The ankle sprain is one of the more common lower limb injuries incurred by the individual who exercises and for those who don’t. The cause of injury can be as simple as rolling over the ankle whilst walking or during a sporting event. The most common ankle sprain occurs on the lateral (outside) of the ankle and typically involves the lateral ankle ligaments (anterior talofibular, middle calcaneofibular and posterior ligaments). Sprains at the ankle are typically graded as 1, 2 an 3. With grade 1 sprains often only being minor sprains and grade 3 sprains being much more serious (where total disruption of the ligament(s) occur and possible avulsion).

Ankle sprains can take as short as a few days to many many weeks to resolve. Treatment in the early stages is focused on RICER (Rest, Ice, Compression, Elevation & Referral). It is important to follow these principles in the early stages to reduce swelling, inflammation, pain an aid in the healing process. In more serious ankle sprains, referral for an X-Ray might be indicated to rule out any avulsion fractures.

Once the swelling settles down, many individuals find that they can begin to walk more easily without discomfort. Manual therapy (massage, taping, mobilisation) to the area can aid in the recovery of the sprained ankle. Many individuals once pain free, find themselves returning to everyday activities and sport. In many instances, the individual returns to normal activities and finds themselves rolling over on their ankle again and again. Rehabilitation of an ankle sprain is very important and often treatment and management of the individual with a sprained ankle focuses heavily on getting the individual back to normal walking in a pain free state. Due to the nature of the ankle sprain (where ligaments are stretched, muscles react & joint motion locks down), it is extremely important to provide the individual with an appropriate rehabilitation and corrective exercise program to return the individual to everyday activities whilst reducing their risk of future ankle sprains. Rehabilitation and corrective exercises should incorporate proprioceptive & balance training, range of movement exercises and strengthening exercises. Typically exercises prescribed in the early stages include active range of movement of the ankle (foot pumping, ankle rolls), as well as single leg balance exercises and calf raises. This is often the point where exercise prescription an rehabilitation stops.

Training of the clients balance and proprioception in all three planes of motion (using head, arm and foot drivers) is important to challenge ones reactive ability. The video below is an example of the rehabilitation program (single leg balance and reach exercise) prescribed for a client of mine once pain subsides and single weight bearing can occur.

Other exercises that are important to train the client in (these are often prescribed in a staged manner once the client demonstrates an ability to carry these out in a safe manner without aggravating their ankle) include squats, lunges, step up/down, jumping and hopping. Tools such as wobble boards, bosu balls, hand weights etc can be added to further challenge one neuromusculoskeletal system.

If you suffer from recurrent ankle sprains or have recently twisted your ankle, touch base with your local osteopath to get advice on treatment, management and rehabilitation. At Principle Four Osteopathy we aim to provide you with a thorough assessment, treatment and management program that is suited to your needs.

Principle Four Osteopathy is located in the heart of the Melbourne City CBD 3000 at 29 Somerset Place, Melbourne City CBD 3000. To speak to an osteopath or make an appointment, please call 03 9670 9290 or email Check us out at

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