08/06/2026
Initial management of an ankle sprain can be confusing. There’s a ton of conflicting information out there. Here is a down and dirty safe way to start the healing process.
To ice or not to ice… That is always the question. Personally, I don’t mind ice for pain, but it will not help get rid of swelling and doesn’t do much to prevent swelling. I would prefer elevation and motion for both of those. If you are going to ice for pain stick to 20 minutes on, 60 minutes off. DO NOT ICE JUST TO ICE.
As you are starting to move the ankle, loaded or unloaded, make sure that you respect pain. If the body gives you pain, you know you’re at your threshold for an acute injury.
1-ABC: doing ABCs with your foot as if your big toe is a pencil will help to promote motion, swelling, reduction, and muscle activation. All of this is key to progression. Don’t work into painful range of motion, and you can almost not overdo these as long as there’s no increase in pain. Goal is to start with half the alphabet two times daily and increase from there.
2- banded work. We should hit all main directions at the ankle can move. With a load have enough to provide feedback, but not create pain outright. Starting with 3 sets of a smaller rep range and then progressing the rep count is a safer way to promote healing than to pile on resistance. Start with doing this one time daily and progress to 2 to 3 times if tolerated well.
3- balance: not all ankle sprains will allow for you to put full weight-bearing on them immediately. This is where weight shift come in handy. You start by resting on your side and gradually shift weight to your injured side until the pain increases. Then you shift back to your good side. This will start to introduce force through the joint and nervous system, allowing for stability work as well as turning down the body’s sensitivity to pain.
4- I didn’t mention calf raises or pushing down on the gas pedal because that is a longer conversation based on pain level and strength available. I will post a video more about that soon. Essentially, if you can’t do a single leg calf raise then do pumps with a band until you feel safe.
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