Sprained Ankle Physiotherapy in Newcastle

What is an ankle sprain?

An ankle sprain occurs when the ligaments around the ankle are overstretched or torn.

Ligaments are strong bands of connective tissue that help stabilise the joints. The most commonly injured ligaments are on the outside of the ankle, usually following an inversion injury where the foot rolls inwards.

A typical lateral ankle sprain can affect:

• Anterior talofibular ligament (ATFL)

• Calcaneofibular ligament (CFL)

• Posterior talofibular ligament (PTFL)

Less commonly, the ligaments on the inside of the ankle can be injured. A high ankle sprain, or syndesmosis injury, affects the ligaments connecting the tibia and fibula and can require a different rehabilitation approach.

What causes a sprained ankle?

An ankle sprain usually occurs when the foot suddenly changes position while the body continues moving.

Common causes include:

• Landing awkwardly after jumping

• Rolling your ankle while running

• Changing direction quickly during sport

• Stepping onto an uneven surface

• Tripping or falling

• Contact with another player

• Running on uneven ground

• Previous ankle injuries

Ankle sprains are particularly common in sports involving running, jumping and rapid changes of direction, including football, rugby, basketball, tennis and running.

Symptoms of a sprained ankle

Symptoms depend on the severity and location of the injury.

Common symptoms include:

• Ankle pain

• Swelling

• Bruising

• Tenderness around the ankle

• Difficulty putting weight through the foot

• Reduced ankle movement

• Pain when walking or running

• Difficulty going up and down stairs

• Weakness

• A feeling that the ankle is unstable

Some people are able to walk relatively normally after a mild sprain, while more significant injuries can make weight-bearing extremely difficult.

How severe is my ankle sprain?

Ankle sprains are sometimes classified into three grades:

Grade 1 ankle sprain

A mild sprain involving stretching and minor damage to the ligament.

You may experience mild pain and swelling but can usually walk with relatively little difficulty.

Grade 2 ankle sprain

A moderate sprain involving a partial tear of one or more ligaments.

There is often more significant swelling, bruising and pain, with difficulty walking or exercising.

Grade 3 ankle sprain

A severe sprain involving a complete ligament tear or significant disruption.

This can cause substantial swelling, bruising, pain and instability and may make weight-bearing very difficult.

However, the grade of an ankle sprain does not always tell us exactly how quickly you will recover. Your symptoms, physical function and ability to progressively load the ankle are more important when planning rehabilitation.

Do I need an X-ray for a sprained ankle?

Not every ankle sprain requires an X-ray.

During your assessment, your physiotherapist will consider whether there are signs that you may have sustained a fracture. This can include assessing specific areas of tenderness and your ability to bear weight.

The Ottawa Ankle Rules are commonly used to help determine whether an X-ray may be appropriate following an acute ankle injury.

If there is significant bony tenderness, inability to take weight through the ankle or another concern about a fracture, you may be advised to seek further medical assessment.

Sprained Ankle Treatment

The treatment of an ankle sprain depends on the severity of the injury and how long ago it occurred.

Early management

In the first few days, the priorities are generally to manage pain and swelling while allowing the ankle to begin moving and bearing weight as tolerated.

Depending on your symptoms, this may involve:

• Relative rest from aggravating activities

• Gradually increasing weight-bearing

• Ankle movement exercises

• Compression

• Elevation

• Appropriate pain relief

• Temporary use of a brace or support when required

Complete immobilisation is not usually necessary for a straightforward mild ankle sprain.

Restore ankle movement

An ankle sprain can cause stiffness, particularly around the ankle joint and calf.

Your rehabilitation may include exercises to restore:

• Ankle dorsiflexion

• Ankle plantarflexion

• Inversion and eversion

• Calf flexibility

• Normal walking mechanics

Restoring normal movement can help prepare the ankle for progressively higher levels of activity.

Strengthening

An important part of ankle rehabilitation is rebuilding strength.

Exercises may target the muscles responsible for controlling the foot and ankle, including:

• Calf muscles

• Peroneal muscles

• Tibialis anterior

• Foot muscles

• Wider lower-limb muscles

Exercises can progress from simple resistance work to single-leg strengthening and more demanding functional movements.

Balance and proprioception

An ankle sprain can temporarily reduce your balance and ability to sense the position of your ankle.

This is sometimes referred to as impaired proprioception.

Rehabilitation may therefore include:

• Single-leg balance

• Balance on unstable surfaces

• Reaching exercises

• Hopping

• Landing exercises

• Changes of direction

This is particularly important if you participate in sport.

Return to running and sport

Returning to sport too quickly can increase the risk of re-injury.

Your rehabilitation should gradually expose the ankle to the movements and loads required by your sport.

For a runner, this might progress from:

Walking → jogging → continuous running → faster running → hills → intervals

For field and court sports, rehabilitation may additionally involve:

Running → acceleration → deceleration → jumping → landing → cutting → sport-specific drills

The aim is not simply to get the ankle feeling better. It is to restore the capacity required for your normal activity.

How long does a sprained ankle take to heal?

Recovery varies depending on the severity of the injury.

A mild ankle sprain may improve considerably within a few weeks, while a more significant ligament injury can take several weeks or months to fully recover.

Factors that can influence recovery include:

• Severity of the ligament injury

• Previous ankle sprains

• Amount of swelling and pain

• Strength and balance

• Sporting demands

• Rehabilitation

• Whether there are associated injuries

It is common for the ankle to feel better before it has completely regained its strength and stability. This is one reason why completing rehabilitation is important even after everyday walking becomes comfortable.

Why does my ankle still hurt after a sprain?

Persistent symptoms after an ankle sprain are relatively common.

If your ankle continues to hurt, swell or feel unstable several weeks after the original injury, there may be factors that have not fully recovered.

These can include:

• Reduced ankle strength

• Reduced balance

• Joint stiffness

• Persistent ligament injury

• Tendon irritation

• Reduced tolerance to running or jumping

• An associated cartilage or bone injury

• Incomplete rehabilitation

If symptoms are not improving as expected, a physiotherapy assessment can help determine what is limiting your recovery.

Recurrent ankle sprains

Having one ankle sprain increases your risk of sustaining another.

This can happen if the ankle has not fully recovered its strength, balance, movement or ability to tolerate rapid changes in load.

Rehabilitation aimed at improving strength, balance and sport-specific control can reduce the risk of future ankle problems.

A long-term prevention programme may include calf and ankle strengthening, balance exercises and sport-specific hopping, landing and change-of-direction exercises.

Sprained Ankle Physiotherapy in Newcastle

At NE Physio, we provide physiotherapy for ankle sprains in Newcastle, from recent injuries through to persistent ankle pain and instability following previous sprains.

Your assessment will look beyond the injured ligament to understand how the ankle is functioning as a whole. We will assess your movement, strength, balance and ability to perform the activities that are important to you.

Your rehabilitation programme will then be progressed according to your goals, whether that is returning to running, getting back to football, returning to the gym or simply walking without pain.

Frequently Asked Questions

How soon should I see a physiotherapist for a sprained ankle?

You do not necessarily need physiotherapy for every mild ankle sprain. However, an assessment can be particularly useful if you have significant pain or swelling, difficulty walking, a history of recurrent ankle sprains or symptoms that are not improving.

Early physiotherapy can also help guide your return to activity and reduce the risk of persistent ankle problems.

Should I walk on a sprained ankle?

For many uncomplicated ankle sprains, gradually putting weight through the ankle as tolerated is appropriate. You may initially need to reduce your walking or use a brace or other support.

If you cannot put weight through the ankle or have significant pain, you should be assessed to rule out a more significant injury or fracture.

Should I use ice for a sprained ankle?

Ice can provide short-term relief of pain for some people, particularly during the first few days. However, it is not a treatment that repairs the ligament.

The focus should be on managing symptoms while gradually restoring movement, strength and weight-bearing capacity.

Can I run with a sprained ankle?

Running is usually modified or temporarily stopped during the early stages of a significant ankle sprain.

Once walking is comfortable and the ankle has regained sufficient movement and strength, running can be gradually reintroduced. Returning too quickly can increase the risk of aggravating the injury or sustaining another sprain.

How do I know when my ankle is ready to return to sport?

Your ankle should be able to tolerate the demands of your sport without significant pain or swelling.

Depending on your sport, this may include being able to perform single-leg calf raises, hopping, jumping, landing, accelerating, decelerating and changing direction with good control.

Can a sprained ankle cause long-term problems?

Yes. Some people develop persistent pain, stiffness, weakness or instability following an ankle sprain.

This is more likely when rehabilitation is incomplete or when there are associated injuries. Persistent symptoms should be assessed rather than simply ignored.

Can you sprain your ankle again?

Yes. Previous ankle sprains are an important risk factor for future sprains.

Improving ankle strength, balance, proprioception and the ability to tolerate sport-specific movements can help reduce this risk.

When should I seek medical assessment for an ankle injury?

Seek medical assessment if you have severe pain, significant deformity, an inability to bear weight, marked bony tenderness or symptoms that suggest a fracture or significant ligament injury.

If your ankle is not improving as expected, a physiotherapy assessment can help determine why.

Book Sprained Ankle Physiotherapy in Newcastle

If you have recently sprained your ankle or are still experiencing pain, weakness or instability following an ankle injury, NE Physio can help you return to normal activity and sport safely.