A rolled ankle can swell quickly and make every step uncomfortable. Most ankle sprains improve without surgery, but the right early care, gradual movement and progressive strengthening can make the return to walking, work and sport safer.
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What is an ankle sprain?
An ankle sprain happens when one or more ligaments around the joint are overstretched or torn, usually after the foot twists or rolls. Most sprains affect the ligaments on the outside of the ankle. The damage can range from a small ligament injury to a complete rupture, so symptoms and recovery times vary.
Typical symptoms include pain, swelling, bruising, reduced movement and difficulty walking or using stairs. Weakness and poorer balance can persist after the initial pain settles, which is why rehabilitation involves more than waiting for the swelling to disappear.
Could it be a broken ankle?
It is not always possible to distinguish a sprain from a fracture by appearance alone. NICE recommends that trained healthcare professionals use the Ottawa ankle and foot rules to decide whether an X-ray is needed after a suspected fracture. These rules depend on specific areas of bone tenderness and the ability to bear weight; they are not a substitute for self-diagnosis.
Contact NHS 111 after an ankle injury if the pain is severe or worsening, swelling or bruising is substantial, the joint is very stiff, or you cannot walk more than a few steps. Go to A&E if the ankle is at an odd angle, bone is visible, there is a serious wound, or the toes look blue or white or feel numb. These can be signs of fracture or compromised circulation.
What should you do in the first 48 to 72 hours?
The NHS advises PRICE measures during the first two to three days:
- Protection: use supportive footwear, a brace or another suitable support if needed.
- Rest: pause sport and avoid repeatedly provoking significant pain.
- Ice: apply a wrapped ice pack for up to 20 minutes every two to three hours. Do not put ice directly on the skin.
- Compression: a bandage can support the ankle during the day, but it should not cause numbness, colour change or increasing pain.
- Elevation: raise the ankle on pillows when practical to help manage swelling.
For the first couple of days, the NHS also advises avoiding heat, alcohol and massage because they may increase swelling. If you have poor circulation or reduced sensation, ask a healthcare professional before using ice or heat.
When should you start moving the ankle?
Protection does not mean complete immobilisation for every sprain. Once pain allows, begin gentle, comfortable ankle movement so the joint does not become unnecessarily stiff. NHS Inform recommends gradually restoring normal movement as soon as possible, stopping and seeking advice if it becomes too painful.
Simple early movements may include slowly pointing the foot away and drawing it back towards you, then moving the ankle gently from side to side. Keep the range small at first. Mild discomfort can be acceptable, but sharp pain or a clear increase in swelling afterwards suggests the dose was too high.
Ankle sprain exercises: a staged approach
The correct starting point depends on the severity of the injury. The stages below are general milestones, not a rigid timetable.
Stage 1: restore movement and comfortable walking
- Gentle ankle pumps and side-to-side movement.
- Short, comfortable walks, increasing distance gradually.
- Supported weight transfer from one foot to the other.
Avoid forcing a limp through long walks. If you cannot bear weight or walking is becoming harder rather than easier, seek clinical advice.
Stage 2: rebuild strength
- Double-leg calf raises, progressing towards single-leg calf raises.
- Light resistance-band movements in different directions.
- Controlled sit-to-stand or step exercises if comfortable.
Strength work should feel challenging without producing a major flare later that day or the next morning. Add repetitions, resistance or range gradually rather than changing everything at once.
Stage 3: balance, direction changes and sport
- Single-leg balance near a stable support.
- Step-downs and controlled direction changes.
- Small hops, then running and sport-specific drills when appropriate.
Return to running or court sport should be based on function, not the calendar alone. Useful signs include near-normal movement, minimal swelling, comfortable brisk walking, good single-leg control and the ability to hop without pain or giving way. Build speed, distance and cutting movements in stages.
How long does an ankle sprain take to heal?
Many sprains feel noticeably better after about two weeks, but this does not mean the ligament and balance system are ready for unrestricted sport. NHS advice suggests avoiding strenuous exercise such as running for up to eight weeks because returning too quickly can cause further injury.
NHS Inform describes gradual recovery over roughly 8 to 12 weeks: movement and swelling should start improving in the first two weeks; walking and range often approach normal during weeks two to six; and day-to-day function continues to recover through weeks six to twelve. Severe sprains can take several months.
Recovery is not always linear. A temporary increase in swelling after doing more does not automatically mean you have caused new damage, but the overall trend should be improving. Adjust the next day's activity if symptoms stay clearly elevated.
How can physiotherapy help?
A physiotherapist can assess movement, swelling, strength, balance and walking, and check whether the history suggests a fracture or another injury. A tailored plan may include:
- advice on supports, footwear and short-term activity modification;
- graded movement and weight-bearing;
- calf and ankle strengthening;
- balance and coordination training;
- a progression back to work, running or sport;
- referral for medical assessment or imaging when appropriate.
If pain is centred in the heel rather than following a twist, read our guide to plantar fasciitis and heel pain. If the pain is at the back of the ankle and developed with repeated loading, our Achilles tendinopathy guide may be more relevant.
When should you get further help?
Ask for an assessment if pain is worsening, you cannot bear weight, the ankle repeatedly gives way, or numbness and tingling persist. Contact a GP or MSK clinician if the injury is stopping normal activities or is not improving with self-care. NHS Inform advises speaking to a healthcare professional if symptoms are worsening or have not improved within 8 to 12 weeks.
People with diabetes, poor circulation or reduced sensation should seek advice sooner because foot and ankle problems may require closer monitoring.
Talk to a physiotherapist before choosing treatment
The free initial consultation lets you meet the physiotherapist, explain your ankle symptoms and understand how the service works before making any decision about treatment.
Book your free initial consultation
Paid physiotherapy sessions are optional and secondary. There is no obligation to book one after the free consultation.
Sources
- NHS: Sprains and strains (page reviewed 23 April 2024; accessed 4 October 2026).
- NHS: Ankle pain (accessed 4 October 2026).
- NHS Inform: Ankle sprain (updated 24 August 2026; accessed 4 October 2026).
- NICE NG38: Fractures (non-complex) assessment and management (accessed 4 October 2026).
This article provides general information and does not replace an individual medical assessment.