Ankle Sprain: When To Seek Help?


Ankle sprains are extremely common. Whether you’ve sprained your ankle playing sport, chasing the kids around the backyard or walking down stairs after 1 too many beers (I see the latter more than you’d think!), it’s difficult to know when to seek help.

The simplest and most common ankle sprain occurs when your foot is slightly pointed and rolls inwards. This mechanism of injury tends to over stretch or tear fibers of the anterior talofibular ligament (ATFL). The amount of force going through the ankle will determine whether the ATFL fibers are stretched, torn a little bit or completely torn apart.

Unfortunately, injuries are rarely “textbook.” Ankle sprains are often more complex then just an ATFL sprain. There are numerous ligaments, tendons and bones that can be damaged when you twist your ankle. So, unless you get a diagnosis from a professional, such as a physiotherapist, you won’t know if it’s a simple ATFL sprain. I’ve outlined the stages of healing for an ATFL sprain. If your symptoms don’t match, I would advise you to seek help.


0-72hrs: Inflammatory phase

Common symptoms

  • General swelling around the ankle. Also, may be localized to the outside of the ankle.
  • Bruising around the outside of the ankle.
  • Pain can be sharp, achy or throbbing. Mainly on the outside of the ankle.
  • Pain present at rest and when putting weight through foot.
  • Difficult to walk without a limp. May be unable to walk at all.


  • Rest, ice, compress and elevate (RICE)
  • Gentle ankle exercises - rotate ankle in a circle and reverse in other direction.


72hrs - 6 Weeks: Sub-Acute phase

Common symptoms

  • Swelling starts to decrease. By 6 weeks should be gone.
  • Bruising starts to change color from black/blue to yellow/green and will lighten. Eventually completely fade by 6 weeks.
  • Pain should be less sharp and more of an ache initially. It will start to quickly decrease. By 6 weeks should be gone.
  • Little pain at rest.
  • Should be able to put weight through foot and walk normally. Some pain in the first week or 2 is normal, but it will be pain-free soon after.
  • Weakness or decreased confidence in balancing on that foot initially. You should start to feel more confident in the movements you can do e.g. jogging, changing direction.


  • Walk normal! In order for your ligament to heal effectively you need to walk normally. If you don’t feel confident to after the inflammatory phase then it’s time to seek A physiotherapist can diagnose your injury, tape your ankle for support and provide advice for further management.
  • Balance on the injured leg. Aim for 30 secs. Once that’s easy, try balancing with your eyes closed. Have a wall or table there to hold on to if you are too unbalanced.

  • Calf raises. Aim for 30. Once that’s easy, try a single leg calf raise. Aim for 30 on each leg.

  • Calf stretch. Hold for 30 secs.

  • If you are a sports person or someone who needs to function at faster then walking pace and not in a straight line (or enjoys pinot in heels!), then it’s time to seek help. You’ve done the hard work to start the healing process, however, the physio will now rehabilitate you back to sport or full function. Another important part of your treatment will be to prevent further ankle sprains.

Good luck for your ankle rehabilitation!