The Ultimate Guide to Ankle Sprain Rehab

While ankle sprains are extremely common orthopedic injuries, they are often treated poorly during the recovery process. Although many ankle sprains resolve without long-term problems if given appropriate early care, failing to rest an ankle sprain early on or returning to sports too quickly are two of the most common causes of delayed healing, persistent pain or weakness, and recurrent ankle sprain injuries.

We’ve put together this complete guide on how to treat an ankle sprain, featuring advice on early treatment, knowing when to get it evaluated or imaged, exercises to help recover strength and proprioception, taping or bracing considerations, and recommendations for returning to sport following injury.

EVREST Principle

EVREST is a common acronym that many healthcare providers use to remember the key early treatment guidelines for soft tissue injuries like ankle sprains.

• Protect/support the injured area

• Ice

• Elevate when possible

• Rest relative to pain

• Avoid stressful activities

• Compression

Treatment of Ankle Sprains in the First 48-72 Hours

Ice

Ice should be used regularly for the first couple of days after an ankle sprain. This is the optimal time to control pain and swelling. Apply ice for short durations – 10 minutes is plenty. Ice more frequently if needed. Do not apply ice directly to the skin. You can use an ice pack, ice in a plastic bag, or a bag of frozen vegetables.

Elevation

Whenever possible, keep the ankle elevated above the level of the heart. Elevation works best when you can prop up the leg for long periods like when sitting or lying down. Do this as often as you can for the first 48-72 hours after injury, as this will help limit ankle swelling.

Compression

Wearing an elastic ankle sleeve or wrap can help limit swelling and provides support to injured ankle ligaments. Wrap the bandage tightly, but not too tight that circulation is affected.

Mild ankle sprains can often be treated with just a supportive ankle brace. If pain is severe or ankle stability is significantly decreased, a walking boot can provide extra support for a few days. If you are unable to put weight on the ankle at all, develop extreme swelling, or have visible deformity, these are indications to obtain early medical attention after an ankle sprain.

Weight-Bearing Status

It can be difficult to know how much weight you should be putting on an injured ankle. Many patients do better with limited weight bearing through the injured ankle for the first few days.

Using crutches allows you to stay mobile without placing excessive weight on the ankle. If pain is minimal and you are able to walk without a limp, it is typically okay to begin slowly placing weight on the injured ankle.

Physical Therapy Exercises

Immediately After Injury

• Stop activity

• Protect ankle

• Ice

• Compression

• Elevation

• Avoid putting weight on it if it hurts

First 2 Days

• Keep portable ice on injured ankle

• Elevate ankle when possible

• Wear an elastic ankle wrap or brace

• Begin moving ankle through range of motion pain-free as soon as possible

Exercise: Ankle Pumping

As soon as it is tolerable, begin moving the ankle through a pain-free range of motion. Ankle pumps, pointing and flexing the foot, and alphabet exercises are all simple movements that can be repeated throughout the day to help limit stiffness.

After First Few Days

As you recover from your injury, begin working on ankle strengthening exercises. Because muscles help support and stabilize the ankle joint, building strength is very important following an ankle sprain.

Exercise: Resistive Ankle Motion

Use your hand to provide resistance while moving the ankle up, down, and side-to-side. Band exercises can also be used but are not necessary until later in the recovery process.

Exercise: Calf Raises

As the calf muscles are a critical source of stability for the ankle joint, it is important to include calf raises as you recover from an ankle sprain.

Balance Training

Balance and proprioceptive training should be included as early as possible in the recovery process. Standing on one leg is a simple way to begin retraining balance. Once you can do this easily, progress to standing on a pillow or cushion. Continue to advance until you can stand on uneven surfaces without any problem.

Balance and proprioception, which refers to your ankles ability to sense position, are just as important as strength in preventing ankle sprains. Incorporate these types of exercises into your routine as you recover from injury.

Bracing and Taping

Ankle braces and taping can be very useful during rehabilitation from an ankle sprain and during your early return to activity. Lace up ankle supports or semi rigid ankle braces provide structure and protection without restricting range of motion.

Footwear Considerations

Shoes with good heel counters and stability features help prevent unnecessary ankle motion. Ill fitting shoes and worn out sneakers provide the least amount of ankle support and should be avoided, particularly when returning to sports.

Returning to Sport

It’s difficult to predict exactly how long it will take for an ankle sprain to heal. A good rule of thumb is that your ankle should have near normal range of motion and strength when compared to your uninjured ankle prior to returning to sport. You should also be able to perform agility activities such as jumping and cutting without worry of re-injury.

Ideally, patients will work through a graduated return to activity protocol that continues to build strength and proprioception while slowly adding sport specific movements. If you rush this process and return to activity too early, you increase your risk of re-injury. This is one of the leading causes of chronic ankle problems.

Get Help for Ankle Pain & Sprains

With any luck, you won’t have to experience an ankle sprain again. However, if pain or instability persist despite appropriate care, it may be time to get evaluated by a specialist. At Treasure

Valley Foot & Ankle, we take the time to ensure that we haven’t missed any hidden ligament injuries, cartilage problems, or underlying biomechanical issues that may be causing your pain or preventing your ankle from recovering.

Frequently Asked Questions

Q1: What should I do immediately after spraining my ankle?

A: Stop the activity right away and protect the ankle from further injury. Use ice, compression, and elevation as soon as possible. Avoid putting weight on the ankle if it is very painful. If you cannot bear weight at all, have severe pain, or notice significant deformity, you should seek medical evaluation.

Q2: Is it better to rest your ankle or move it after a sprain?

A: Relative rest is best. Avoid high-impact or painful activities, but begin gentle, pain-free ankle movement as soon as you can. Early motion helps reduce stiffness and supports proper healing.

Q3: How long does it take for an ankle sprain to heal?

A:

• Mild sprains: a few days to 2 weeks

• Moderate sprains: 4–6 weeks

• Severe sprains: several months, especially if instability develops

Recovery time depends on the severity of the ligament injury and adherence to rehab.

Q4: Should I use ice or a brace for an ankle sprain?

A: Ice can help reduce pain and swelling when applied for 10–20 minutes at a time, several times per day, with a barrier to protect the skin. An ankle brace is often helpful for support and pain relief during recovery, though it is not always required unless advised by a clinician.

Q5: When should I see a doctor for an ankle sprain?

A: You should seek medical care if pain, swelling, or instability persists for several weeks, if you cannot bear weight, or if you experience recurrent ankle sprains. These may indicate a more serious ligament injury or chronic ankle instability.