In the early rehabilitation of an ankle sprain, which sequence best describes progression?

• A. Protect and rest early, apply ice, gradually restore ROM, proprioception, and progressive weight-bearing as tolerated.
• B. Start aggressive ROM immediately, then rest.
• C. Apply heat early for swelling to dissipate.
• D. Delay any weight-bearing until full ROM is achieved.

Answer: (A)

In the early rehab of an ankle sprain, the main idea is to control swelling and protect healing tissues while gradually restoring function. Start with protecting and resting the ankle to minimize further tissue stress, then apply ice to reduce swelling and pain. Once the initial inflammation is under control, begin a gradual, pain-free range-of-motion program to prevent stiffness and preserve joint mechanics. As mobility improves, add proprioception and neuromuscular training to reestablish balance and control, which helps prevent future sprains. Finally, introduce progressive weight-bearing as tolerated to stimulate healing and maintain strength and function without overloading the injured tissues.

This approach is better than pushing aggressive ROM too early, using heat when swelling is present, or delaying weight-bearing until full ROM is achieved, all of which can increase pain, swelling, and the risk of reinjury.