Ankle Injury Rehabilitation Exercises: Step-by-Step Guide

A rolled ankle can sideline you fast. The swelling, bruising, and twinges with each step make walking uncertain. Maybe you’ve iced and rested, but you’re unsure what to do next—or when it’s safe to push. Doing too much too soon risks setbacks; doing too little leaves you stiff, weak, and prone to reinjury.

The fix is a structured, stepwise rehab plan. This guide lays out what to do, when to start, and how to progress with clear, pain‑guided milestones. You’ll begin with protection and swelling control, then restore motion, activate key foot muscles, build strength and balance, and finally return to running, sport, or work without guesswork.

You’ll learn how to rule out a fracture and when to seek care; what to prioritize in the first 48–72 hours; the sequence of exercises—from early range of motion to bands, heel raises, and balance drills; when to add impact and agility; mistakes to avoid; and a 6–8 week plan. Ready to get back on your feet—safely?

Step 1. Confirm it’s a sprain and rule out fracture (when to seek care)

Before you begin ankle injury rehabilitation exercises, make sure the injury is appropriate for home rehab. Sprains involve overstretched or torn ligaments; fractures and significant tendon injuries require different care. A quick self-screen can help you decide if you should start this guide or seek medical evaluation first.

• Severe pain or rapidly increasing swelling/bruising
• Visible deformity or bone “out of place”
• Unable to bear weight or take a few steps
• Point tenderness directly on ankle or midfoot bones
• Numbness/tingling or the foot looks pale/cold
• Not improving after a few days, or you’re unsure

If none of these red flags are present, it’s reasonable to treat the injury as a sprain and begin the stepwise plan below. Start with protection and swelling control in the first 48–72 hours, then progress based on pain and function. If problems arise at any point, contact your clinician—follow‑up care is key.

Step 2. Protect, rest, and control swelling in the first 48–72 hours

The first two to three days are about calming the ankle so healing can start. Prioritize pain and swelling control before pushing ankle injury rehabilitation exercises. This short reset helps you move sooner, restore motion faster, and avoid chronic stiffness.

• Protect: Use a supportive shoe or high‑top, lace‑up boot for stability; avoid painful movements and uneven ground.
• Rest: Modify activity. Short, necessary walks only; no running, jumping, or cutting.
• Ice: Apply a cold pack wrapped in a thin towel several times per day to limit swelling and soreness.
• Compression: Wear a snug elastic wrap or sleeve; remove and rewrap if you feel numbness or tingling.
• Elevation: When seated or lying down, raise the ankle above heart level to help fluid drain.

By 48–72 hours, you should see swelling ease and be able to put some weight down with less pain. If swelling accelerates or you can’t take a few steps, contact your clinician.

Step 3. Begin gentle weight bearing and gait retraining

As pain and swelling ease, reintroduce loading to kickstart recovery. For minor sprains, walking is part of rehab—use a supportive high‑top, lace‑up shoe or hiking boot for stability, but don’t force your foot into a boot if it hurts. The goal now is a smooth heel‑to‑toe pattern without a limp; if you’re limping, you’re not ready to increase.

• Start with weight shifts: Hold a counter and gently shift weight side‑to‑side and forward‑back to test tolerance.
• Use an assistive device if needed: Crutches or a cane in the opposite hand help move from partial to full weight bearing.
• Short, frequent walks: On level surfaces, roll from heel to toe; stop if pain rises beyond mild or swelling increases afterward.
• Progress cues: Pain stays mild during activity and settles within 24 hours; swelling trends down; gait looks even.

Step 4. Restore ankle range of motion with early exercises

Regaining motion early limits stiffness and speeds recovery. Begin as soon as pain allows, moving only in a pain‑free to mildly uncomfortable range. Perform these seated or lying down, and stop if pain spikes or swelling worsens afterward. Pair early range‑of‑motion work with brief icing to calm symptoms.

• Ankle alphabet: Sit, lift the heel slightly, and slowly “write” A–Z with your big toe. Do 1–2 sets.
• Side‑to‑side knee swing: Foot flat on the floor, gently swing the knee left and right while keeping the foot planted for 2–3 minutes.
• Ankle pumps: Pull toes toward you, then point away in a smooth rhythm, 20–30 reps.
• Ankle circles: Make small circles each direction, 10 reps each way.

Do 2–5 short sessions per day; apply a cold pack after early sessions as needed.

Step 5. Activate foot intrinsic muscles for arch support

Strong foot intrinsic muscles help your arch support the ankle, improving balance and reducing strain as you progress. Begin these seated, staying pain‑free. They pair well with early range‑of‑motion work and can be done on both feet for symmetry.

• Towel scrunch: Sit with your foot on a towel on a hard floor. Use your toes to scrunch the towel toward you, then push it back. Repeat 8–12 times. To progress, place a small weight (e.g., a soup can) on the far end of the towel.
• Marble pickup: Place 20 marbles in front of you. Use your toes to pick up each marble and drop it into a bowl. Complete all 20 marbles, then relax. Do daily.

Step 6. Stretch the calf and Achilles safely

As soon as you can move without sharp pain, add gentle calf and Achilles stretching to restore ankle dorsiflexion and reduce reinjury risk. Keep all stretches pain‑free, with the heel down and toes pointing forward. Hold—don’t bounce. Aim to stretch daily, especially before and after activity, and pair stretching with your early ankle injury rehabilitation exercises.

• Standing calf stretch (back knee straight): Face a wall, injured leg back, knee straight, heel flat. Lean hips forward until you feel a calf stretch. Hold 15–30 seconds; repeat 2–4 times.
• Bent‑knee calf stretch (soleus focus): Same setup, but bend the back knee slightly while keeping the heel down. Hold 15–30 seconds; repeat 2–4 times.
• Seated towel stretch (if standing hurts): Sit with the knee straight, loop a towel around the forefoot, and gently pull the foot toward you. Hold 15–30 seconds; repeat 2–4 times.

Step 7. Start pain-free isometric strengthening

Once motion and short walks are tolerable, add pain‑free isometrics to activate stabilizers without moving the joint. Keep pain ≤2/10. Do 1–2 sets daily. When these feel easy and gait is even, move to bands.

• Ankle eversion: Seated, foot beside a sturdy wall or furniture. Push the outside of your foot outward into it for 6 seconds, then relax. Repeat 8–12 times.
• Ankle opposition (isometric): Feet together, press the injured foot inward against the other for 6 seconds (8–12 reps). Then place the other heel on top of the injured foot and pull the toes up against it for 6 seconds (8–12 reps).

Step 8. Progress to resistance band strengthening (4-way ankle)

When isometrics feel easy, advance to 4‑way resistance‑band work—these ankle injury rehabilitation exercises load every motion and stabilize the joint. Use light resistance for smooth, pain‑guided reps and a slow return. Do 8–12 reps, 1–2 sets, 3–5 days/week; stop if pain increases.

• Dorsiflexion: Anchor the band; loop over the forefoot. Knee straight, pull toes toward you; slowly return.
• Plantarflexion: Hold band ends; loop midfoot. Gently point the toes; control the return without lifting the knee.
• Inversion: Band around the inside of the foot; cross the other foot to anchor. Rotate inward without turning the leg.
• Eversion: Band around the outside of the foot; anchor under the other foot or table. Push outward; avoid leg rotation.

Step 9. Build calf strength with heel raises and eccentrics

Your calf muscles and Achilles power push‑off and stabilize every step. Begin once you can stand and walk without increasing pain or swelling. Train on flat ground first, holding a counter for balance, and let discomfort—not pain—guide the dose.

• Two‑leg heel raises: Stand tall, knees straight. Lift both heels as high as comfortable, then lower with control. Do 2 sets of 10, most days of the week.
• Shift then single‑leg: Gradually place more weight onto the injured side during two‑leg raises. When that’s easy and pain‑free, perform the raise on the injured leg only (use light hand support as needed).
• Slow lowers (eccentric focus): Rise up with both feet; transfer weight to the injured side and lower slowly for 3–5 seconds. Start with 6–10 controlled lowers.

Stop if pain spikes or your heel wobbles—quality reps beat quantity.

Step 10. Rebuild balance and proprioception

With motion and strength improving, restore your ankle’s “position sense” so it reacts quickly on uneven ground and resists reinjury. Begin when you can stand without increasing pain. Keep these ankle injury rehabilitation exercises short, controlled, and pain‑free.

• Single‑leg balance: Stand on the injured leg, arms out like a “T.” Use a chair, counter, or wall for light support if needed. Hold up to 30 seconds, rest, and repeat 8–12 times. It’s wise to repeat on the other leg.
• Progress when steady: First master 30 seconds with eyes open. Then try eyes closed. When that’s easy and pain‑free, stand on a pillow or foam. Start in supportive shoes; progress to barefoot for added challenge. Do daily.

Step 11. Add functional lower-body strength and mobility

With pain down and balance improving, link your ankle to the rest of the kinetic chain. Functional, closed‑chain moves train the foot, ankle, knee, and hip to share load so walking, stairs, and work tasks feel natural again. Keep pain ≤2/10 during exercise and no swelling increase the next day.

• Sit‑to‑stand: From a chair, feet hip‑width, knees track over toes. Stand tall, control the sit. 2 sets of 8–12.
• Supported mini‑squat: Light hold on a counter. Small range, heels stay down, knees over toes. 2 sets of 8–12.
• Step‑ups: 4–8 inch step. Lead with the injured leg up, down with control. 2 sets of 8–10.
• Lateral weight shifts: Hold a counter; shift hips over the injured foot with a gentle knee bend. 10–15 slow reps.
• Ankle rocks at wall: Heel down, gently drive the knee toward the wall and back. 10–15 reps.

Do these 3–4 days/week alongside your ankle program; progress range before adding height or load.

Step 12. Introduce impact and agility when ready

When walking is pain‑free without a limp and balance and heel‑raise work feel steady, you can begin carefully reloading with light impact and change‑of‑direction. Keep all work pain‑guided: mild discomfort is okay, but ease off if pain increases during exercise or swelling rises afterward. Early sessions should be short, with full recovery between efforts, in supportive shoes (consider a brace or tape initially).

• Return to impact gradually: Transition from brisk walks to brief jog intervals, alternating with walking on level ground.
• Small double‑leg jumps: “Pogo” hops with soft, quiet landings; progress height slowly.
• Jump rope (low, quick): Short sets with relaxed ankles; stop if form fades.
• Line hops: Forward‑back and side‑to‑side, double‑leg first; progress to single‑leg when painless.
• Agility patterns: Figure‑8s, lateral shuffles, gentle zigzags; increase distance first, speed last.

If pain exceeds “mild” or soreness/swelling persists beyond 24 hours, scale back and repeat the prior step before advancing.

Step 13. Use clear milestones to progress between phases

Advance your ankle injury rehabilitation exercises only when symptoms meet simple checkpoints. Use the 24-hour rule: if pain or swelling is higher the next day, scale back and repeat the prior step. If a box isn’t checked within a week, hold steady or contact your clinician.

• From protection to walking: Swelling trends down; pain is mild; you can take a few steps without a sharp increase.
• To early ROM: Movements are pain‑free to mildly uncomfortable; no spike in swelling afterward.
• To isometrics: Short walks are tolerated without next‑day flare.
• To bands (4‑way): Isometrics are pain‑free; full weight bearing without a limp.
• To heel raises: Standing and walking don’t increase pain; two‑leg heel raises feel controlled.
• To balance progressions: Single‑leg balance holds up to 30 seconds with eyes open.
• To impact/agility: Walking is pain‑free without a limp; heel raises and balance are steady; no next‑day swelling.

Step 14. Follow a sample 6–8 week ankle rehab plan

Use this pain‑guided template to organize your ankle injury rehabilitation exercises. Timelines vary—advance only when you meet the milestones in Step 13. If soreness or swelling lingers beyond 24 hours, repeat the prior week.

• Week 0–1 (calm and move): Protect, ice, compression, elevation. Short, supported walks. Early ROM (alphabet, knee swings, pumps/circles) 2–5 mini‑sessions/day. Towel scrunch or marble pickup daily. Gentle calf/Achilles stretches, 15–30 seconds, 2–4 reps.
• Week 1–2 (load and activate): Gait retraining. Isometrics (eversion/opposition) 6‑second holds, 8–12 reps. Two‑leg heel raises 2×10. Single‑leg balance (eyes open) up to 30 seconds.
• Week 2–4 (strength and control): 4‑way band work 8–12 reps, 1–2 sets, 3–5 days/week. Progress heel raises to single‑leg or slow eccentrics. Mini‑squats, step‑ups 2×8–12. Balance on foam/eyes closed.
• Week 4–6 (impact and agility): Walk‑jog intervals on level ground. Low pogo hops, line hops (double‑leg), figure‑8s. Maintain bands, stretches, heel raises.
• Week 6–8 (return to play): Single‑leg hops, quicker shuffles, sport‑specific drills. Return when pain‑free, no limp, and no next‑day swelling; consider brace/tape initially.

Step 15. Use bracing, taping, footwear, and orthotics strategically

External support can calm symptoms, improve confidence, and lower reinjury risk while you rebuild strength and balance. Use them to enable quality movement—not to replace your exercises—and taper as gait, heel raises, and balance normalize.

• Bracing: A lace‑up or semi‑rigid ankle brace adds stability for walking early and for initial return to sport. Wean as control improves.
• Taping: Good for short, higher‑demand bouts. Remove if you feel numbness or tingling.
• Footwear: Choose supportive, high‑top/lace‑up shoes or hiking boots early; don’t force a painful boot.
• Orthotics/insoles: Arch‑supporting inserts can improve alignment; consider custom options if instability or flat feet persist.

Step 16. Avoid common mistakes and watch for red flags

A solid plan can stall if you overdo it or skip key steps. Keep your rehab pain‑guided, progress only after meeting milestones, and prioritize quality movement over volume. If symptoms escalate or confidence drops, pause, reset the last step, and check in with your clinician.

• Common mistakes to avoid:

  • Pushing through sharp pain or a limp
  • Skipping early range‑of‑motion work or stretching
  • Relying on a brace instead of strengthening and balance
  • Jumping to running/jumping before heel raises and 30‑second single‑leg balance are steady
  • Ignoring next‑day symptoms—scale back if pain or swelling increases

• Red flags—seek care:

  • Unable to bear weight or pain is worsening
  • Rapidly increasing swelling/bruising or visible deformity
  • Numbness/tingling or the foot looks pale/cold
  • Point tenderness on ankle/midfoot bones
  • No improvement after a few days or repeated “giving way”

Step 17. Adjust for special situations (high ankle sprain, chronic instability, kids, diabetes)

Some scenarios call for a more conservative, supervised approach. Keep the 24‑hour rule, emphasize quality over volume, and coordinate with your clinician. The following tweaks help you tailor ankle injury rehabilitation exercises without skipping the essentials of motion, strength, and balance.

• High ankle (syndesmotic) sprain: Progress slower; prioritize pain‑free walking, ROM, and isometrics. Delay cutting/pivoting and hopping until walk‑jog, heel raises, and balance are painless and steady.
• Chronic ankle instability (“giving way”): Double down on single‑leg balance progressions and 4‑way band work (especially eversion/inversion). Use a lace‑up brace or tape for higher‑demand activity while you strengthen.
• Kids/adolescents: Keep sessions short and fun; use bodyweight and light bands. Stop immediately if there’s a limp or next‑day soreness; seek guidance if symptoms linger.
• Diabetes: Protect skin—ice through a towel, inspect feet daily, and wear supportive shoes. If swelling, redness, or wounds appear, or sensation is reduced, contact your clinician and advance only under supervision.

Step 18. Know when to call a foot and ankle specialist in Central Virginia

Even with a solid home plan, some ankle injuries need expert evaluation. Call a foot and ankle specialist in Central Virginia if you notice any of the following.

• Unable to bear weight or pain is worsening
• Rapid swelling/bruising or any visible deformity
• Numbness/tingling or the foot looks pale/cold
• Point bone tenderness over the ankle or midfoot
• Repeated “giving way” or recurrent sprains/instability
• No improvement in 3–7 days or you’re stuck progressing
• Suspected high ankle sprain or significant sports demands
• Diabetes, wounds, or reduced sensation in the feet

Step 19. How Achilles Foot and Ankle Center supports your recovery

You don’t have to rehab alone. Our specialists guide every phase of your ankle injury rehabilitation exercises—from accurate diagnosis to a safe, confident return to sport or work. We combine conservative care with advanced technology and, when needed, surgical expertise, so your plan fits your goals, timeline, and lifestyle.

• Precise diagnosis: Digital imaging and ultrasound-guided care
• Conservative solutions: Bracing, taping, custom orthotics, injections
• Progression you can trust: Medically guided milestones and return-to-play testing
• Convenience: Same-day appointments, patient portal, and multiple Central Virginia locations
• Advanced options: State-of-the-art Foot and Ankle Surgery Center when surgery is necessary

Your recovery roadmap

You’ve got a clear, step‑by‑step path: calm swelling, restore motion, activate the foot, build strength, reclaim balance, then layer in impact and agility. Let pain guide—not stop—you. Keep sessions short, frequent, and high‑quality. Use the 24‑hour rule to pace progress, and the milestones to decide when to advance. Consistency beats heroics; steady work now prevents setbacks later and helps you return confident, stable, and strong.

If you hit a plateau, have sport or job demands, or just want a personalized plan, our Central Virginia team is ready to help. From precise diagnosis and bracing to custom orthotics, therapy progressions, and return‑to‑play testing, we’ll tailor your roadmap and walk it with you. When you’re ready, connect with the specialists at Achilles Foot and Ankle Center and get back to what you love—with a plan you can trust.