Rolled ankle? Read this now
For TLDR version, watch the video:
Hello, This was a recorded conversation that I had with my patient. They had recently rolled their ankle during a rugby game.
When people say they “rolled” their ankle, they’re usually talking about an ankle sprain—specifically, an inversion sprain, which is the most common type. That means the foot twists inward, and the outer part of the ankle takes the brunt of the damage.
Your ankle is held together by ligaments—tough, rope-like bands of connective tissue that stabilize your joints and keep bones from wandering too far from their buddies. On the outside of the ankle, there are three key ligaments (you don’t need to memorize them, but just for fun: the ATFL, CFL, and PTFL).
When you roll your ankle, those ligaments can stretch too far or tear, kind of like pulling a rubber band past its limit. Depending on how badly they’re damaged, you might have:
Grade I sprain – just a little stretch, maybe a few fibers torn. Mild swelling, still walkable.
Grade II sprain – partial tear. Moderate pain, swelling, and some instability.
Grade III sprain – complete rupture. Big swelling, bruising, and likely limping or inability to bear weight.
What Happens Immediately After?
Within seconds, your body jumps into damage control mode. Here's the cascade:
Inflammation kicks in – Blood vessels open up (a process called vasodilation) to bring in cells that help clean up damage. This causes swelling, redness, and heat.
Pain signals get sent – Nerves in the area send SOS messages to your brain, telling you to back off and avoid further injury.
Fluid rushes in – The damaged area gets puffy because of plasma and white blood cells moving in. It’s all part of the clean-up and repair crew.
Bruising can show up – If small blood vessels are damaged, blood can leak into surrounding tissue and give that classic blue-purple color.
Behind the Scenes: Tissue Repair
Over the next few days to weeks, your body gets busy:
Fibroblasts arrive on the scene—these are cells that start laying down collagen, a kind of scaffolding to help rebuild the torn ligament.
New blood vessels form (called angiogenesis) to bring in nutrients and oxygen.
Eventually, the new collagen organizes itself to become strong and flexible—though this takes time, and without proper rehab, it might not heal in the most optimal way.
Why Some Ankles Stay Weak
Here’s the tricky part: if you don’t properly rehabilitate a sprained ankle, you can end up with chronic instability. That means the ligaments never quite get their full strength and responsiveness back, and the tiny muscles and sensors that help your ankle balance (proprioceptors) don’t fully recover.
That’s why doing balance exercises and mobility work is so important—not just resting and hoping for the best!
If you have rolled your ankle or want to avoid rolling it again, click here to book or give us a call on 0402 832 329.
