How Do You Get Back to Running After Rolling Your Ankle?

You rolled your ankle. It swelled up, maybe bruised, and walking on it hurt for the first few days.

A week later it’s feeling better, so when can you run again?

The answer usually isn’t based on how many days have passed. It’s based on what your ankle can actually do.

We see people at very different stages after an ankle sprain. Someone might come in three days after it happened with swelling and difficulty walking. Someone else comes in six weeks later because it’s still stiff, swollen or sore every time they try to run. Others arrive months later because the ankle still doesn’t quite feel right, clicks, swells after activity or never regained its previous strength.

Regardless of when you present, there are five main things we want to work through before getting you confidently running again.

First, Work Out What You’ve Actually Done

Before loading an ankle, we need to understand the injury.

How did you roll it? Where is the swelling and bruising? Can you comfortably put weight through it? Where is it tender? How does the ankle move? Are there signs that structures other than the commonly injured lateral ankle ligaments may be involved?

Most ankle sprains don’t automatically require imaging. However, your history and assessment may indicate that an X-ray, further imaging or medical review is appropriate, particularly when we’re concerned about a fracture, syndesmosis injury or another injury that may change management.

If you couldn't take four steps straight after the injury, still can't, or have tenderness directly on the bone, get it assessed by a physio or GP before starting rehab. Once we’re comfortable with what we’re dealing with, rehabilitation starts.

And usually, movement starts earlier than people expect.

The 5 Things We Rebuild

1. Strength

One of the first things we want to restore is the ability of your ankle and leg to produce and tolerate force. Calf training can often begin early, but the starting point depends on what you can currently tolerate. That might mean a supported calf raise, double-leg calf raise, partial range or an isometric hold. If you’re further along, it might be a full single-leg calf raise off a step.

We’ll also assess and train the muscles around the outside of the ankle, including the peroneals, which contribute to controlling the foot and ankle. And we don’t stop at the ankle. If you’ve spent days or weeks limping, avoiding one side or using crutches, the rest of the leg has been involved too. We commonly bring hip and single-leg strength back in early with exercises such as a supported staggered squat.

2. Range of Motion

A swollen ankle often becomes a stiff ankle. One of the measurements we commonly use is the knee-to-wall test, which gives us an objective way of measuring ankle dorsiflexion.

Rather than simply deciding that an ankle “feels tight”, we can measure it, compare sides and track whether it changes over time. As a general clinical reference, we often see knee-to-wall measurements somewhere around 7–12 cm, but the important comparison is you. Your previous injury history, anatomy and other ankle all give us context.

We also want movement in the other directions. Can you turn the ankle comfortably in and out? Can you achieve full plantarflexion at the top of a calf raise? Ultimately, we’re trying to restore enough movement for the things you actually want your ankle to do, and so it doesn’t limit you later on.

3. Balance and Proprioception

Standing on one leg is often one of the earliest things people associate with ankle rehabilitation, but balance has a progression too.

Initially, the challenge might simply be standing on one leg while maintaining good contact through your foot, keeping your knee unlocked and controlling your hip. From there we can progressively add movement, turning, reaching, closing your eyes or uneven surfaces.

Eventually, if you’re returning to running or sport, we need to move beyond simply being able to stand still. Your ankle needs to respond to movement, changing surfaces, directions and situations you don’t have time to consciously prepare for.

4. Walking and Endurance

You don’t go from resting an ankle to suddenly running five kilometres. Walking is part of rehabilitation too.

If your daily activity dropped significantly after the injury, we gradually build it back towards your normal level. Depending on where someone starts, that might mean increasing daily steps by only 100–500 at a time and seeing how the ankle responds.

We’re interested in what happens during the activity, but also afterwards and the following day. Can you tolerate progressively more walking without a meaningful increase in pain, swelling or altered movement?

Once walking capacity is building, we can start applying exactly the same progression to running.

5. Running, Jumping and plyometrics

Running involves repeatedly leaving the ground and landing on one leg, so at some point your rehabilitation needs to prepare you for impact.

Once someone has regained enough calf strength and control, we might begin with two-leg jumping. From there we can add different directions, progress towards single-leg hopping and eventually introduce multidirectional hops.

You don’t necessarily have to complete every possible jumping exercise before taking your first jogging steps. Once basic two-leg impact is comfortable and the rest of the assessment supports it, we may begin introducing a slow jog while continuing to build single-leg capacity alongside it.

Once you've been assessed and are cleared to start, a simple starting point might be 30 seconds of easy jogging followed by 30 seconds of walking for 5–10 rounds.

Then we see how you respond.

The ‘Two Green Tick’ Rule

One of the simplest rules we use when returning someone to running is our two green tick rule.

Complete your planned run once and respond well? That’s one green tick.

Complete the same run again and respond well? That’s two.

Now we can consider progressing something.

That might mean increasing your running interval, total duration, distance, speed or eventually changing the terrain. But we don’t increase everything simultaneously.

If the ankle becomes meaningfully more painful, swollen or reactive, that’s information. We may need to repeat the same level, temporarily reduce it or work out which part of the progression exceeded your current capacity.

The goal isn’t to prove that you can run once. It’s to gradually rebuild enough capacity that running becomes something your ankle can tolerate repeatedly.

What If It’s Been Months and My Ankle Still Isn’t Right?

An ankle can feel significantly better after the initial pain settles while still having deficits in range, strength, balance or impact tolerance.

If it has been six weeks, six months or even a year and your ankle is still swelling, feels unstable, remains restricted or repeatedly becomes painful (or has started to click) when you try to run, it deserves another look.

It doesn’t automatically mean something serious has been missed. It means we need to reassess where you are now, identify what hasn’t recovered and determine whether rehabilitation alone is appropriate or whether further investigation is warranted.

If you’ve rolled your ankle and you’re not sure how to safely get back to walking, training or running, book an appointment with the By Design Physiotherapy team and we can assess where you’re currently at and what needs to come next.

This is general information only. Ankle injuries vary in severity and some require medical assessment or imaging. If you’re managing pain or an injury, speak with your physio about what’s right for you.