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Ankle Sprain and Strain

painful running injury

One of the most common sports injuries that often go untreated, is the common ankle sprain/ strain. An ankle sprain can be a debilitating and often painful, which can result in difficulty walking, driving and sometimes working. Early intervention and correct rehabilitation will result in a faster return to normality.

So, what actually causes an ankle sprain or strain?

Due to the forces that the ankle has to withstand, as well as the mass it supports, the ankle joint is often a tennis, basketball, soccer or volleyball players demise. They are an acute injury, often caused by a traumatic event where the foot “rolls” inwards under the body. The sensation of the ankle “giving way”, may be felt or a popping or crack sound may be heard.

There are numerous factors that are commonly involved with an ankle strain including:

  • Uneven surfaces.
  • Quick change of direction when walking or running.
  • Landing awkward from jump, hop or bound.
  • Direct force to the inside of ankle, forcing the foot to roll under.



Initial management focuses on the RICER principle of REST, ICE, COMPRESSION, ELEVATION, REFERALL. The main objective is to focus on resolving and reducing the inflammation (swelling) in the area.

RELATIVE REST- Gentle ankle movements that do not increase will be good to maintain movement around the joint and assists in reducing swelling.

ICE – Ice for 15-2o min every 1-2 hours

COMPRESSION – Gentle and uniform compression around the ankle with assist with swelling- ENSURE THE COMPRESSION IS NOT TIGHT OR LOCALISED

ELEVATION – Keeping the ankle elevated will further assist in managing swelling.

You may need crutches initially to take some weight off the ankle when walking. Consult with your physiotherapist who can assess the ankle and commence treatment accordingly. You should avoid any movement or activity that increases your pain or swelling


The time frame for recovery will depend on the level of tissue injury. For a lower grade ankle strain it will take around 4 weeks to restore full function. Higher grade strains take around 6 weeks to recover to full function. During this 4-6 week period you may experience episodes of increased swelling, this is just the ankle letting you know you have done too much at that time of tissue healing.

NB: Use RICE to manage aggravations.


  • The goals of rehabilitation following an ankle strain are:
  • Reduce swelling and pain in the area
  • Improve movement at the ankle
  • Normalise walking pattern
  • Improve strength around the ankle
  • Improve balance and ankle joint proprioception
  • Gradual return to sport specific/work specific tasks

It is EXTREMELY important to undergo appropriate full rehabilitation following an ankle strain. All the evidence states the number one risk factor of straining the ankle, is if you have previously strained the ankle. 

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