Acute ankle sprains, what you need to know [2022].

If you have just sprained your ankle there are a few key steps to ensure you get the management absolutely right for the best result.

We have a look at the 4 top actions you need to take:

  • Do you need an x-ray
  • Ice and compression
  • Strapping for an ankle sprain
  • Getting the ankle moving again.

1. Do you need an x-ray for an  ankle sprain?

The first question we usually get is should I get an x-ray done? In the initial or acute phase there are a set or rules we use to determine if you need an x-ray known as the Ottawa ankle rules.

ankle lateral view

ankle medial view


If there is pain felt at the sites A, B,C or D and you can’t take any more than three steps with out assistance then that indicates an x-ray is useful to rule out a fracture.




2. ICE and compression for ankle sprain/ injury.

This seems to be becoming a controversial topic these days with people disagreeing on its use. However the use of ice with an acute injury has really stood the test of time in getting people back on their feet (forgive the pun).

A good protocol is:

10 – 15 mins in an bucket of water and ice 3- 4 x day.

During early stage rehab periods of 3-5 mins icing between rehab exercises or drills have proven useful.

For more information regarding the latest acute injury management check out our blog 

3. Strapping for an acute ankle sprain

If the swelling allows, strapping an ankle can make the world of difference in allowing you to weight bear and reduce the pain.

Its also a useful skill to have when starting to get back to activity and sport just to give you extra support, confidence and stability.

4. You’ve got to move it, move it!  Getting mobility at the ankle back following ankle sprain:

Especially in the case of recurrent ankle injuries the mobility of the injured side is very important. Individuals with less range at the affected ankle are at increased risk of further sprains.

Getting the ankle moving within what your pain allows is an effective way to get the healing process going. In the early days (day 1-10), your pain is a good guide as to what you can do.

Returning to sport or hobbies after ankle sprain.

Once you’ve got through the acute stage you need to rehab the whole lower limb, not just the ankle, back to the level you need it.

The following skills need to be assessed and trained  for successful rehabilitation  and also prevention of ankle and lower limb injuries. So if you’re about to start your sporting season (Netballers, Basketballers, footballers – I’m looking at YOU!)

  • Hip and core strength.
  • Advanced balance skills.
  • Don’t forget to train the foot intrinsic muscles
  • Improve the “stiffness” of the ankle  with plyometric exercises eg. skipping, jumping and change of direction in running drills.
  • The ability to land and take off effectively.
  • Maintaining the range of motion at the ankle and forefoot.

Last but not least I’ll leave you with this fact:

Remember the biggest predictor of an ankle injury is not sufficiently rehabilitating a previous ankle injury !

As always get your ankle assessed to get  you on the right path, Book online here.

Read more on rehabbing your ankle in this blog here: magnificent 7 exercise tips after ankle sprain



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Gabriella Sophie Schiftan, Lauren Ashleigh Ross, Andrew John Hahne

The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: A systematic review and meta-analysis
Journal of Science and Medicine in Sport, Volume 18, Issue 3, 2015, pp. 238-244

Doherty, C., Bleakley, C., Hertel, J., Caulfield, B., Ryan, J., & Delahunt, E. (2016). Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability: a prospective cohort analysis. The American journal of sports medicine, 44(4), 995-1003.

Smith, B. I., Curtis, D., & Docherty, C. L. (2018). Effects of hip strengthening on neuromuscular control, hip strength, and self-reported functional deficits in individuals with chronic ankle instability. Journal of sport rehabilitation, 27(4), 364-370.

Hubbard, T. J., & Hertel, J. (2006). Mechanical contributions to chronic lateral ankle instability. Sports medicine, 36(3), 263-277.