When Can I Do Physical Therapy for a Sprained Ankle?

Medically reviewed by Misty Seidenburg

“When can I do physical therapy for a sprained ankle?”  Starting at the right time can help facilitate healing and get you back to your life as quickly as possible.

Rehabilitation from a sprained ankle happens in stages, and everyone’s treatment plan is unique. But generally, physical therapy begins once the initial pain and swelling has subsided. Typically, that is anywhere from a few days to a week after the initial injury.

What Is an Ankle Sprain?

An ankle sprain is a common injury that occurs when the foot turns or twists beyond the normal range of motion. This unnatural motion causes the connective ligaments of the leg, ankle, or foot to overstretch or in severe cases, tear.

While ankle sprains are common among athletes who “cut” and “pivot” frequently, like in football, soccer, or basketball, they also affect the general population. You can sprain your ankle carrying groceries in from the car just as easily as you might racing down the soccer field.

Ankle sprains are graded by severity.

• A grade-1 sprain is considered a mild injury. The ligament is overstretched, and it can take from a couple of weeks to two months to fully heal.
• A grade-2 sprain is a moderate injury where the ligament is overstretched or partially torn. Recovery can take up to three months.
• A grade-3 ankle sprain is a severe injury. The ligament is fully torn and could require surgery and take upwards of nine months to a year to fully heal.

Because an injured ligament is more prone to reinjury, recurrent sprains are possible and are quite common occurring in over 1/3 of people. Physical therapy to rebuild muscle strength and restore balance can is proven to help reduce your risk of a future sprain.

The good news is up to 85% of ankle sprains respond to conservative treatments. (More severe injuries may require surgical intervention.)

Ankle Sprain Symptoms

You may not realize that an awkward turn or twist of your foot has caused any damage. Here are some signs and symptoms of an ankle sprain to be aware of:

• Ankle pain
• Bruising
• Swelling
• Throbbing
• Stiffness
• Tenderness
• Instability in the ankle joint
• Inability to bear weight on the affected foot
• An audible noise or sensation of a “pop” or “snap” at the time of injury

Your healthcare provider will diagnose an ankle sprain with a physical exam and imaging tests that show the extent of ligament damage (and rule out broken bones.)

Physical Therapy for Ankle Sprains: What Are the Benefits?

If a ligament tear is causing your ankle pain and swelling, physical therapy is shown to help patients rehabilitate and return to activity safely and gradually. Many people brush off rehab for an ankle sprain because they assume it is a minor injury.

Physical therapy offers many benefits for ankle sprains and similar injuries:

• Pain management: evidence-based therapies relieve symptoms without medication or surgery
• Balance restoration: improving stability and balance through targeted exercise
• Improved strength and mobility: tailored movements and exercises to build ankle strength and promote healthy movement
• Lowered risk of reinjury: techniques and education to help patients move more efficiently and reduce their risk of future sprains

When to Start Physical Therapy on a Sprained Ankle

Physical therapy can start very quickly after confirming you do not have a fracture. (Your physician, physical therapist, or athletic trainer can determine if imaging is necessary before starting therapy.)

Now, that does not mean we will have you up and exercising at your first session. We begin with an evaluation to examine the injury site and assess how ligament damage is affecting function and range of motion in the ankle, foot, and leg. Your therapist makes a note of your pain level and uses that as a baseline to track your progress.

Physical therapy for an ankle sprain begins with gentle range of motion exercises, like “writing” the alphabet with your ankle, for example. These can start as soon as a day or two after your accident.

Once the pain and swelling has decreased, we focus on exercises to strengthen the injured tissues. Toe raises, lunges, and exercises during resistance bands are all gentle and effective at this stage.

From there, you move on to proprioceptive training that helps you relearn how to control the position of your injured ankle joint. This training is not only beneficial for your recovery; it will help you avoid recurrent injuries. Research shows proprioceptive training helps reduce the incidence and recurrence of ankle sprains in athletes with and without a history of previous sprains.

Next, we tackle sport- or task-specific stretches and exercises, using your ankle in ways that reflect your regular daily activities. This is especially important for athletes of all ages who are eager to get back on the field or the court. Once you meet your physical therapy goals, your therapist clears you for a full return to activity.

While we’ve provided a general overview of physical therapy for an ankle sprain, remember that your journey is just as unique as you are. Trust your licensed physical therapist to create a treatment plan that is customized just for you.

An ankle sprain that goes untreated can lead to lifelong joint pain and instability. Take the time and trust the movement experts to oversee your recovery and your return to activity. Find a physical therapy clinic near you.