# Ankle sprain An ankle sprain is a stretch or tear of the ligaments that hold the ankle together, usually on the outside when the foot rolls under you. It often happens on a trail run or hike, in the bike park, or when landing a jump. We assess the ankle, get it moving early, and rebuild strength and balance to lower the chance of another sprain. ## Symptoms - Pain and swelling around the ankle, often on the outside - Bruising that spreads toward the foot or toes - Pain when you put weight on the foot - Stiffness, especially first thing in the morning - Feeling unsteady on rough or uneven ground - An ankle that keeps rolling or gives way ## Assessment First we ask how the ankle rolled, whether you could walk on it afterward, and whether you have sprained it before. Then we look at the swelling and bruising, and find where it is tender. We test the ligaments on each side of the ankle. We also check the ligament just above the ankle that joins the two lower leg bones (the syndesmosis), because a twisting fall can hurt it. We look for signs of a broken bone (fracture). If one is possible, a doctor or nurse practitioner needs to see you first, and may order an X-ray, before rehab goes further. Then we test how the ankle moves, how it takes weight, and your balance on each leg. ## Treatment Early on, the aim is to protect the ankle but keep it moving. A brace or tape protects the ligament while the swelling settles, and some people need crutches for the first days. We get you walking, within comfort, as early as the ankle allows. Rehab then builds in stages: - **Movement:** getting the full bend back at the ankle, which you need for squatting and walking downhill. - **Strength:** the calf, and the muscles on the outside of the lower leg that turn the foot back out when it starts to roll. - **Balance:** standing on one leg, then on a soft surface or with your eyes closed, then hopping. This trains the ankle to react quickly on uneven ground. - **Sport drills:** hopping, landing and changing direction, then work on rough ground. Balance training is the part people most often skip, so we build it in from the start. Hands-on treatment can ease stiffness along the way. For ankle braces, see [splints and bracing](https://backinactionphysiotherapy.com/services/splints-and-bracing). Once you are hopping and landing well, [strength and conditioning](https://backinactionphysiotherapy.com/services/strength-and-conditioning) can take the work further. ## Getting back to sport Your return is guided by how the ankle tests, not by the calendar. We check hopping, landing and balance on the injured side against the other ankle. Then we practise the ground your sport brings: rocks, roots and loose dirt on trail descents, or jump landings in the bike park. We can show you how to tape the ankle, or help you choose a brace, for your first outings back. ## When to come in Book an assessment soon after a sprain that makes you limp. Come in too if the ankle stays swollen, stiff or sore, feels unsteady on rough ground, or has been sprained more than once. See a doctor or nurse practitioner first if the bony knobs on either side of the ankle hurt to press. The same applies to the bones halfway along either edge of the foot. These can be signs of a broken bone, which needs an X-ray. Go to the emergency department right away, or call 911, if any of these happen: - the ankle looks out of shape - you cannot put weight on the leg, even for a few steps - your foot is numb, cold or pale ## Who treats it - [Therese Leigh, Physiotherapist, BSc Physiotherapy, MHA, Dip Sport Physio, FCAMPT, GunnIMS](https://backinactionphysiotherapy.com/team/therese-leigh) - [Mike Conway, Physiotherapist, M. PT Sports, M. PT Manips, M. PT Studies, BSc Kin, CHT, GunnIMS, FCAMPT, CSCS](https://backinactionphysiotherapy.com/team/mike-conway) - [Bianca Matheson, Physiotherapist, BSc PT, Grad Dip PT Manips, Dip Sports Physio, FCAMPT, GunnIMS](https://backinactionphysiotherapy.com/team/bianca-matheson) - [Jian Soares, Physiotherapist, M ClinPhys, BSc PT, FCAMPT](https://backinactionphysiotherapy.com/team/jian-soares) - [Dana Elliott, Physiotherapist, MScPT, BSc](https://backinactionphysiotherapy.com/team/dana-elliot) - [Julie Charette, Physiotherapist, BSc PT, Cert. MDT](https://backinactionphysiotherapy.com/team/julie-charette) - [Emilie Noble, Physiotherapist, MSc PT, BSc Kines, AN-IMS](https://backinactionphysiotherapy.com/team/emilie-noble) - [Cameron Gant, Physiotherapist, BSc Physiotherapy, PG Cert Sports Physio](https://backinactionphysiotherapy.com/team/cameron-gant) - [Nicole Klopfer, Physiotherapist, B Physiotherapy (Hons) (UMelb), M Physiotherapy (Manips) (UWA), PGrad Cert Cont & PF Rehab (UMelb), GunnIMS](https://backinactionphysiotherapy.com/team/nicole-klopfer) - [Michael Pearce, Physiotherapist, BSc PT](https://backinactionphysiotherapy.com/team/michael-pearce) - [Kelsey Rey, Physiotherapist, MPT, BHK](https://backinactionphysiotherapy.com/team/kelsey-rey) - [Keeley Wentzel, Physiotherapist, BSc Physiotherapy (Hons)](https://backinactionphysiotherapy.com/team/keeley-wentzel) ## Services - [Physiotherapy](https://backinactionphysiotherapy.com/services/physiotherapy) - [Sports Physiotherapy](https://backinactionphysiotherapy.com/services/sports-physiotherapy) - [Splints and Bracing](https://backinactionphysiotherapy.com/services/splints-and-bracing) - [Strength and Conditioning](https://backinactionphysiotherapy.com/services/strength-and-conditioning) - [Registered Massage Therapy (RMT)](https://backinactionphysiotherapy.com/services/massage-therapy) ## Frequently asked questions ### Should I stay off a sprained ankle? Briefly. For the first day or two, take it easy and raise the ankle when you sit, which helps with swelling. Ice can ease the pain for some people. After that, start walking on it as comfort allows. Ligaments respond well to gradual load as they heal, and long rest leaves the ankle stiff and weak. If you could not walk on it at first, have it checked for a broken bone. ### Why do I keep spraining the same ankle? Unfinished rehab, often. After a sprain, the ligaments can stay a little loose, and the ankle can be slower to sense when it starts to roll. If rehab stops when the pain stops, the ankle stays weaker and less steady than before. That is why one sprain often leads to another. Balance and strength work can help close that gap, even years after the first sprain. ### Should I tape or brace my ankle for sport? Often, yes. After a sprain, tape or a lace-up brace can lower the chance of rolling the ankle again once you are back. Many trail runners and riders keep using one on rough ground. Tape tends to loosen during activity, so a brace can suit long days better. Keep up the balance and strength work as well. ### How long does a sprained ankle take to heal? It varies. It depends on how badly the ligaments were hurt and whether other parts of the ankle were injured. The pain often settles well before the ligament has regained its strength. That is why feeling fine is not the same as being ready. Going back to trails or jumps too early raises the chance of another sprain. ## Massage for recovery Massage therapists do not diagnose, so start with a physiotherapist. Once you have a diagnosis and a plan, our registered massage therapists can help with the recovery. [About massage therapy](https://backinactionphysiotherapy.com/services/massage-therapy) *This page is general information, not a diagnosis or a substitute for an assessment. If you are unsure, see a health professional.*