Ankle Sprain Recovery and Rehab Exercises

Ankle sprains are one of the most common injuries, affecting people of all ages. While most heal without surgery, many people do not rehabilitate properly — leading to weak ankles, recurring sprains and reduced confidence. Here is a complete guide to recovering well.

Whether you rolled your ankle walking on uneven ground, playing sport, or stepping off a kerb, the recovery process is the same. The goal is not just to get out of pain, but to restore full strength, balance and confidence so you do not re-injure the joint.

What happens when you sprain your ankle

An ankle sprain occurs when the ligaments that support the ankle are stretched or torn — most commonly on the outside of the ankle when the foot rolls inward. Sprains are graded by severity:

• Grade 1 (mild): Ligament is overstretched but not torn. Mild swelling and tenderness. You can usually walk.
• Grade 2 (moderate): Partial tear of the ligament. Moderate swelling, bruising and pain. Walking is painful.
• Grade 3 (severe): Complete tear of the ligament. Significant swelling, bruising, instability. You cannot bear weight.

Most sprains are grade 1 or 2 and respond well to conservative management. Grade 3 sprains may need a longer period of protection and occasionally surgical review.

Stage 1: First 48 to 72 hours — protect and calm

The immediate goal is to control swelling and protect the injured ligament. Follow the PRICE protocol:

• Protect: Use a brace or support to prevent further injury
• Rest: Avoid activities that cause pain; use crutches if you cannot walk without limping
• Ice: Apply for 15 to 20 minutes every 2 hours (wrapped in a towel)
• Compress: A compression bandage helps control swelling
• Elevate: Rest the ankle above hip level when sitting or lying

After 48 to 72 hours, if swelling has stabilised, you can begin gentle movement.

Stage 2: Days 3 to 14 — restore movement

Once the acute phase has passed, the priority shifts to restoring range of motion. Prolonged immobilisation weakens muscles and stiffens joints, so early gentle movement is important.

Exercise 1: Ankle alphabet

Sit in a chair and imagine your big toe is a pen. Slowly trace the letters of the alphabet in the air, moving only your ankle. This promotes full range of motion in all directions. Do the full alphabet once or twice daily.

Exercise 2: Gentle circles

Sit with your foot lifted. Slowly rotate your ankle 10 times clockwise, then 10 times counter-clockwise. Keep the movements slow and controlled.

Exercise 3: Towel stretch

Sit on the floor with your leg extended. Loop a towel around the ball of your foot. Gently pull the towel towards you until you feel a stretch in your calf and the back of your ankle. Hold for 20 seconds, repeat 3 times.

Exercise 4: Towel scrunches

Sit in a chair with a small towel on the floor in front of you. Using only your toes, scrunch the towel towards you. This strengthens the small muscles of the foot and ankle. Repeat 10 times.

Stage 3: Weeks 2 to 6 — build strength

As pain and swelling subside, the focus shifts to strengthening the muscles that support the ankle — particularly the calf muscles and the muscles on the outside of the lower leg (peroneals), which help prevent the ankle from rolling inward.

Exercise 1: Calf raises

Stand holding a chair for support. Rise onto your toes, lifting both heels. Hold for 2 seconds at the top, then lower slowly. Do 3 sets of 15. Progress to single-leg calf raises as you get stronger.

Exercise 2: Resistance band inversion and eversion

Sit on the floor with your leg extended. Loop a resistance band around your foot. Turn your foot inward against the band (inversion), then outward (eversion). Do 3 sets of 10 in each direction. This strengthens the muscles on both sides of the ankle.

Exercise 3: Single leg stand

Stand near a wall for support. Stand on the injured leg for 30 seconds. Progress to 60 seconds, then try with eyes closed. This begins the balance training that is critical for preventing re-injury.

Stage 4: Weeks 4 to 8 — restore balance and function

This is the most important and most often skipped phase. Balance (proprioception) is impaired after a sprain because the ligament's nerve receptors are damaged. Without retraining, your ankle will not sense when it is about to roll — leading to recurrent sprains.

Exercise 1: Balance on an unstable surface

Stand on a cushion, pillow or balance board on the injured leg. Hold for 30 seconds. Progress to doing this with eyes closed or while turning your head. Do 3 sets.

Exercise 2: Single-leg reach

Stand on the injured leg. Slowly reach the other foot forward, to the side, and backward, tapping the toe lightly each time. Return to centre between each reach. Do 3 sets of 5 reaches in each direction.

Exercise 3: Hopping

Once you can balance confidently, start hopping on the spot on the injured leg. Progress to hopping forward, sideways and backward. Do 3 sets of 10 hops. This builds the power and control needed for running and sport.

Exercise 4: Walking on uneven ground

Practice walking on grass, gravel or sand. This trains the ankle to adapt to unpredictable surfaces — the most common scenario for re-injury.

Returning to sport

Before returning to sport, you should be able to:

• Walk and jog without pain or limping
• Hop on the injured leg 10 times without pain
• Balance on the injured leg for 30 seconds with eyes closed
• Run and change direction without hesitation
• Complete sport-specific drills (e.g. zigzag running, jumping) without pain

Rushing back too soon is the most common cause of recurrent sprains. Take the time to complete all four stages.

When to see a physiotherapist

While mild sprains can be managed at home, you should seek physiotherapy if:

• You cannot bear weight after 48 hours
• Pain or swelling is severe or worsening
• The ankle feels unstable or gives way
• You have had multiple sprains (chronic ankle instability)
• You are returning to sport and want to ensure full recovery
• You have numbness, tingling or extreme bruising (possible fracture or nerve involvement)

A physiotherapist can assess the severity, rule out a fracture, provide manual therapy to restore joint mobility, guide you through a progressive rehab programme, and use taping or bracing to support the ankle during recovery.

Preventing future sprains

Once you have sprained your ankle, you are at higher risk of spraining it again. Long-term prevention includes:

• Continuing balance and proprioception exercises even after recovery
• Wearing supportive footwear appropriate for your activity
• Using an ankle brace or tape for high-risk activities if you have a history of sprains
• Warming up properly before sport
• Strengthening the calf, peroneal and hip muscles

Frequently asked questions

About Rutvi Patel

Rutvi Patel is an HCPC registered physiotherapist (MCSP) with a Master's degree in Sports and Exercise Biomechanics. She visits people at home across West Yorkshire, helping them recover from pain, injury and surgery with tailored rehabilitation programmes built on an advanced understanding of how the body moves.

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