So You Sprained Your Ankle, Now What?
By: Kelsie Mazur, DPT
Ankle sprains are one of the most common injuries people experience, whether they’re athletes, weekend warriors, or simply going about their daily routines. It’s easy to think of them as a minor inconvenience, but ankle sprains can have long-lasting effects if not treated properly. Lateral ankle sprains can be challenging and frustrating due to having the highest injury AND reinjury rate amongst any lower-body injury. The high reinjury rates are likely because most ankle sprains aren’t properly managed in the first place So, buckle up and let's learn what TO DO if you’ve found yourself with a sprained ankle.
What is an Ankle Sprain
An ankle sprain occurs when the ligaments in the ankle are stretched or torn. Ligaments are tough bands of connective tissue that link bones together, providing stability to the joint and limiting excessive movement. While the ankle is supported by several ligaments, the most commonly sprained ones are located on the outside (lateral) part of the ankle.
A lateral ankle sprain happens when one or more of the ligaments on the outer side of the ankle are injured. These ligaments help keep the ankle stable and prevent it from moving too much. The reason these sprains are so common is that the ligaments on the outside of the ankle are more vulnerable to injury, especially when the ankle rolls or twists. The ligaments on the inside of the ankle or those involved in high ankle sprains are much less likely to get hurt. In fact, up to 70% of people will experience a lateral ankle sprain at some point in their life. What’s even more concerning is that once you’ve sprained your ankle, you’re at a much higher risk of spraining it again—especially within the first year. In fact, people who’ve sprained their ankle once are twice as likely to reinjure it (that is if you did not receive propr rehab on it). That’s why lateral ankle sprains are one of the most common and recurring injuries people face.
Do I need an x-ray? How Serious Is the Sprain? Understanding the Grades
Ankle sprains are generally classified into three grades based on how severe the injury is:
Grade I (Mild): The ligament is stretched but not torn. Recovery usually takes 2-4 weeks.
Grade II (Moderate): The ligament is partially torn. Recovery usually takes 1-2 months, and you may feel more ankle instability.
Grade III (Severe): The ligament is completely torn. Recovery can take 3+ months, and you may experience significant instability in the ankle.
Most ankle sprains don’t require an X-ray unless a fracture is suspected. If you go to an urgent care, they most likely will x-ray it to rule out a fracture. If you go directly to a physical therapist, the therapist will determine whether or not an x-ray is necessary, as they are equipped with the necessary knowledge and expertise to make that decision.
The Nitty Gritty: What to do if you have an ankle sprain:
The old R.I.C.E. (Rest, Ice, Compression, and Elevation) method for ankle sprain rehab is now considered outdated. In fact, complete rest can actually be one of the worst things for recovery… Instead, a new approach called P.O.L.I.C.E. is now recommended. In this updated method, "Rest" is replaced with Protection and Optimal Loading. This means that while it’s important to protect the injured area from further strain, it’s equally important to gradually introduce safe, controlled loads to the injured tissues. This gentle loading helps stimulate the healing process without over-stressing the injury. So all in all, this means if you sprained your ankle, try and get in to see a physical therapist ASAP. They can provide you with exercises you can do to allow safe optimal movement right away.
For an acute ankle sprain, the primary goals are:
Minimize swelling
Restore ankle function for daily activities
Normalize walking
Reducing swelling doesn’t require complete rest or constant icing, as was once commonly advised. While it's important to protect the injured area, particularly in the first 1-3 days, avoiding all movement is unnecessary. A good rule of thumb is to pay attention to how your body responds: if walking or specific exercises significantly increase your pain or swelling, you may be overdoing it and should scale back.
In summary, a lateral ankle sprain occurs when the ankle twists or rolls inward at high speed. For an acute sprain, the main goals are to reduce swelling, restore ankle function for daily activities, and normalize walking. As you begin to load the injured area, a simple guideline is to listen to your body: if walking or certain exercises are significantly increasing your pain or swelling, you may be pushing too hard and need to reduce the intensity. Crutches or a brace may be necessary during the early stages for support.
As rehabilitation progresses, it’s important to see a Doctor of Physical Therapy who will emphasize exercises that target ankle impairments, including improving range of motion, strength, endurance, power, and sensorimotor control (such as proprioception and dynamic balance). Functional activities like hopping, jumping, and sport-specific movements should also be incorporated- But under DPT guidance. Before returning to sports or your usual activities, ensure there is no pain, that you feel confident in your ankle’s stability, and that you have full functional control.
Lastly, don’t overlook the importance of walking! Track your steps and gradually increase the number each week as part of your recovery.
Did you know that we offer free 1-on-1 injury screens? Wattage Physical Therapy will take an in depth look at your ergonomics, posture, muscle tone, muscle weaknesses, and movement patterns to create a plan for YOU. If this article intrigues you, you can directly email me, Kelsie at Kelsie@wattagept.com. I would be happy to help you start the process of living a life free from pain.