| What We Treat
Ankle Sprain
Rolled your ankle and hoping it’ll just settle? Ankle sprains are the most common musculoskeletal injury there is — and the most commonly under-rehabilitated, which is why so many people go on to sprain again.
Overview
What Is an Ankle Sprain?
An ankle sprain is injury to the ligaments supporting the ankle, most commonly the ligaments on the outside when the foot rolls inwards. Around a third of people who sprain an ankle go on to develop persistent symptoms or recurrent instability, largely because the initial injury is treated as trivial and rehabilitation stops as soon as the swelling settles. Proper rehabilitation substantially reduces that risk.
Tap a structure, or use the buttons, to compare the main types of sprain.
Lateral Ankle Sprain
The foot rolls inwards, straining the ligaments on the outside of the ankle. The anterior talofibular ligament is injured first and most often. Pain and swelling sit on the outside of the ankle, usually just in front of and below the bony point.
Symptoms
How It Tends to Feel
Sprains present fairly consistently, with severity determining the degree of each feature:
Pain on the Outside
Localised to the outer ankle, just in front of and below the bony point, in the great majority of sprains.
Rapid Swelling
Swelling developing within hours, sometimes considerable, often with bruising tracking into the foot over days.
Difficulty Weight-Bearing
Ranging from a limp to being unable to put weight through it at all in more severe injuries.
Bruising
Often appearing a day or two later and tracking down towards the toes, which looks alarming but is normal.
Instability
A sense of the ankle giving way, particularly on uneven ground, which may persist long after the swelling settles.
Stiffness
Loss of ankle movement, particularly pulling the foot upwards, which needs actively addressing.
Causes & Risk Factors
What Drives It
Sprains happen when the ankle is forced beyond its available range faster than the muscles can respond.
Landing or Stepping Awkwardly
Landing on another player’s foot, stepping off a kerb, or catching a root on uneven ground.
Court and Field Sports
Basketball, netball, football and racquet sports have the highest incidence, largely from landing and cutting.
Previous Sprain
The single strongest risk factor. A previously sprained ankle is several times more likely to be sprained again.
Reduced Balance and Control
Impaired proprioception after a previous injury makes the ankle slower to protect itself.
Reduced Ankle Dorsiflexion
Limited ability to pull the foot upwards is associated with increased sprain risk.
What to Expect
Recovery Stages
Rehabilitation continues well past the point where the ankle feels normal — that gap is where recurrent sprains come from.
Acute
Protect, reduce swelling, start moving
- Screen for fracture using the Ottawa ankle rules — not everyone needs an X-ray
- Relative rest, elevation and compression to manage swelling
- Weight-bear as comfortable; complete rest slows recovery
- Begin gentle ankle movement early, particularly pulling the foot upwards
Tap through the stages. The balance and strength phases are what prevent the next sprain.
How We Can Help You
Treatment & Management
Sprains recover well, but the difference between a sprain that resolves and one that becomes recurrent instability is almost entirely down to whether rehabilitation continued past the point of comfort.
What the evidence says
The Ottawa ankle rules are validated criteria that reliably identify who needs an X-ray after an ankle injury, with very high sensitivity for detecting fractures. Applied properly they allow the majority of people to avoid unnecessary imaging.
Proprioceptive and balance training after ankle sprain has consistent evidence for reducing recurrence — systematic reviews report substantial reductions in repeat sprains. Bracing during the first season back also reduces recurrence in court sports.
When to Seek Help
Red Flags — Don’t Ignore These
Most ankle injuries are sprains. These features suggest a fracture or more significant injury:
⚠ Seek prompt medical assessment if you notice:
- Inability to take four steps immediately after the injury and at assessment (possible fracture — attend A&E)
- Bony tenderness along the back edge or tip of either ankle bone, or over the outer midfoot
- An obvious deformity, or the ankle looking out of shape
- Numbness, coldness or loss of pulse in the foot (call 999)
- Calf pain, swelling or warmth in the weeks afterwards, particularly if immobilised (possible clot — seek same-day assessment)
These symptoms need same-day medical assessment. Please contact your GP or NHS 111 today, or attend A&E if they are severe or worsening quickly.
Common Questions
Frequently Asked Questions
Do I need an X-ray?
Often not. The Ottawa ankle rules are validated criteria based on where you’re tender and whether you can take four steps. Applied properly they identify almost all fractures while sparing most people an unnecessary X-ray. They can be applied at assessment.
Should I rest it completely?
No. Early controlled movement and weight-bearing as comfortable produce better outcomes than immobilisation. Ligaments heal better under controlled load, and prolonged rest causes stiffness and weakness that outlast the original injury.
Why do I keep spraining the same ankle?
Because the first sprain damaged the nerve endings that tell your brain where your ankle is in space, and that proprioceptive deficit persists unless it’s specifically retrained. It’s the single most under-treated aspect of ankle sprains, and balance training addresses it directly.
How long until I can play sport?
A mild sprain often allows return within two to four weeks; a more significant one six to twelve. High ankle sprains take considerably longer. Return should be based on regaining strength, balance and confidence rather than on the swelling having gone.
Don’t Let It Become a Recurring Problem
Proper assessment, early loading, and the balance work that actually reduces the chance of doing it again.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.