankle strength, power, movement, balance, asymmetry and more. These can help empower the client as well as help our physios make more accurate data-informed decisions regarding return to play.
Written by
Cathal O’Kane
Senior Physiotherapist
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