Short answer
Rolling your ankle on rocky Cape Town trails usually sprains the ligaments on the outside of the ankle. Most sprains recover well with early, gradual movement and balance training. You need an X-ray if you cannot take four steps or have tenderness on the bone. Without rehab, re-sprains are common.
Common causes
Uneven, rocky ground
Lion’s Head chains, Platteklip steps and loose descents.
Fatigue
Late in a long hike or run, foot placement gets sloppy.
Previous sprains
An ankle that has been sprained before is more likely to go again.
What usually helps right now
- Protect it for a day or two, but start moving it gently early.
- Use ice and elevation for swelling.
- Walk as soon as you can without a limp.
- Start balance work, such as standing on one leg, within the first week or two.
What to avoid
- Complete rest for weeks.
- Rocky trails before you can balance and hop on it without pain.
When to book an assessment
- It is not improving after a week.
- It keeps giving way.
- You have a race or big hike coming up.
Get urgent medical care if
- Unable to take four steps, or tenderness on the ankle or foot bones: get an X-ray.
- Pain high above the ankle after a twist can be a high ankle sprain or fracture.
How we treat it
- AssessHistory, movement and clinical tests, with screening for anything that needs a doctor.
- ExplainA clear diagnosis in plain language, and what recovery usually looks like.
- TreatHands-on care where it helps: joint and soft tissue work, dry needling or adjustments.
- RebuildExercises and a training plan so it holds up, with an end point.
Questions
How long does a sprained ankle take to heal?
Mild sprains one to three weeks, moderate sprains three to six weeks. Full strength and balance take longer.
Should I tape or brace my ankle for hiking?
Bracing or taping reduces the chance of re-spraining for several months after an injury.