What should I do in the first few days after twisting my ankle?
Protect it, ease the swelling, and start gentle movement as soon as pain allows. Most sprains do better with early, careful movement than with a week on the sofa.
First, rule out a break. If you cannot take a few steps or the bone is tender, go for an X-ray before anything else.
How do I know if it might be a fracture?
Get it checked the same day for any of these signs. You cannot take a few steps, the ankle bone hurts when pressed, the midfoot is tender or the ankle looks out of shape. Numbness or a cold, pale foot also needs urgent care.
In Ipoh, go to the emergency department at Hospital Raja Permaisuri Bainun, Fatimah Hospital, Pantai Hospital Ipoh or another hospital with an emergency unit. Take someone with you to drive. Our page on when to seek medical care has more.
What can I do on day one?
The first day is about protecting the joint and controlling the swelling.
- Stop the activity and take weight off the ankle. Use a stick or a family member’s shoulder if needed.
- Apply ice wrapped in a cloth for about ten to twenty minutes, a few times through the day.
- Wrap the ankle snugly, but not so tight that the toes tingle or turn blue.
- Raise the foot on a cushion when you sit or lie down.
- Avoid heat, massage and alcohol for the first days, as they can increase swelling.
Our guide on heat or ice for an injury explains why ice first and heat later.
What changes on day two and three?
Once the worst of the swelling settles, begin to move. Draw the alphabet in the air with your big toe, pump the ankle up and down, and rotate it gently within comfort.
Walk short distances at home with a normal heel-to-toe step if you can. Limping spreads the strain to the knee and hip, so use a stick if it helps you walk normally.
Our page on rest or move after an injury shows how to judge the amount.
What about the days after that?
Add standing balance next. Stand near the kitchen counter on the injured leg for a few seconds, then lengthen the time.
Rise up on your toes, and step up and down on the bottom stair.
The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) clinical practice guideline on lateral ankle sprains was revised in 2021 and covers first-time sprains and chronic ankle instability [1]. We use it as a reference, together with what we find when we examine you.
When can I go back to badminton, futsal or the trail?
Return to sport when there is no swelling, you can walk and jog without a limp, hop on the injured foot and change direction without pain or fear. A twisted ankle that goes back to uneven ground too soon is likely to twist again.
Ipoh’s trails at Bukit Kledang are full of roots and loose stones, and the five-foot ways have broken slabs and drains. Our guides on ankle care on Ipoh hill trails and futsal ankle and knee injuries help you plan your return. If confidence is the problem, see confidence after injury.
How can a physiotherapist help at home?
We check the ligaments, the swelling and your balance, and tell you whether the ankle needs an X-ray first. Then we guide the movement and strengthening so the ankle is ready for your sport and your stairs.
Home physiotherapy in Ipoh means you do not need to hobble to a clinic. See also our page on ankle sprain. Our Canning Garden centre is opening soon for those who prefer to come to us.