Ankle Sprain Rehabilitation: When Can You Return to Sport?

What actually happens when you sprain your ankle?

An ankle sprain occurs when one or more ligaments around the ankle are overstretched or injured. The most common mechanism is rolling the ankle so the foot turns inward, affecting ligaments on the outside of the ankle.

Symptoms can include pain, swelling, bruising, difficulty walking, reduced ankle movement, tenderness and a feeling of weakness or instability. Severity varies considerably. Some sprains are relatively mild, while others involve more substantial ligament injury and significantly affect walking and sport.

An assessment may also be necessary to determine whether symptoms could indicate a fracture or another injury rather than assuming every rolled ankle is “just a sprain”. Healthdirect notes that assessment can include examining the ankle, checking weight-bearing ability and, where indicated, imaging such as an X-ray to rule out a fracture. You can also read our guide on when an X-ray or scan may be helpful after an injury.

What should you do immediately after an ankle sprain?

During the early stages, the priority is usually protecting the ankle while managing pain and swelling. Current Healthdirect guidance recommends relative rest from painful activity, ice, compression and elevation during the first couple of days. It also notes that gentle exercises, walking and weight bearing can be appropriate as tolerated. For more context, read our guide to using heat or ice after an injury.

That last part is important. An ankle sprain does not necessarily mean lying on the lounge for a week waiting for your ankle to negotiate a peace treaty with gravity. The appropriate amount of activity depends on the severity of the injury.

If you cannot comfortably put weight through the leg, have substantial swelling or bruising, or you are unsure about the injury, contact our team at One Stop Physio Moorebank for an assessment. Seek urgent medical care for deformity, severe pain or other concerning symptoms.

Do ankle sprains need physiotherapy?

Not every minor ankle sprain requires extensive physiotherapy. Consider booking an assessment with our team at One Stop Physio Moorebank when:

• walking remains painful or difficult
• swelling or movement restriction persists
• the ankle feels unstable or repeatedly gives way
• you have sprained the same ankle several times
• you play a sport involving running, jumping or changing direction
• you are unsure how to progress rehabilitation safely
• you need to return to physically demanding work
• you are struggling to regain strength or confidence.

At One Stop Physio, physiotherapy in Moorebank for sports and musculoskeletal injuries can include assessment, education and an individual exercise rehabilitation program based on your presentation and goals.

The important word is individual. A recreational walker and a competitive rugby league player do not place similar demands on their ankles, so their return-to-activity criteria should not be identical.

What does ankle sprain rehabilitation involve?

Ankle rehabilitation generally progresses as symptoms and function improve rather than following one rigid timetable.

Restoring ankle movement

Swelling and pain can make the ankle feel stiff after a sprain. Early rehabilitation may include appropriate movements designed to gradually restore comfortable range of motion. The aim is not to aggressively force the ankle through pain. Movement can be progressively restored according to how the injury responds.

Rebuilding strength

An ankle needs to tolerate force during walking, running, jumping and landing. Rehabilitation may progress from simple strengthening exercises towards more demanding movements. Depending on the individual, exercises might eventually include calf raises, resisted ankle exercises, squats, split squats or lunges, step exercises, single-leg strengthening and jumping or landing drills.

Improving balance and proprioception

Rehabilitation is not only about muscle strength. The ability to sense and control the position of the ankle, often called proprioception, is important during unpredictable movement. Balance training might progress from standing on one leg to tasks involving movement, landing, catching, throwing or reacting to external cues.

Reintroducing running and jumping

Being able to walk without pain does not automatically mean you are ready for sport. Rehabilitation may progressively introduce jogging, faster running, acceleration, deceleration, hopping, jumping, landing, lateral movement and changes of direction. How quickly these are introduced depends on the injury and the person’s progress.

When can you return to sport after an ankle sprain?

There is no number of days that applies to everyone. More significant injuries generally take longer to recover. Rather than relying exclusively on time, return-to-sport decisions should consider what the ankle can actually do.

Depending on your sport and injury, our team at One Stop Physio Moorebank may assess:

• pain and swelling
• ankle movement
• strength and balance
• hopping ability
• running tolerance
• jumping and landing
• change-of-direction ability
• confidence in the ankle
• ability to complete sport-specific tasks.

Returning to golf presents very different ankle demands from returning to netball, soccer, basketball or rugby league. Rehabilitation should reflect those differences.

Can you play sport if your ankle does not hurt anymore?

Pain settling is encouraging, but it is not the only consideration. Imagine an athlete whose ankle no longer hurts during normal walking but who still has substantially reduced single-leg balance, calf strength and hopping ability.

Walking pain-free does not tell us whether the ankle is ready to absorb force while landing from a jump or changing direction at speed. This is why functional rehabilitation matters. The goal is to bridge the gap between “my ankle feels better” and “my ankle can handle my sport”.

What if you have sprained the same ankle several times?

Repeated ankle sprains deserve attention. Some people describe their ankle as constantly “giving way”, particularly when running on uneven ground, landing or changing direction.

If that sounds familiar, simply waiting for each episode of pain to settle may not address relevant functional deficits. A physiotherapy assessment can look at ankle movement, strength, balance, control and the demands of your activity. Rehabilitation can then target identified deficits and progressively expose the ankle to the movements you need to perform.

Should you tape or brace your ankle when returning to sport?

Taping or an ankle brace may be appropriate in some situations, depending on the injury and individual. Healthdirect notes that some more significant ankle sprains may require an ankle brace for several weeks.

Support should not automatically replace rehabilitation. If your goal is returning to sport, rebuilding movement, strength, balance and sport-specific capacity remains important. Our Moorebank team can assess whether taping or bracing is appropriate for your injury and return-to-sport goals.

What does return-to-sport rehabilitation look like?

Towards the later stages, exercises should increasingly resemble the demands you intend to return to.

• For a runner, this might involve gradually increasing running distance, pace and terrain.
• For a soccer player, rehabilitation might progress towards sprinting, cutting, kicking and reactive changes of direction.
• For a netball or basketball player, jumping, landing, lateral movement and rapid direction changes may become increasingly important.
• For rugby league, the ankle may eventually need to tolerate running, acceleration, cutting, contact situations and unpredictable movement.

This progression helps move rehabilitation beyond simply treating symptoms.

Sports injury physiotherapy in Moorebank

If you have sprained your ankle and want to return to sport, work or regular exercise, book an assessment with our team at One Stop Physio Moorebank so we can identify what you need to rebuild.

One Stop Physio Moorebank provides physiotherapy for sports and musculoskeletal injuries at 132 Nuwarra Road, supporting patients from Moorebank, Liverpool, Chipping Norton, Wattle Grove, Hammondville and surrounding South West Sydney suburbs.

Our team can assess your movement and function and develop a rehabilitation program around your individual injury and the activity you are trying to return to. Rather than using the highly scientific return-to-sport test of “it does not hurt much anymore, she’ll be right”, the aim is to progressively demonstrate that your ankle can handle the demands you are putting back on it.

Sources and further reading

• Healthdirect: sprained ankle
• One Stop Physio: Physiotherapy in Moorebank

Important: This article contains general health information and does not replace an individual assessment. Contact our team at One Stop Physio Moorebank if you need help deciding what to do next. Seek urgent medical care for severe injuries or concerning symptoms.