Ankle sprains are one of the most common injuries we treat at South Simcoe Physiotherapy. Whether they happen during sports, while hiking, stepping off a curb, or simply slipping on an uneven surface, many people assume they’ll heal on their own with enough time.
While some mild sprains do improve without treatment, many people are surprised to find that weeks—or even months—later they still have pain, swelling, stiffness, or a feeling that their ankle “gives out.”
This case study follows a typical patient and shows how physiotherapy can help restore strength, confidence, and prevent future injuries.
INDEX
The Injury
The Physiotherapy Assessment
Why Rest Alone Wasn’t Enough
The Treatment Plan
The Outcome
When Should You See a Physiotherapist?
The Bottom Line
The Injury
Mark, a 34-year-old recreational hockey player, injured his right ankle during a weekend game. While chasing a loose puck, another player accidentally stepped on his skate, causing his foot to roll inward. He immediately felt a sharp pain on the outside of his ankle and had difficulty putting weight on it.
Within an hour, his ankle had become noticeably swollen, and bruising developed over the next day.
Like many people, Mark searched online and decided to rest, ice the ankle, wear a compression wrap, and wait for it to improve.
After two weeks, the swelling had decreased, but something still wasn’t right.
He could walk, but any attempt to jog, pivot, or go down stairs caused pain. The ankle also felt unstable, especially on uneven ground.
That’s when he decided to book an assessment.
The Physiotherapy Assessment
During Mark’s initial assessment, we discussed how the injury happened, what activities were painful, and what his goals were. His biggest goal was getting back to hockey without worrying about re-injuring his ankle.
The physical examination revealed several findings:
- Mild swelling remained around the outside of the ankle.
- Tenderness over the lateral ankle ligaments.
- Reduced ankle range of motion, particularly when bending the ankle forward.
- Weakness in the muscles that stabilize the ankle.
- Poor single-leg balance compared to the uninjured side.
- Pain with hopping and cutting movements.
Fortunately, there were no signs suggesting a fracture, and his symptoms were consistent with a moderate lateral ankle sprain.
Why Rest Alone Wasn’t Enough
Many ankle sprains improve enough that people can walk within a few weeks. Unfortunately, being able to walk normally doesn’t necessarily mean the ankle has fully recovered.
After a sprain, several important changes can occur:
- The supporting ligaments become stretched or injured.
- The muscles around the ankle become weaker.
- Balance and joint position sense (proprioception) decline.
- The ankle becomes less responsive to sudden movements.
These changes increase the risk of repeated ankle sprains.
Research has shown that individuals who suffer one ankle sprain are significantly more likely to experience another if strength, balance, and movement control are not properly restored.
The Treatment Plan
Mark’s rehabilitation focused on gradually rebuilding everything the injury had affected.
Phase One: Reduce Pain and Restore Motion
Early treatment included:
- Gentle mobility exercises
- Swelling management
- Manual therapy to improve ankle movement
- Gradual return to normal walking
The goal wasn’t simply to reduce pain—it was to restore normal movement before progressing to harder exercises.
Phase Two: Strength and Balance
Once walking became comfortable, treatment shifted toward rebuilding strength.
Exercises included:
- Heel raises
- Resistance band strengthening
- Single-leg balance exercises
- Step-ups
- Controlled squats
These exercises challenged both the muscles and the nervous system, helping the ankle regain stability.
Phase Three: Return to Sport
As Mark improved, rehabilitation became more specific to hockey.
Exercises progressed to include:
- Hopping drills
- Lateral movements
- Agility exercises
- Acceleration and deceleration drills
- Sport-specific direction change
Before returning to hockey, we ensured he could jump, land, cut, and balance confidently without pain.
The Outcome
After approximately seven weeks of physiotherapy, Mark had:
- Full ankle range of motion
- No swelling
- Excellent balance
- Restored strength
- Confidence returning to hockey
Perhaps most importantly, he understood how to continue maintaining his ankle strength to reduce the likelihood of another injury.
When Should You See a Physiotherapist?
Not every ankle sprain requires extensive treatment, but there are several signs that it’s worth booking an assessment.
Consider seeing a physiotherapist if:
- Pain lasts longer than one to two weeks.
- Swelling isn’t improving.
- Your ankle repeatedly rolls or feels unstable.
- Walking or using stairs remains difficult.
- You cannot return to your normal activities.
- You play sports and want to reduce the risk of another sprain.
Early assessment can often speed recovery and identify problems before they become long-term issues.
The Bottom Line
An ankle sprain may seem like a minor injury, but it can have lasting effects if it’s not properly rehabilitated. Simply waiting for the pain to settle isn’t always enough to restore strength, balance, and stability.
A personalized physiotherapy program helps address the underlying impairments—not just the symptoms—so you can return to work, sports, and everyday activities with confidence.
If you’ve recently rolled your ankle or are still dealing with an old ankle injury that never quite recovered, physiotherapy can help you get back to doing what you enjoy safely and confidently.