Ankle sprain rehabilitation — what to do step by step?

After an ankle sprain, first check whether you need an X-ray – e.g. if you cannot take 4 steps. Then protect the joint and raise your leg, put weight on it gradually within the limits of pain, restore mobility, and then train balance and strength. Balance training reduces the risk of spraining the ankle again. How quickly you move on to the next steps depends on how severe the injury is.

Below you will find criteria for when to see a doctor first about your ankle, advice for the first few days, 6 steps of rehabilitation without a rigid timetable, 4 exercises with dosage, and the most common mistakes.

How can you tell if an ankle sprain is serious?

Sprains are usually divided into 3 grades. In grade I the ligaments are stretched, swelling is slight and you can walk. In grade II the ligaments are partially torn, with clear swelling and bruising. In grade III the ligament is ruptured and the joint is unstable. The final assessment of how severe the injury is should be made by a doctor or physiotherapist.

The ligament most often injured is the anterior talofibular ligament on the outer side of the ankle, when the foot “rolls” inwards. How strong the pain is in the first few hours does not always match how severe the injury is, so it is worth repeating the assessment after a few days, once the swelling has gone down.

What to do in the first few days after a sprain?

In the first few days, protect the joint from painful movements, raise your leg above the level of your heart, use a compression bandage and gradually put weight on the leg within the limits of pain. A cold compress may reduce pain, although its effect on healing is debated. Take anti-inflammatory and pain-relief medicines only as described in the leaflet or as recommended by a doctor.

These principles are described by the PEACE & LOVE acronym from 2020: first protection, elevation, compression and education, then load, movement, exercise and looking after circulation. It is important not to immobilise the joint for longer than the doctor advised – after injuries without a fracture, early, controlled movement usually supports healing.

What does rehabilitation look like step by step?

Rehabilitation after an ankle sprain follows 6 steps: assessing the injury, protection and controlling swelling, walking with weight-bearing within the limits of pain, restoring mobility, balance and strength training, and finally returning to work or sport. You move on to the next step once you meet the criteria, not after a set number of days.

1. Assessing the injury – ruling out a fracture, determining the grade of the sprain.
2. Protection and swelling – raising the leg, a bandage, possibly an orthosis recommended by a doctor.
3. Weight-bearing – walking within the limits of pain, with crutches if needed.
4. Mobility – bending and straightening the foot, ankle circles, rolling the foot freely through each step when walking.
5. Balance and strength – standing on one leg, heel raises, exercises with a resistance band.
6. Return to activity – running, jumping, changes of direction, and then sports training.

The pace of these stages is set by the treating doctor and the physiotherapist, and with grade III sprains and after fractures you proceed strictly according to their recommendations.

Which exercises should you do after an ankle sprain?

Once a fracture has been ruled out and the swelling starts to go down, mobility exercises, followed by balance and strength exercises, are usually safe when done within a pain level of up to 3 on a 0–10 scale. The 4 exercises below are general in nature. Start balance exercises next to a stable support, e.g. a kitchen worktop, so you do not risk falling.

1. Foot alphabet. Sitting down, “write” the capital letters of the alphabet in the air with your toes. The whole alphabet once, 2–3 times a day.
2. Heel raises. Standing at a worktop, raise your heels and slowly lower them, on both legs. 10 repetitions, 2 sets, once a day.
3. Standing on one leg. At a worktop, stand on the injured leg with your knee slightly bent. 3 attempts of 20–30 seconds, once a day; when it gets easy – with your eyes closed.
4. Turning the foot out with a band. Sitting down, loop an elastic band around the front of your foot and turn your foot outwards against the resistance. 10–12 repetitions, 2 sets.

If the pain gets worse or spreads, stop the exercise and consult a physiotherapist.

How does a physiotherapist help after an ankle sprain?

The physiotherapist assesses the stability of the joint, range of motion, gait and balance, and then puts together an exercise programme suited to the stage of healing. They may use manual therapy for limited mobility and kinesio taping to support the joint while you return to activity. In Rydułtowy a consultation costs PLN 180, and manual therapy with kinesio taping costs PLN 190.

The number of visits is decided individually after the consultation. If it is difficult for you to get to the clinic after the injury, the physiotherapist can come to your home – we describe how this works in our article rehabilitation at the clinic or at home.

Prices valid from 08.2026.

Which mistakes delay recovery?

The most common mistakes are prolonged immobilisation without a doctor’s recommendation, walking “through sharp pain”, giving up balance exercises as soon as the ankle stops hurting, and returning to running and team games without checking stability. Ignoring the signs of a fracture and putting off an X-ray when the Ottawa rules criteria are met is also risky.

We describe other injuries and joint pain in our guide joint pain and injuries – shoulder, elbow, knee, foot, and the difference between pain after exercise and an injury in our article pain after training or an injury.

Summary

After an ankle sprain, first rule out a fracture (Ottawa rules, including the 4 steps), then protect the joint and gradually put weight on the leg. Balance and strength training is key, because it reduces the risk of another sprain. The pace of rehabilitation is set by the doctor and the physiotherapist, and a consultation in Rydułtowy costs PLN 180.

Frequently asked questions

Sources

• Vuurberg G. et al., Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline, British Journal of Sports Medicine, 2018.
• Martin R.L. et al., Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021, JOSPT, 2021.
• Stiell I.G. et al., A study to develop clinical decision rules for the use of radiography in acute ankle injuries, Annals of Emergency Medicine, 1992.
• Dubois B., Esculier J.F., Soft-tissue injuries simply need PEACE and LOVE, British Journal of Sports Medicine, 2020.