Ankle Sprain
A stretched or torn ligament, usually from rolling your ankle outwards. Most people walk on it within days and recover in 2 to 6 weeks. Skip the rehab and it often comes back.
Do I need an X-ray? Most sprains don’t. Doctors use the Ottawa ankle rules: you need one if you couldn’t take 4 steps straight after the injury and still can’t, or if there is bone tenderness at the back edge or tip of either ankle bone, at the base of the outer long bone of the foot, or over the bony bump on the inner midfoot.
The ankle sprain ladder
Move early, load gradually. Long rest is a step backwards here.
- Step 1 · Self-careProtect, then walkA couple of easy days with ice and elevation, then walk as soon as pain allows. Crutches briefly if needed.
- Works
- Early walking: back to work and sport sooner than in a cast. Ice and elevation: weak evidence, may ease early swelling
- Cost
- Free, or about $10–25 for an ice pack
- How long
- Protect for 2–3 days; walk within days
- Watch for
- Heat, alcohol, running and massage in the first 2–3 days can boost swelling
Couch-and-cast is out. Pain-guided walking is in.
- Step 2 · PharmacyAnti-inflammatory gel or tabletsFor pain and swelling in the first few days.
- Works
- Gel: about 1 extra person in every 2–4 gets good pain relief within a week, with fewer side effects. Tablets: modest relief
- Cost
- About $5–20
- How long
- A few days, up to a week
- Watch for
- Tablets aren’t for everyone (stomach ulcers, kidney problems, some heart conditions, pregnancy). Check with your pharmacist
A short-term helper, not a reason to skip rehab.
- Step 3 · PharmacyLace-up brace or tapeSupports the ankle while the ligaments heal.
- Works
- Cuts repeat sprains by about half when worn for sport. Better than a bandage
- Cost
- About $30–80 for a brace; tape is cheaper but needs skill
- How long
- Early on, then for sport for at least 6 months
- Watch for
- A tubular bandage alone does very little
A crepe bandage is a hug, not a brace.
- Step 4 · Allied healthExercise and balance training (physio)Ankle circles, calf raises and single-leg balance, building to hopping and changing direction.
- Works
- Cuts repeat sprains by about a third or more: the best prevention
- Cost
- Physio about $90–130 a session (private health extras may help). Home programs work too
- How long
- Start in the first week; keep going for 3 months
- Watch for
- Stopping once it feels fine. That’s exactly when sprains come back
Stand on one leg while you brush your teeth. Cheapest insurance you’ll ever buy.
- Step 5 · PrescriptionShort-term boot or castFor a severe sprain, a doctor may suggest one for up to 10 days, then rehab.
- Works
- In one large trial, faster early recovery than a compression bandage in severe sprains
- Cost
- Boot about $80–200; often supplied by the hospital
- How long
- Up to 10 days
- Watch for
- Stiffness and calf weakness if worn too long; clot risk in some people
A short holiday for your ankle, not a long-term lease.
- Step 6 · SpecialistSurgeryFor an ankle that keeps giving way despite a full rehab program.
- Works
- Good results for most with ongoing instability, but no good trials. Rarely needed after a first sprain
- Cost
- Free in public hospitals (waits apply) or private with an out-of-pocket gap
- How long
- Months of rehab afterwards
- Watch for
- Infection, nerve irritation, stiffness
Only after you’ve actually done the rehab. Actually done it.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Ultrasound therapyTrials show no real benefit for ankle sprains. The machine hums; the ankle doesn’t care.
- Coloured kinesiology tapeLittle better than sham taping in trials. Looks sporty, does little.
- Platelet-rich plasma (PRP) injectionsSmall studies, no clear benefit, and costly.
- Days of icingMay numb pain briefly, but there’s little evidence it speeds healing. Walking does more.
- An X-ray for every sprainMost don’t need one. The Ottawa ankle rules pick out the few that do.
What you can do
- Use pain as a guide: mild discomfort with exercise is fine.
- Return to sport once you can hop and change direction without pain.
- Keep up balance exercises for 3 months, even when it feels better.
- Brace or tape for sport for at least 6 months after a sprain.
- Print our ankle sprain exercise handout and stick it on the fridge.
See your GP if
- You can’t walk 4 steps, or have bone tenderness (see the X-ray rules above)
- Not improving after 1 week, or still painful or unstable after 6 weeks
- The ankle keeps giving way
- Pain is high on the shin, or at the back of the heel (Achilles)
Go to the emergency department if the ankle or foot looks deformed, is cold, pale or numb, or a bone is visible.
Common questions
How long does a sprained ankle take to heal?
Most people can walk on it within days and recover in 2 to 6 weeks, though severe sprains take longer. Keep up balance exercises for 3 months to lower the chance of another sprain.
Do I need an X-ray for a sprained ankle?
Most sprains don’t. You need one if you couldn’t take 4 steps straight after the injury and still can’t, or if there is tenderness over specific spots on the ankle or foot bones.
Should I rest a sprained ankle or walk on it?
Walk on it as soon as pain allows, using crutches briefly if needed. Early movement leads to faster recovery than rest, and long periods in a cast slow things down.
Should I use ice or heat on a sprained ankle?
Wrapped ice for 15 to 20 minutes every 2 to 3 hours may ease pain and swelling in the first 2 days. Avoid heat, alcohol and massage for the first 2 to 3 days.
Why is my ankle still swollen weeks after a sprain?
Some swelling, especially at the end of the day, is normal for 4 to 6 weeks and can linger for a few months. If pain, giving way, clicking or locking continues after about 6 weeks, get it checked, as a cartilage injury, hidden fracture or high ankle sprain can be missed.
Should I wear an ankle brace?
A lace-up brace or tape helps you return to activity sooner. If you’ve sprained your ankle before, wearing a brace or tape for sport over the next year roughly halves the chance of spraining it again, alongside balance exercises.
What is a high ankle sprain?
An injury to the ligaments joining the two lower leg bones just above the ankle, usually from the foot twisting outwards. Pain sits higher than a normal sprain, and recovery often takes 6 to 8 weeks or more, so it needs proper assessment.
Helpful resources
- Ankle sprain exercise handoutPrintable, one page, with sets and progressions. Free, from us.
- Sports Medicine Australia: Ankle injuriesSports-focused fact sheet on rehab, taping and bracing to stop it happening again. Free.
Evidence and more information
- NSW ACI: Ottawa ankle rules
- Healthdirect: Sprained ankle
- BJSM: Soft tissue injuries need PEACE & LOVE
- Cochrane: Topical NSAIDs for acute pain
maladywise.com/ankle-sprain/