Ankle injuries are one of the most common problems in football, affecting players at every level from junior weekend games to senior competition. Most are ankle sprains, but how serious is a sprain really, what should you do in the first 48 hours, and how can you stop it happening again?
Why the ankle is so vulnerable in football
Football involves rapid changes of direction, sudden stops, jumping and landing, and frequent contact with other players — all of which place enormous demand on the ankle joint and its supporting ligaments. A sprain occurs when these ligaments are stretched or torn, most commonly when the foot rolls inward (an inversion sprain).
Grading an ankle sprain
Sprains are generally graded by severity: Grade 1 involves mild stretching of the ligament with minimal swelling and the player can usually continue; Grade 2 involves partial tearing, with noticeable swelling, bruising and difficulty weight-bearing; Grade 3 is a complete tear, with significant swelling, instability and an inability to bear weight. Grading matters because it directly affects the recovery timeline and treatment approach.
What to do straight after injury
In the first 24–48 hours, the priority is protecting the ankle from further damage while managing swelling. This generally means avoiding aggravating movements, applying ice, using compression (such as taping or a brace), and elevating the leg. Avoid the temptation to "run it off" — continuing to play on a significant sprain can turn a two-week injury into a two-month one.
Getting an accurate diagnosis
Not every ankle injury is a straightforward ligament sprain. A thorough assessment by a physiotherapist is important to rule out fractures (particularly in growing bones) and other structures that can be involved, such as tendons or cartilage. If there's any doubt, imaging may be recommended.
Rehabilitation and return to play
A structured rehabilitation program is the single biggest factor in preventing re-injury — and re-injury is common in ankles that return to sport too early or without proper strengthening. A good program progresses through pain and swelling management, restoring full range of motion, rebuilding strength (particularly in the muscles that control side-to-side stability), and finally sport-specific balance and agility work before a full return to training and matches.
Preventing future ankle sprains
Once a player has sprained an ankle, they're statistically more likely to do it again — which is why prevention matters as much as treatment. Effective strategies include ongoing balance (proprioception) training, ankle strengthening exercises as part of a regular training routine, proper warm-ups before games and training, and taping or bracing for players with a history of sprains.
If your child has rolled an ankle playing football, a proper assessment ensures they recover fully and return to the game with confidence — rather than carrying a niggling weakness into next season. Book an assessment with our paediatric and sports physiotherapy team in the Sutherland Shire.
Written by Aaron Babb, MAppSc Physiotherapy — Founder & Director, Aevum Health & Physiotherapy.