Managing the sore and stubborn ankle

Published: 23 Jan 2020

Managing the sore and stubborn ankle

The classic “rolled ankle” is one of the most common injuries seen within the clinic. It is also one of the most common injuries not seen within the clinic.

After an ankle roll, the outside of the ankle is often quite sore and makes you limp for a couple of days but then after that comes good.  Then you can usually return to sport with some strapping tape to support it. Unfortunately though, just because the pain is gone, doesn’t mean your ankle is healed and it is safe to return to doing anything you like.

Thinking long term

When the ankle ligaments are damaged, the body’s ability to detect where your ankle is in space is reduced. We call this impaired proprioception.  If not loaded appropriately and this ability restored, the chances of re-injury are drastically increased.

ankle sprain physio

This injury can result in damage to the lateral ligaments.

Research studies have shown up to 4 years after an initial ankle sprain up to 46% of people still experience pain, up to 34% experience recurrent sprains and up to 55% report ongoing instability.

I have recently had an influx of patients come in with ankle and foot pain as a result of a previously mismanaged ankle sprains. What exactly does this look like? Restricted ankle range of motion (particularly into dorsiflexion), decreased strength and stability, pain with any ankle movement or with running, jumping and hopping. So if this sounds like you, getting pain around your ankle joint, months or weeks after an ankle sprain, there is a good chance this is what is happening.

Bruising post ankle sprain can be quite apparent.

Still sore, what can you do?

SO what can you do about it? After a thorough history and assessment, we can perform some hands-on manual therapy to help address the soft tissue or joint restriction that may be limiting your movement. A specific strengthening program can then be devised to improve any weakness in the muscles that act upon your foot and ankle. Unfortunately due to this pain coming about weeks or months after the injury it usually can take a little longer to rehab than it would’ve if addressed early on. The key learnings from this: if you “roll” your ankle get it assessed and treated early to stop these complications from arising down the track.


Vuurberg, G. et al. (2018) Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. BJSM. Retrieved from: