Ankle sprains are incredibly common and the rehabilitation protocol is often stopped once running is resumed if at all. I want to show you some easy exercises that can be implemented after an ankle sprain or ways to avoid a sprain all together.
There are four major ligaments on the inside (medial) and outside (lateral) in the ankle that can each be affected by an ankle roll or sprained ankle. And three different levels that are likely to indicate your return to play time frame after a rehab program.
The three different grades are marked 1,2 and 3 being the most severe indicating a total rupture (tear) of the ligament in question.
The initial care of a sprain includes RICE – Rest, Ice, Compress, and Elevate.
After this, weight-bearing (taking weight through the foot) as tolerated is needed to re-strengthen the muscles and ligaments involved back to pre-sprain levels.
Commonly the rehabilitation exercise step is missed in low-level or grade 1 sprains, as it does not cause pain, therefore the person does not seek professional advice.
I would suggest seeking assistance to improve strength back to pre-injury or beyond to prevent further sprains with future activity.
A reported 20% of acute ankle sprains develop into chronic ankle instability or repetitive ankle injuries.
With an ankle focused exercise program, you can reduce the frequency and severity of these sprains. A professional may also be able to identify other previously unknown factors contributing to an increased risk of continued ankle sprains.
When do I seek assistance?
If you have had a recent small ankle sprain, seeing an exercise physiologist or physiotherapist for an exercise program focussed on injury prevention may reduce future risk.
If you have had reoccurring, annually, or more often and have not followed this up with someone, I would recommend seeking assistance to prevent or reduce the severity of the sprains. I am often asked if having an appointment with your GP will help. A GP will likely look at the ankle and refer you over to a musculoskeletal specialist. Skipping the GP appointment is okay if you know where to find an AEP. However, seeking advice from your GP is at your discretion, perhaps you have a lot of pain, swelling, and bruising that you are not feeling confident with, getting that peace of mind is appropriate.
Initial rehabilitation exercises
As said previously, getting that ankle back to being just as if not stronger than it was before the injury is key to getting back to activities.
Initially, we want to ensure you have a full range of the ankle. Imagining you have dipped your big toe in ink and draw the alphabet on a floating piece of paper in the air is a good way to start.
Increasing the resistance on the ligaments by using a resistance band is an easy way to get started. Exercise bands can also be used long-term for maintenance once back to your usual activities of sport. I personally use PTP bands and recommend their “MediBand” range for these exercises.
Wrap the band around your foot and hold each end of the band.
Use the other foot to hold the band down, this changes the angle of pull/ resistance.
Now, imagine there is a mirror on the bottom of your foot. Angle the foot away from the pull of the band.
Now, try the opposite, this one you should be able to get a little more motion out of the ankle. To do the other side, we want to cross our feet over, so the angle of pull is opposite to the previous exercise.
Then, imagine the mirror again and turn the bottom of the foot away from the band.
Once you’ve surpassed band exercises and back to weight-bearing, I encourage challenging the ankle and its structures by trying the following exercises.
Walking on the heels, the toes, the inside and the outside of the foot. These shouldn’t cause pain, if they do, it might be too soon for their implementation.
Balance is another aspect but not the final piece of the puzzle. Try standing on one leg and get used to weight-bearing. Make sure the ankle can correct once this is too easy, complete standing on a pillow to reduce the stability and increase the work required by the ankle.
Prevent further ankle sprains
This should not be the end of your ankle exercise protocol. If you can return to your activities or sport, that is great. However, there are plenty more exercises and ways to continue to develop the ankles supporting structures.
Ensuring the tendons have regained the stiffness they require for explosive movement and are strong enough to avoid a roll if the ankle is put under the same stressors.