Private sprained ankle clinic in London, same-day physiotherapy.

The first 72 hours

1. Protect, but keep weight going through it. Use the ankle as much as pain allows, with crutches only if you genuinely cannot walk. Putting weight through the joint early speeds recovery.
2. Ice for comfort. A wrapped ice pack for 10 to 20 minutes, every two to three hours for the first day or so. Never place ice directly on skin.
3. Elevate. Rest the foot above the level of your heart whenever you are sitting or lying — this does more for the swelling than anything else.
4. Move it gently from day one. Small ankle movements several times an hour keep the joint from stiffening and help the swelling drain.
5. Avoid HARM for the first 72 hours — Heat, Alcohol, Re-injury and Massage over the injury all increase bleeding and swelling.

Pain relief

Paracetamol, or an anti-inflammatory such as ibuprofen taken by mouth or applied as a gel, at the dose on the packet. Check with a pharmacist first if you have asthma, stomach problems, kidney disease or take blood thinners.

What recovery looks like

Bruising tracking down into the foot and toes over the first few days is normal and follows gravity — it is not a sign the injury is worsening.

Exercises

Start the first two as soon as you can move the ankle, and add balance work once you can stand comfortably on the leg. Ten repetitions of each, three times a day.

• Ankle alphabet. With the foot in the air, slowly draw each letter of the alphabet with your big toe. It moves the joint through every direction without you having to think about it.
• Up and down, in and out. Point the foot down, then pull the toes up towards you. Then turn the sole inwards and outwards. Slow and controlled, to the point of a stretch rather than sharp pain.
• Calf stretch. Stand facing a wall, injured leg back, heel down, and lean forwards until you feel a stretch in the calf. Hold 30 seconds, repeat three times.
• Heel raises. Holding a worktop for balance, rise onto your toes and lower slowly. Build towards doing it on the injured leg alone.
• Balance work — the important one. Stand on the injured leg alone for 30 seconds, holding something at first, then without. Progress to doing it with your eyes closed. Aim for a few minutes a day.

Come back to be seen if

• you still cannot put weight through the ankle after three to five days;
• the ankle keeps giving way, or feels unstable on uneven ground;
• there is no real improvement after six weeks;
• pain is focused on the bone rather than the soft tissue, or is worsening;
• you need to get back to sport, a physical job, or a specific event and want a structured plan.