Ankle sprains are common, and they can linger if you only rest and ice. The old R.I.C.E. advice helps early pain and swelling, but it does not rebuild balance, strength or confidence. Do ankle sprains heal with rest alone? No, not well. Without a structured plan, re-injury risk rises and sport returns drag out.
Why R.I.C.E. on its own falls short
Rest, ice, compression and elevation tame symptoms. The ankle still needs guided loading to restore tendon and ligament capacity, joint mobility, and reflex control around the foot and calf. Modern care focuses on pain-guided activity, progressive strength, and balance retraining. That is the difference between walking without a limp and cutting sharply on the field.
When to seek assessment
Get checked promptly if you cannot weight-bear four steps, pain is severe at the bony edges of the ankle or mid-foot, or numbness appears. A grade I sprain is mild, grade II involves partial ligament tear, and grade III is a complete tear that often needs bracing and close supervision. Early assessment also rules out syndesmosis injuries, which need a different pathway.
If you are looking for a physio near me, choose someone who tests function, not just swelling. A short-term brace or tape may protect the joint, but it should not replace targeted exercise.
At-a-glance: 4-week milestones
| Week | Primary goals | Key checks to progress |
|---|---|---|
| 0–1 | Calm pain, regain gentle range, start weight-bearing | Walk without a limp for household distances, swelling trending down |
| 1–2 | Build strength and balance, normalise gait | 10 pain-free double-leg calf raises, single-leg stance 30 seconds |
| 2–3 | Add hopping, direction change, light jogging | 20 single-leg calf raises, hop in place x 20 with good control |
| 3–4 | Power, agility, sport skills | Hop tests ≥85% of uninjured side, no next-day swelling after drills |
Week 0–1: Settle, then move
Protect the ankle with relative rest and short walks on flat ground. Ice in brief bouts during the first 48 hours if pain is high, and use a firm elastic bandage with the foot elevated when resting. Start gentle range the same day if tolerated: ankle pumps, alphabet shapes, and pain-free dorsiflexion. Add isometrics for the calf and peroneals by pressing the foot lightly into a towel in four directions.
Balance work begins early. Stand on the sore leg while holding a bench, 5–10 seconds at a time, repeated across the day. Can you accelerate progress by pushing through sharp pain? No. Let pain guide volume and pace, not the clock.
Week 1–2: Strength and balance take the lead
Shift focus to muscle endurance and joint control. Use a resistance band for inversion, eversion, dorsiflexion and plantarflexion. Progress to slow double-leg calf raises, then eccentric lowers off a step. Gait should now look smooth. Add single-leg stance without hand support, then eyes-closed holds and small head turns. Gentle joint mobilisation from a therapist can help stubborn stiffness, especially loss of dorsiflexion.
When can you run again? Start light jogging in short intervals late in this phase only if you can hop in place without pain, land quietly, and complete a 20-minute brisk walk with no next-day flare.
Week 2–3: Hopping and change of direction
Power and proprioception matter now. Move to single-leg calf raises, lateral band walks, and step-downs. Add pogo jumps, line hops, and low box step-offs with soft landings. Begin gentle change-of-direction drills, such as figure-8 walks that become jogs. Include the knee-to-wall test to check ankle bend, aiming to match the other side over time.
This is also where sports physiotherapy adds value through field-based progressions, footwear review, and taping tweaks for your code, whether netball, soccer or footy.
Week 3–4: Sport skills and return checks
Build speed and complexity. Use shuttle runs, lateral shuffles, zig-zag cuts and decelerations. Progress hops to single-leg triple hops and lateral bounds. Keep strength work twice a week to maintain gains. Your return checklist should include no swelling the morning after training, equal or near-equal hop distance, and confident cutting at match-like speed.
Should you keep using ice now? Use it only for brief comfort if a heavy session stirs symptoms. Prioritise recovery habits that support tissue capacity, like sleep, protein with meals, and an active cooldown.
Smart supports: tape, braces and shoes
A semi-rigid brace or figure-of-six tape can protect the ankle during the first six to eight weeks of sport. Taper support as strength and balance improve, not by date alone. Choose shoes with a stable heel counter and minimal play through the rearfoot. Replace worn boots that wobble at the heel, since that encourages repeat sprains.
Prevent the next sprain
Keep a maintenance routine even after you feel “back”. Two short sessions each week work well: single-leg calf raises, band eversion, balance holds on an unstable surface, and a small dose of hops. Add a warm-up that includes ankle-focused drills before training and matches. Small habits now save weeks later.
Evidence-based care does not have to feel complex. A clear plan with measured progressions keeps you moving and gets you back to what you love. If you live near Morley or Noranda, our team supports the wider community, including Dianella physiotherapy clients who want practical guidance, not generic printouts. For acute sprains or persistent niggles, ask for a Dianella musculoskeletal physio approach that blends hands-on treatment, graduated loading and sport-specific drills.
Which clinician should guide a field return after a moderate sprain? A registered Dianella physio with experience in lower-limb rehab is the safe choice.
Your 4-week takeaways
- Start movement early, let pain set the pace.
- Build strength and balance every week.
- Add hopping and cutting once landing is quiet and controlled.
- Use tape or a brace while you rebuild capacity.
- Keep two short maintenance sessions each week.
If you need structured help tailored to your sport, book with our team at Morley Physiotherapy. We build plans that fit your goals and schedule, and we keep the steps clear from day one.