You've just twisted your ankle and now it's swelling up before your eyes. You don't know whether to put ice on it, bandage it, or whether you can walk on it. This situation is stressful, especially when you're afraid of making the injury worse by doing something wrong.

• If you can put some weight on your foot, that's an excellent sign (no fracture likely).
• Early movement promotes healing, while total immobilization delays it.
• Anti-inflammatory drugs can slow down natural healing.
• Ligaments can take up to 8 weeks to fully regenerate.

This article provides a day-by-day guide to your recovery. To understand the modern approach to sprains, check out our article on PEACE and LOVE.

What should you do immediately after spraining your ankle?

The initial pain tends to paralyze us and scare us, which is normal. First, take the time to calm down, and then try the following:

• Gently move your toes a little
• Touch your toes and foot with your fingers to see if you still have good sensation
• Try to make small movements with your ankle gently

If all goes well, then we can already feel more reassured.

You can try putting your foot down without putting any weight on it and see how it goes. Just being able to put your foot down is a good sign, even if only 10-20% of your weight is tolerable. If you can limp 3-4 steps, that's an even better sign.

‍

‍

The acute phase 0-48 hours:

For this phase, here are the important elements:

• Avoid doing what hurts
• Continue to do anything that doesn't hurt (even with a large swelling, if walking doesn't hurt, you can walk on the foot)
• Avoid taking anti-inflammatory drugs (see the blog article on the management of sprains – Link to Blog #3)
• Use a compression bandage on the ankle to help reduce swelling
• Elevate your foot in the air whenever you are resting sitting or lying down

‍

The subacute phase from day 2:

From day 2, it is important to start stimulating the ankle very gradually and without increasing the pain. Here's what to do:

• Practice putting weight on the foot (standing facing the counter)
• Walk with small steps around a table or counter (to have support if needed)
• When resting, move the foot in all directions (foot up, foot pointed, foot inward and foot outward)
• Do a pain-free cardio activity to promote good blood circulation for up to 20 minutes, twice a day. For example:

Do stationary cycling (if it is painful, put the ankle on a bench to the side and pedal with the healthy leg)

• Swim without using your legs (use a float to keep your legs on the surface).

During this phase, use pain as an indicator to know if you're overdoing it. There should be no increase in pain. It's important to listen to your body.

‍

10 mini-tips to understand your pain

Those who have had the greatest impact on my patients' lives. 1 per day, 2 min.

(function(){

// GHL form_embed.js reads UTM from parent page URL

// Add UTM params to URL before loading iframe

var path = window.location.pathname;

var parts = path.split('/').filter(Boolean);

var slug = parts[parts.length - 1] || 'homepage';

var source = parts[0] || 'direct';

var url = new URL(window.location.href);

if (!url.searchParams.has('utm_term')) {

url.searchParams.set('utm_term', slug);

url.searchParams.set('utm_source', source);

url.searchParams.set('utm_medium', 'cta-inline-form');

window.history.replaceState({}, '', url.toString());

}

})();

Days 2 to 7:

Gradually increase weight-bearing and walking as tolerated. Here are some exercises to do without increasing pain, while holding onto a counter for support:

• Balance on one leg on the injured ankle.
• Rise up onto your toes.
• Do small squats.
• Practice walking without limping (take smaller steps if needed).

‍

Days 7 to 14:

After 7 days, there should already be significant improvement. Here are some exercises you can practice, again without increasing pain:

• If you are no longer limping, you can increase your walking distance. Otherwise, continue with short distances.
• Go up and down stairs without limping, using a handrail for support. Gradually reduce your reliance on the handrail.
• Balance on your injured ankle and turn your head from side to side to increase the difficulty of the exercise.

‍

Need professional advice?

Our physical therapists can assess your condition and offer you a personalized treatment plan.

Weeks 2 to 8:

Depending on the severity of the sprain, ligaments can take up to 8 weeks (and sometimes longer) to regenerate. Therefore, it's important to do exercises throughout this healing process to optimize the quality of the new tissue that will be formed.

At this stage, exercises should be more specific to each person's condition and functional needs. The following elements should be gradually incorporated:

• Walking on uneven surfaces.
• Jumping (with two legs first, then with one leg).
• Running.
• Squatting or kneeling.
• Exercises specific to your sport or work.

Throughout this process, if you can't control the level of pain, you're afraid to do exercises, or your condition isn't improving day by day, you should consult a physiotherapist.

‍

Sources

• Petersen W, Rembitzki IV, Koppenburg AG, Ellermann A, Liebau C, Brüggemann GP, Best R. Treatment of acute ankle ligament injuries: a systematic review. Archives of orthopaedic and trauma surgery. 2013 Aug;133(8):1129-41.
• Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE.