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Sports injury

Sprains and strains physiotherapy

A sprain or strain is an injury to a ligament, muscle or tendon. Most settle with a few days of protection then early, guided loading, and physiotherapy can show you how.

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Understanding the condition

A sprain is an injury to a ligament, the tough band that joins one bone to another, and a strain is an injury to a muscle or tendon.1 Ankles, knees, wrists, hamstrings and the back are common sites, and the usual signs are pain, swelling, bruising and trouble using the area.1 Many people recover within a few weeks. Examples such as lateral ankle sprains and hamstring strains average around two to three weeks, although severity and the joint involved change this.2 Some ankle and foot injuries that look like sprains are actually broken bones, so a quick clinical check using the Ottawa ankle rules decides whether an x-ray is needed.56

Current sports medicine advice has moved on from rest, ice, compression and elevation (RICE). The PEACE and LOVE approach suggests protecting the injury for the first one to three days, then adding load early and gradually, because prolonged rest can weaken healing tissue.3 The physiotherapy guideline for lateral ankle sprains recommends progressive weight bearing, external support such as a brace or tape, and a structured exercise program with balance and strength training.4 It advises against therapeutic ultrasound for acute ankle sprains.4 Your physiotherapist adjusts timing to your injury and goals, and recovery varies from person to person.

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Sprains and strains physiotherapy

What to look out for, and how we help

Symptoms are a guide, not a diagnosis. Your GP confirms the diagnosis; our team helps you manage it day to day.

What you might notice

  • Pain when the injury happened, and when you move or load the area
  • Swelling, often developing within hours
  • Bruising that may appear or spread over the next day or two
  • Tenderness, stiffness, or a feeling that the joint is loose or giving way
  • Difficulty putting weight on the leg or using the area as you normally would
  • Seek urgent medical review if you cannot take four steps straight after the injury and when examined, have tenderness over the bony points of the ankle or midfoot, the area looks out of shape, the pain is severe, or it is not improving after about a week, as this may be a fracture or a more serious injury.

How our team helps

  • Assessment and diagnosis, including whether an ankle or foot injury needs an x-ray before treatment starts
  • An individual exercise program with early, graded loading, balance work and strengthening
  • Hands-on therapy within comfortable limits, alongside your exercises
  • Walking aid prescription, such as crutches, when you need them for the first days
  • Return to work or sport planning so you build back up in steps
  • Reports for your GP, insurer or workers compensation claim

Your PDC care team

The teams and services that most often support people with this condition. They work from one shared plan, and one GP referral reaches all of them.

Allied health teams

Physiotherapy
Physiotherapy
Allied health team
Physiotherapy
Musculoskeletal treatment and rehabilitation to help you move better and manage pain.
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Related services

Related conditions

Terms explained

Plain English explanations for this condition are being added.
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Sources and clinical review

Our care draws on the JOSPT 2021 lateral ankle ligament sprain clinical practice guideline, the Ottawa ankle rules and the PEACE and LOVE framework for soft-tissue injuries.

  1. Healthdirect Australia. Sprains and strains. Healthdirect; last reviewed June 2024.
  2. Better Health Channel. Sprains and strains. Victorian Government; last reviewed 2 October 2023.
  3. Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020;54(2):72-73.
  4. Martin RL, Davenport TE, Fraser JJ, et al. Ankle stability and movement coordination impairments: lateral ankle ligament sprains revision 2021. J Orthop Sports Phys Ther. 2021;51(4):CPG1-CPG80.
  5. Heyworth J. Ottawa ankle rules for the injured ankle: useful clinical rules save on radiographs and need to be used widely. BMJ. 2003 Feb 22.
  6. MDCalc. Ottawa ankle rule [online clinical decision tool summary of the Ottawa ankle and foot rules; not a guideline; no author or date shown; cited 2026 Oct 4].
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Common questions

Should I use RICE or PEACE and LOVE for a sprain?
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RICE (rest, ice, compression, elevation) has largely been replaced in sports medicine by PEACE and LOVE. That means protecting the injury for one to three days, then loading early as pain allows. Ask your doctor or pharmacist about pain relief, as anti-inflammatories may not suit everyone.

Do I need an x-ray for a sprained ankle?
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Not always. The Ottawa ankle rules suggest an x-ray if you have ankle pain and tenderness over the back edge or tip of either ankle bone, tenderness over two particular midfoot bones, or you cannot take four steps. A clinician needs to examine you to apply them.

How long does a sprain or strain take to heal?
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It varies. Lateral ankle sprains average about two and a half weeks and hamstring strains about three weeks, but severity, the area injured and your activity all matter. Gradual loading, rather than prolonged rest, is generally advised for recovery.

When should I see a physio for a sprain or strain?
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Book an assessment if you cannot put weight on the limb, swelling or pain is significant, or it is not improving after about a week. We check for fracture, start a guided program and explain what you can safely keep doing.

Do I need a referral for a sprain or strain, and can I claim?
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No referral is needed for private appointments. With a GP Chronic Condition Management Plan, Medicare rebates apply to up to five eligible allied health services a calendar year. Private health extras and workers compensation (WorkCover WA) commonly cover sports and work injuries.

Not sure where to start?

Tell us what is going on and we will point you to the right discipline, or to more than one. Most people start with a single appointment and leave with a plan the rest of the team can see.

Or go straight to a service

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