Ankle sprains are among the most prevalent musculoskeletal injuries, affecting individuals of all ages and activity levels. In the United States alone, an estimated 2 million ankle sprains occur each year, making them a leading cause of emergency room visits and missed physical activity. These injuries can happen suddenly, whether from a misstep on uneven terrain, a sports-related incident, or simply rolling your ankle during daily activities.
While ankle sprains can range from mild to severe, they often result in pain, swelling, and limited mobility, impacting overall function. Without proper treatment, they can lead to chronic instability and an increased risk of re-injury. Fortunately, physical therapy for ankle sprains plays a crucial role in recovery, promoting healing, restoring strength, and improving balance and mobility. A structured rehabilitation program helps you regain full function and reduces the likelihood of future sprains, ensuring long-term ankle health.
What is an Ankle Sprain?
An ankle sprain occurs when the ligaments supporting the ankle are stretched or torn due to excessive twisting or rolling of the joint. This injury often occurs during physical activities like running, jumping, or stepping on an uneven surface. The severity of an ankle sprain varies based on the extent of ligament damage.
Ankle Sprain Severity
Ankle sprains vary in severity, ranging from mild ligament stretching to complete ligament tears. Understanding the different sprain grades helps determine the appropriate treatment and recovery time.
- Grade 1: A mild ankle sprain where the ligaments are stretched but not torn. Symptoms include slight swelling and tenderness but minimal pain or instability. Recovery typically takes a few days to a week.
- Grade 2: A moderate sprain involving partial tearing of the ligament. Symptoms include swelling, bruising, and difficulty bearing weight on the affected foot. Recovery may take several weeks with proper rehabilitation.
- Grade 3: A severe sprain where the ligament is completely torn, causing significant swelling, bruising, and instability. This may require a longer rehabilitation process and, in some cases, surgery.
How to Diagnose an Ankle Sprain
A healthcare professional can diagnose an ankle sprain by physical examination, assessing pain, swelling, and range of motion. Imaging tests such as X-rays or MRI scans may be recommended to rule out fractures or severe ligament damage. Early diagnosis is crucial for an effective recovery plan.
Why Physical Therapy Is Important for Ankle Sprains
Physical therapy is essential for treating ankle sprains as it aids in reducing pain, restoring strength, and preventing long-term complications. The findings in this study indicate that early physiotherapy intervention has a positive effect on patient-focused foot- and ankle function after an acute ankle sprain during the first three months after the injury. Research has shown that early physiotherapy intervention positively impacts foot and ankle function within three months after an acute ankle sprain.
Physical Therapy Treatment for Ankle Sprains
Physical therapy plays a crucial role in recovery by addressing pain, restoring mobility, and strengthening the ankle. A well-structured sports injury rehabilitation plan can help prevent future injuries and ensure a full return to daily activities.
RICE Method
The initial phase of treatment involves the RICE (Rest, Ice, Compression, Elevation) method to manage swelling and pain. Resting the injured ankle prevents further damage, while ice application reduces inflammation. Compression and elevation help control swelling and improve circulation.
Manual Therapy
Hands-on techniques such as joint mobilization, soft tissue massage, and stretching improve mobility, reduce pain, and restore function. Manual therapy helps break down scar tissue and enhances the range of motion in the ankle joint.
Therapeutic Exercises
Rehabilitation exercises focus on strengthening the muscles surrounding the ankle, improving flexibility, and enhancing stability. A well-structured program of physical therapy ankle strengthening exercises helps restore normal movement patterns and prevent re-injury.
Modalities
Additional treatments such as ultrasound therapy, electrical stimulation, and cold therapy may reduce pain and promote healing. These modalities enhance circulation and accelerate tissue repair.
Rehabilitation Exercises for Ankle Sprains

Rehabilitation exercises are essential for regaining strength, flexibility, and balance in the ankle after a sprain. A structured exercise program can accelerate recovery and reduce the likelihood of re-injury.
Ankle Alphabet
This exercise involves tracing the letters of the alphabet with your toes while sitting or lying down. It helps restore mobility and range of motion, making it an excellent early-stage rehabilitation exercise. This movement helps engage the ankle in various directions, promoting circulation and flexibility.
Side to Side Knee Swing
Sitting on a chair, gently move your knee from side to side to promote ankle mobility and flexibility. This motion encourages a natural range of movement, reducing stiffness and enhancing joint function.
Towel Scrunch
Place a towel on the floor and use your toes to scrunch it toward you. This strengthens the small muscles in the foot and ankle, improving grip strength and dexterity. Performing this exercise consistently helps enhance foot stability and prevent further injuries.
Calf Stretch
Stretching the calf muscles helps maintain flexibility and prevent tightness, contributing to ankle stiffness. Keeping the calf muscles loose reduces strain on the Achilles tendon and promotes better movement mechanics.
Ankle Eversion
Move your foot outward against resistance to strengthen the lateral ankle muscles and improve stability. This exercise helps protect the ankle from rolling injuries and supports better control during movement.
Ankle Opposition
Press your foot against a stable object or resistance band to improve ankle strength and control. This movement enhances muscle coordination and contributes to improved balance and proprioception.
Resisted Ankle Inversion
Using a resistance band, move your foot inward to strengthen the medial ankle muscles. Strengthening these muscles helps prevent excessive inward rolling of the ankle, reducing the risk of sprains.
Resisted Ankle Eversion
Opposite to inversion, this exercise strengthens the lateral stabilizing muscles of the ankle. Consistently performing this exercise improves ankle endurance and helps prevent recurrent injuries.
Resisted Ankle Dorsiflexion
Using a resistance band, pull your foot upward to strengthen the front ankle muscles. This movement enhances walking mechanics and supports proper foot positioning during daily activities.
Single-Leg Balance
Standing on one leg helps improve proprioception and balance, reducing the risk of future ankle sprains. This exercise also strengthens stabilizing muscles, enhancing overall coordination and injury prevention.
Tips to Prevent Future Ankle Sprains
Preventing ankle sprains requires strength, flexibility, and awareness of movement. By taking proactive steps, individuals can reduce the likelihood of re-injury and maintain optimal ankle health.
- Wear proper footwear that provides adequate support and cushioning.
- Warm up before physical activities to prepare the muscles and ligaments for movement.
- Strengthen the ankle muscles through targeted exercises to improve stability.
- Practice balance training to enhance coordination and proprioception.
- Avoid uneven surfaces and be mindful of movements that could increase the risk of rolling your ankle.
- Use supportive braces or taping if you have a history of ankle sprains for added stability during high-risk activities.
When to Seek Professional Help

While many mild ankle sprains heal with home care, it is essential to seek professional help if you experience persistent symptoms or worsening pain. Severe pain and swelling, an inability to bear weight on the affected foot, or ongoing instability may indicate a more serious injury that requires medical attention. Delaying treatment can lead to long-term complications, including chronic ankle instability or recurrent sprains.
Recurring ankle sprains can weaken the ligaments and make future injuries more likely. Seeking the expertise of a physical therapist ensures proper rehabilitation and recovery. A physical therapy session at Backcountry Physical Therapy can provide personalized treatment and rehabilitation plans, guiding you through strength-building exercises and mobility work to restore ankle function and prevent future injuries.
Conclusion
Ankle sprains are common but should not be ignored. Proper diagnosis, treatment, and rehabilitation through physical therapy for a sprained ankle are essential for a full recovery. You can regain strength, mobility, and confidence in your ankle’s function with targeted exercises and preventative measures. If you experience a sprain, consult a physical therapist to start your recovery journey and prevent future injuries.
FAQs
What do you do at physical therapy for your ankle?
A physical therapy session for ankle sprains includes a combination of manual therapy, therapeutic exercises, and modalities such as ice or ultrasound therapy. The goal is to reduce pain, restore range of motion, and strengthen the ankle to prevent future injuries.
Which therapy is best for ankle pain?
The best therapy for ankle pain depends on the cause. A combination of the RICE method, manual therapy, strengthening exercises, and balance training is highly effective for sprains. A physical therapist can tailor a treatment plan based on your specific needs.
How long does ankle physical therapy take?
The duration of ankle physical therapy varies depending on the severity of the sprain. Mild sprains may take a few weeks to heal, while moderate to severe sprains can take several months. Consistent therapy and adherence to rehabilitation exercises can speed up recovery.