An ankle sprain is a common injury and involves injury to the ligaments that support the ankle joint. 

Approximately 2 million incidences of ankle sprain injuries will present to A&E each year. 

Most ankle sprains will heal within a few weeks but it is important to follow a few simple rules to aid this process and help prevent further injury.

The ankle joint is supported by ligaments which help to keep the joint stable. These ankle ligaments could be injured to varying degrees when you sprain your ankle.

These ligaments could be stretched or torn when you twist or roll your ankle.

Following injury, your ankle may be swollen, bruised, painful or stiff. In order to help the natural healing process, follow the advice on this page.

During the first 24-72 hours

Initial treatment is to calm inflammation and control the swelling and pain. This can be managed with:

• Rest. Reduce your activity but try and walk as normally as possible. Avoid forceful or strenuous activities, like running or jumping, until the pain and swelling has settled.
• Ice or frozen peas in a damp tea towel can be applied to the injured area. Apply for up to 20 minutes every 2 hours. Cold can burn so remove if uncomfortable.
• Painkillers are important to help you keep moving around. Paracetamol and ibuprofen are effective pain killers when taken regularly and can be taken together. We do not routinely dispense these as they can be bought cheaply over the counter from a chemist or supermarket. Read the packet instructions for the doses.
• Elevation of the ankle with the knee supported will discourage swelling. 

We no longer offer compression bandages for sprains as they appear not to have an effect on the speed of recovery. But some people find them comforting to wear and you can purchase them from a pharmacy if you want to try one.

Avoid HARM

• Heat can increase inflammation during the first 72 hours
• Alcohol can also increase the blood flow and swelling and also reduce healing.
• Running or impact exercise can make the injury worse or cause re-injury.
• Massage during the first 72 hours can increase bleeding and swelling.

After 48-72 hours

Once the ankle feels less hot and painful, it is essential to start simple flexibility exercises to prevent stiffness. The exercises suggested should be performed slowly and thoroughly, moving into discomfort but short of pain. They can be repeated hourly through the day.

Exercise 1

• Move your foot up and down at the ankle, moving as far as possible in each direction. Repeat 10 times.

Exercise 2

• Place your foot on a flat surface (on a towel) so that you can slide it forwards and backwards.
• Keep your foot flat on the floor and move it as far as you comfortably can.
• Repeat 10 times, 4 times a day.

Exercise 3

• Move your foot in and out at the ankle, so the sole of the foot turns inwards and then outwards. Repeat 10 times.

Exercise 4

• Combine all the above movements by moving the foot and ankle in as large a circle as possible. 
• Compare the movements of your injured ankle with those of your other ankle. They should eventually be the same.
• You can also place a towel or belt looped around your foot, using it to help move your ankle up and down. Repeat 10 times, 4 times a day.

General exercise

As soon as you are able to put some weight through your injured ankle, start to get up and about more, gradually disregarding your crutches if you have them. Short walks are good for the healing ankle. Steadily build up your walking distance.

Please remember to return your crutches to the Emergency Department when you have finished with them.

Progress your exercises to include the following as soon as you can take full weight comfortably on your injured ankle.

Exercise 5

• Time how long you can stand on your injured ankle without overbalancing. Then practice on your injured leg until it as good as your other leg.
• Once you can do the above for 1 minute, practice throwing, catching or bouncing a ball whilst balancing on your injured leg.
• Try balancing on one leg and closing your eyes. You should eventually be equally good on each leg.

Exercise 6 - for strength

• Hold on to a firm support with your feet slightly apart. Then rise up onto your toes and down.
• Repeat until tired, 3 to 4 times daily.
• Progress to performing the exercise on your injured leg alone until it can do the same as your other leg.

Exercise 7 - to regain essential movement

• Lean forward on a firm surface, placing the injured foot flat in front of your other foot. Lean slowly forward, pushing your knee over your foot whilst keeping your heel flat to the floor
• Hold at the point of tightness for 15 seconds.
• Repeat 4 times.

Evidence shows that the sooner this exercise improves, the more likely your ankle is to fully recover.

If you are keen on keeping fit, then swimming and cycling are suitable forms of exercise. If you are aiming to return to sporting activities, you must build up progressively and be able to complete all of the above exercises prior to starting impact exercise and sport. 

Train so that you can complete all of the different elements of your sport/activity with confidence before you participate in the activity fully. If you play a contact sport, you may require a higher level of rehabilitation than the scope of this information leaflet.

It can take 8 – 12 weeks to recovery from and ankle sprain, and even longer with severe sprains or high ankle sprains. It is worth knowing that following a sprain, the ankle can look thickened or swollen for some time.

If you are concerned about the progress of your ankle, then contact your GP or the Emergency Department that you originally attended.

References and Further Information

References | Sprains and strains | CKS | NICE 

© North Bristol NHS Trust. This edition published April 2024. Review due April 2027. NBT002629.