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What to do with acute ankle sprains

This is a very common injury that we see in clinic.  It is usually due to rolling outwards or inwards on your ankle.  Aside from pain there may be swelling and bruising around the ankle and foot.

A common question that clients ask is what they should be doing in the first few days following an ankle sprain. Taking the right steps in the few days and weeks following such an injury can make a large difference to recovery time.


Do you need an Xray?  There are a few rules to follow when considering whether you need further investigation or imaging.  If you have severe pain and are unable to weight bear or are struggling to take a few steps, especially with a forceful injury, we would recommend seeking medical advice sooner rather than later.    The medical professional you see will use guidelines such as the Ottowa rules to determine whether further imaging is indicated.

Cold Treatment

Using an ice pack or cold pack in the week or two after injury has proven useful for pain relief, reduction of swelling and improved function.  You should only use this method if you haven’t lost the feeling in your skin.  Always make sure you wrap the cold compress in a towel to protect your skin.  You can use a compress for upto 20 minutes every 2 hours. Do check your skin regularly during this period to make sure you don’t burn.


Compression of the area from your foot to knee is a useful strategy to reduce swelling in the first two weeks after injury and improve overall recovery time.  A stirrup brace or lace support are more effective than a tubular compression bandage.   You can also combine these by wearing a tubular support under a stirrup brace to enhance the effect.  Remember to keep your toes visible to make sure you are able to see that your toes don’t lose blood flow. This means your compression is too tight!


Keep yourself moving within reason!

Early mobilization with you putting weight through your foot and ankle within your own pain threshold is much better than rest for better recovery time and return to full function or sport.  Keeping moving, within reason, can also help reduce swelling and improve circulation. This will help provide the area with the nutrients it needs for recovery.

Try gentle range of movement exercises in the first week following injury, e.g. ankle circles or ankle pumps.  As your pain improves, gradually increase activity and exercise. Seek advice from your friendly physiotherapist if you need further assistance with treatment or rehabilitation!


Some people find that basic pain relieving and/or anti-inflammatory medication helps manage their symptoms while they recover.  Your pharmacist at your local chemist is a great point of initial contact if you are unsure what would be useful for you and what you may or may not be able to safely take with any other medication you may be on.

Depending on the severity of the injury, recovery can take anything from 2 weeks to several months. The first week following ankle sprain should mainly concentrate on swelling and pain control and getting the ankle moving gently.  A physiotherapist  will be able to help with treatment to help restore strength, movement and control with the aim of getting you back function and sport and most importantly, to reduce the risk of reoccurence.