Rehab After Ankle Sprains: Avoiding Long-Term Joint Damage
An ankle sprain refers to stretching or tearing of the ligaments that support the ankle joint,
most commonly on the outside of the ankle.
Ankle sprains are one of the most common injuries, but without proper rehabilitation, they
can lead to ongoing problems like instability or repeated injuries.
Causes of ankle sprains:
• Sudden twisting movements: Often during sports or walking on uneven surfaces;
• Poor balance or coordination: Reduced control increases the risk of ankle sprain;
• Previous ankle injury: A history of sprains increases recurrence risk;
• Weak surrounding muscles: Reduced support for the ankle joint;
• Inadequate warm-up or footwear: Can increase stress on the ankle joint;
Research suggests that up to 40% of people may develop chronic ankle instability if not
treated properly.
Grades of ankle sprains:
Ankle sprains can be classified based on the severity:
Grade 1 (Mild):
• Slight stretching of ligaments
• Mild swelling and tenderness
• Little or no instability
• Able to walk with minimal pain
Grade 2 (Moderate):
• Partial ligament tear
• Moderate swelling and bruising
• Painful to walk
• Some joint instability
Grade 3 (Severe):
• Complete ligament tear
• Significant swelling and bruising
• Difficulty or inability to bear weight
• Marked joint instability
More severe sprains (Grade 2–3) have a higher risk of long-term instability if not properly
rehabilitated.
Why rehab is important:
If not rehabilitated properly, an ankle sprain can lead to:
• Recurrent sprains
• Persistent pain or swelling
• Reduced balance and coordination
• Long-term joint instability
Exercise-based rehab programs have been shown to reduce the risk of re-injury compared
to rest alone.
Stages during rehabilitation of an ankle sprain:
RICE (early stage):
Avoid activities that cause pain while allowing gentle movement. Helps reduce swelling
and pain in the initial phase.
Restore movement:
Gentle ankle mobility exercises to regain range of motion.
Strengthening:
Strength exercises targeting the calf, ankle, and foot muscles.
Balance & proprioception training:
Improves joint stability and reduces risk of future sprains.
Gradual return to activity:
Slowly reintroducing sport or exercise to avoid re-injury.
Key Rehab Exercises to Get You Started
• Mobility Exercise: Ankle Alphabet
Restores gentle ankle range of motion.
1. Sit comfortably with your leg supported.
2. Use your foot to “draw” the letters of the alphabet in the air.
3. Keep the movement slow and controlled, using only your ankle
Repetitions: 3 rounds of A–Z
• Strength Exercise: Resistance Band Ankle Eversion
Strengthens the muscles supporting the outside of the ankle
1. Sit with your leg straight.
2. Loop a resistance band around your forefoot, anchored on the opposite side.
3. Turn your foot outward against the band slowly.
4. Return to neutral position with control.
Repetitions: 10–15 reps × 3 sets
• Proprioception Exercise: Single-Leg Balance
Improves ankle stability and body awareness
1. Stand on the injured leg (hold onto a wall or a table if needed).
2. Keep your balance for 30 seconds.
3. Progress by:
• Letting go of support
• Closing your eyes
• Standing on an unstable surface (e.g., pillow)
Repetitions: 3 reps on each side.
Rest alone is not enough—targeted rehabilitation is essential to fully recover
and prevent long-term joint damage.
Get in touch with our team at myPhysioSA, and we’ll help you get started with a
personalised rehab program tailored to your needs.
Written by Drishti Patel, Senior Physioherapist at myPhysioSA Mount Barker and Mannum
References:
1. Wagemans, J., Bleakley, C., Taeymans, J., Schurz, A. P., Kuppens, K., Baur, H., &
Vissers, D. (2022). Exercise-based rehabilitation reduces reinjury following acute
lateral ankle sprain: A systematic review update with meta-analysis. PloS one,
17(2), e0262023.
2. De Fazio, A., Fravolini, G., Gabrielli, E., Forconi, F., Maccauro, G., & Vitiello, R., et al.
(2026). Functional and neuromuscular effects of rehabilitation in acute ankle sprain
and chronic ankle instability. Journal of Foot and Ankle Surgery.
