A rolled ankle is one of the most common injuries there is. It can happen stepping off a kerb, landing awkwardly at netball, or on uneven ground during a beach run. One moment you are fine, and the next your ankle is swollen and sore.
Many sprains settle well with sensible early care, but some are more significant than they first appear, and a poorly rehabilitated ankle can be prone to rolling again. This guide covers what to do in the first few days, how to tell when you need an X-ray, and how a physio can help you get back on your feet.
What is an ankle sprain?
A sprain is an injury to the ligaments, the strong bands of tissue that connect bone to bone and help stabilise a joint. The most common type is a lateral ankle sprain, where the foot rolls inwards and the ligaments on the outside of the ankle are stretched or torn.
Sprains are usually graded by severity, from a mild stretch of the ligament (grade 1), to a partial tear (grade 2), to a complete tear (grade 3). Less commonly, the "high ankle" ligaments above the joint are injured, which often takes longer to recover.
What should I do in the first 48 to 72 hours?
Early care aims to protect the ankle and manage swelling while keeping it moving where possible. Many clinicians use the PEACE and LOVE approach, which includes:
Protect: reduce or avoid activities that clearly increase pain for the first one to three days.
Elevate: rest the ankle above the level of your heart when you can.
Compress: a compression bandage or tubular support may help limit swelling.
Educate: understand that active recovery usually works better than prolonged rest or passive treatment alone.
Gentle movement: as pain allows, start moving the ankle, such as tracing the alphabet with your toes, and begin walking with as normal a pattern as you comfortably can.
Ice can be used for pain relief if you find it helps. Some guidelines suggest avoiding anti-inflammatory medication in the first few days, so check with your GP or pharmacist about pain relief that suits you.
When do I need an X-ray or to see a doctor?
Not every sprain needs imaging. Doctors and physios often use guidelines known as the Ottawa ankle rules to decide when an X-ray is worthwhile. See a GP or visit an emergency department if you:
Cannot take four steps on the injured foot, both straight after the injury and when assessed.
Have tenderness directly on the bony points at the back or tip of the ankle bones, or on the outer edge or middle of the foot.
Have an obvious deformity, a wound over the injury, or severe pain that is not easing.
Notice numbness, coldness or colour change in the foot or toes.
Have a calf that becomes painful, swollen, warm or red in the days after the injury, which can be a sign of a blood clot.
Heard a pop at the back of the heel or cannot push off, which may suggest an Achilles injury.
When should I see a physio for a sprained ankle?
It is worth seeing a physio if your ankle is not clearly improving within a few days, if you are unsure how much you should be doing, or if you play sport and want to return safely. A physio can also be a helpful first point of contact to assess whether you may need an X-ray or a GP review.
It is also a good idea to have it checked if you have sprained the same ankle before. Repeat sprains are common, and some people go on to develop ongoing ankle instability or pain. Research suggests that structured rehabilitation, especially balance training, may reduce the risk of re-injury.
What does ankle sprain rehab involve?
After an assessment, your physio will tailor a program to your injury and goals. It commonly includes:
Restoring range of movement, particularly bending the ankle up towards the shin.
Strengthening the calf, ankle and hip muscles.
Balance and proprioception exercises, such as single leg standing and progressing to unstable surfaces.
Gradual return to running, hopping, jumping and changing direction for sport.
Advice on taping or bracing for sport where appropriate.
Hands on treatment and soft tissue work may help some people with pain and stiffness along the way, but the exercise program is usually the main focus. Our sports injury treatment and physiotherapy pages explain more about returning to sport.
How long does a sprained ankle take to heal?
Recovery time varies with the severity and type of sprain. Mild sprains often feel much better within one to three weeks, while more significant tears and high ankle sprains can take several weeks to a few months before full return to sport.
Ligaments continue to remodel for some time after the pain settles, so feeling better does not always mean the ankle is ready for full load. Testing your balance, strength and hopping with a physio before returning to sport may help you make that call.
How can you lower the risk of rolling it again?
Once your ankle has settled, a few everyday habits may help reduce the chance of another sprain:
- Keep up a short balance routine a few times a week, even after you are back to full activity.
- Warm up before sport with some jogging, hopping and change of direction work.
- Take care on soft sand, uneven paths and wet surfaces, which are common around the Gold Coast, particularly when you are tired.
- Choose supportive, well fitting shoes for your sport and replace them when they are worn out.
- Build back into training gradually rather than returning straight to a full load.
If you are a runner, a running assessment and gait analysis may help identify other factors worth working on, and our guide to common sports injuries covers related problems.
Frequently asked questions
Should I keep walking on a sprained ankle?
If you can walk without severe pain and do not meet any of the X-ray criteria above, gentle walking as comfort allows is usually encouraged. If you cannot bear weight, see a GP or emergency department. Crutches or a support may be suggested in the short term.
Is it better to tape or brace my ankle?
Both can provide support during sport, particularly after a recent sprain or for people with a history of sprains. Your physio can help you decide which suits your sport and ankle, and can show you how to tape it.
Why does my ankle keep rolling?
After a sprain, the ligaments, muscle strength and balance reactions may not fully recover without rehab. This can leave the ankle feeling unstable. A targeted strength and balance program is often recommended, and your physio can assess whether anything else is contributing.
Getting help on the Gold Coast
If you have rolled your ankle and want a clear plan for getting back to walking, running or sport, the physiotherapists at The Good Joint in Mermaid Beach can assess your injury and guide your rehab. Learn more about our ankle pain and sprain treatment or book online.
Related reading: Should I use heat or ice on an injury? and What helps Achilles tendinopathy, and what should you avoid?
