What To Do Right After You Sprain Your Ankle (and How to Tell If It’s Serious)

From The Relief Lab at Bodyworks DW

An ankle sprain never happens at a convenient time. One second you’re running, training, stepping off a curb, or just moving through NYC like everyone else — and the next second your foot rolls, pain shoots up the side of your ankle, and your day suddenly gets a new plot twist.

Sprains are incredibly common, especially for runners and athletes. They’re also one of the injuries we see most often in the clinic. The good news?
What you do in the first 24–72 hours makes a huge difference in how quickly you recover.

This guide walks you through the exact steps we recommend to clients (and yes, these are the same steps David used himself after a parkour misstep left him sidelined for weeks).

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Step 1: Make Sure It’s Not a Break

Before treating it like a sprain, rule out anything more serious.

Ask yourself:

• Is the ankle visibly deformed?

• Is the foot pointing in an unusual direction?

• Is bone protruding (obviously yes = emergency)?

If any of these apply: call 911 or go to urgent care immediately.
Trying to “walk it off” with a fracture only tears more soft tissue and lengthens recovery dramatically.

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Step 2: Gently Test Movement (This Tells You a Lot)

If the ankle looks normal, test for small, controlled movements:

• Slow ankle circles

• Flex and point

• Wiggle toes

If you can move it — even if it hurts — it’s more likely a sprain rather than a break.

A quick note on icing:

The old RICE method isn’t the gold standard anymore. Prolonged icing can slow healing, but intermittent icing within the first 24 hours still helps manage swelling.

Use this rhythm:

1. Ice for 10–15 minutes

2. Remove ice

3. Elevate the ankle

4. Make small pain-tolerable movements

5. Lightly stroke around the ankle toward the heart to help fluid move out

Repeat several cycles throughout the day.

The goal is to keep fluids from stagnating while bringing fresh blood and nutrients in.

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Step 3: Carefully Test Weight Bearing

Here’s a safe progression:

1. Start on hands and knees (no ankle load).

2. Stand using your non-injured foot.

3. Gradually shift a small amount of weight onto the injured side.

You’re looking for the type of pain:

• Diffuse, sore, but tolerable: likely a sprain

• Sharp, pinpoint, stabbing, or immediate buckling: could be a tear or hairline fracture → time for imaging

• Pain that worsens dramatically with even light weight: definitely get evaluated

You should not be trying to walk normally on Day 1 — the goal is simply to understand your baseline.

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When Massage Helps (and When It Doesn’t)

Massage is not appropriate in the first 48 hours, while swelling is high and tissue is acutely inflamed.

After that window — once swelling starts to settle — massage can help:

• Improve circulation

• Reduce stiffness in supporting muscles (calf, peroneals, hip stabilizers)

• Restore range of motion

• Help the ankle avoid “healing stuck”

• Reduce compensatory issues (knee, hip, even low back) that arise from limping

If you’re cross-referencing resources, your deeper dive is your new
Ankle Sprains & Shin Splints pains page — this blog is just the “day one to week one” practical guide.

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Step 4: Start Light Stability and Balance Work (Usually Day 3–5)

Once walking is tolerable, incorporate gentle proprioceptive training:

• Standing on one leg

• Light weight shifts

• Small circles

• Wobble board drills (if you have one)

This helps retrain the small stabilizing muscles that protect your ankle long-term.

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Step 5: Return to Activity Gradually

This part is where people get into trouble.

Here’s the safe progression:

1. Walk pain-free

2. Walk briskly

3. Light jog intervals

4. Short run

5. Normal mileage

6. Intensity training

Skipping steps is the #1 reason runners develop chronic ankle instability, or suddenly find themselves with hip, knee, or low back pain months later.