Exercises For Ankle Sprain
RECENT SPRAINED ANKLE? CHRONIC SPRAINED ANKLE?
Have you ever been walking down the street and rolled your ankle? Did it swell up a little, maybe for a few days? Maybe for a few weeks? You likely sprained your ankle. If you didn’t break any bones, just stretched out the side of your ankle you sprained your ankle. Read more to find out what that means and what to do about it.
WHAT DOES IT MEAN TO SPRAIN AN ANKLE?
A sprain is a stretch of ligaments. A sprain is graded from 1-3, 1 being the least and 3 is the most. A grade 1 ankle sprain means you stretched the ligaments a little bit, and they were able to go back to their normal position. A grade 2 means you stretched them a little bit more than a grade 1 and there are some small tears in the ligament, and there are still some fibers of the ligament touching each other. A grade 3 is the most severe, this means you stretched the fibers of the ligament so far that they completely tore from each other.
IS A SPRAINED ANKLE THE SAME AS AN ACHILLES PROBLEM?
No. An Achilles problem is different than a sprained ankle. You can learn about achilles problems here.
WHAT CAN YOU DO ABOUT A SPRAINED ANKLE?
In the first few days you want to do “active rest.” This means you are avoiding strenuous activities, and activities that really aggravate your ankle, and are continuing light activities and activities that do not bother the ankle too much. The strenuous activities may depend person to person. Some people may be able to walk relatively comfortably for a period of time, others may need to be on crutches. Listen to your body. Some light activities include exercises for your core or arms, these exercises are light on your ankle. Completing some gentle range of motion exercises and gentle strength and stretching exercises will help the healing process. They will help decrease the swelling, pain and decrease the chance of future weakness.
WHAT ABOUT R.I.C.E?
RICE stands for Rest, Ice, Compression and Elevation. You want RICE to a point, you don’t want to completely stop everything which is why I discussed active rest above. If you have significant swelling and a throbbing pain, ice, some compression and elevating your leg above the level of your heart can help with the pain and swelling.
WHAT ARE SOME SAFE EXERCISES TO DO?
You should have a formal evaluation by your local physical therapist to determine which exercises are safe for you to complete. You want to complete exercises that are challenging enough, and not overly challenging to your ankle. Your physical therapist can help you determine this.
Some exercises to help decrease the swelling, pain and stiffness are listed below.
Ankle pumps:
This can be done sitting or laying down, if you have a lot of swelling elevate your leg above the level of your heart. Use your ankle muscles to pull your toes toward your nose and then point them downward. Repeat. Only move the ankle as far as it comfortably can.
This can be done sitting or laying down, if you have a lot of swelling elevate your leg above the level of your heart. Use your ankle muscles to move your ankle in clockwise then counterclockwise circles. Repeat. Only move the ankle as far as it comfortably can.
WEIGHT SHIFTS:
I want patients to not be scared to put weight through their foot and ankle so they can continue to walk normally and decrease any limp. This involves progressively increasing weight through the foot and ankle.
Start off standing next to a counter or table. I like the kitchen counter, especially if you have a counter that forms a 90 degree angle at one point because you can stand in that corner for balance support on either side of you if you need that. Put your feet staggered apart, one slightly ahead of the other. You are going to lean forward, putting weight through the front foot as much as you can tolerate. Then you lean back and put weight through the back foot as much as you can tolerate. These are weight shifts. You do this for 30 repetitions with your right foot in front, then 30 repetitions with your left foot in front.
Most people have rolled their ankle at some point in their lives. Most of the time the ankle roll is slight and doesn’t seem to need much care. But . . .
DID YOU KNOW THAT 75% OF LATERAL ANKLE SPRAINS LEAD TO A SECOND ANKLE SPRAIN?
DID YOU ALSO KNOW THAT ABOUT 55% OF PEOPLE WHO SPRAIN THEIR ANKLE DON’T SEEK CARE FROM A HEALTHCARE PROVIDER?
This means that these people are more likely to experience problems with their ankles for the rest of their lives.(1)
I SPRAINED MY ANKLE AND DIDN’T GET CARE
I sprained my right ankle for the first time the Summer before my senior year in high school. I was at soccer camp with my high school soccer team. We did a week long camp, open to all players who would be trying out for our high school team in order to form a bond and learn each other’s playing styles before the season began.
This year happened to be my captain year. Things were going well until they weren’t. We were playing a scrimmage at the end of one of day and I stepped in a small rut in the field and down I went. My ankle swelled up, I had difficulty putting a lot of weight through my ankle and my parents decided to pull me from the rest of camp in order to rest my ankle.
I was sidelined for another week or two and then I was back on the field.
I would wear a light ankle brace or have someone tape my ankle before practices and games and I made it through the season just fine.
Then the first Monday after Thanksgiving was the beginning of the Winter sports season. I was a gymnast.
During the first tumbling pass of the first day of practice of my senior, captain year for gymnastics I landed on the outside of my ankle. My ankle didn’t support me in the slightest, I immediately rolled and sprained it, again. My coach knew I did something bad immediately and my mom came to pick me up from practice.
My parents had a 24 hour rule for me and my injuries: if Ali is still talking about the problem 24 hours later it must be bad, so we go to the physician. I got an x-ray and eventually an MRI. The x-ray was negative for fractures, the MRI was positive for a bad ankle sprain. I was in a short boot and crutches for weeks. It was miserable. Finally, I got into physical therapy and started learning some exercises, but I missed all but one gymnastics meet that year. And this injury ultimately made me decide to not pursue gymnastics in college.
Why do I share this story? Because I don’t want what happened to me to happen to you. If I had gotten exercises after the first “mild” ankle sprain in the Summer, I probably would not have sprained my ankle in the Winter. Or, at least it would not have been so devastating. Read below for the exercises I choose for my patients so they can stay active, improve their range of motion, balance and strength.
Lateral Ankle Sprain
There are exercises you can practice if you’ve had a lateral ankle sprain. I am specifically targeting lateral ankle sprains because they tend to be more common. This type of ankle sprain happens when you roll your ankle and you land on the outside of the foot/ankle, and the bottom of your foot rolls up to face your other foot. As opposed to a medial ankle sprain your ankle rolls in, and the bottom of your foot faces away from the other foot.
I have some go to exercises I use for the first visit when I see patients who had sprained their ankles to immediately start improving motion, stability and strength. The sooner patients start these exercises the sooner they will be back to their activities and less likely to sprain their ankle again, or if they do, at least to a lesser extent.
Exercises
TANDEM BALANCE:
The next one is for balance. Stand next to the counter, in the 90 degree angle if you have one, with your hands on the counter for support. You stand with your feet heel-toe position, like you are standing on a tight rope. When you are ready let go of the counter and balance yourself for 30 seconds at a time. Notice how your ankles wiggle to keep you upright. Practice this 3 times for 30 seconds each with each foot in the front. Is this easy? Try it standing on a pillow, or by closing your eyes!
SINGLE LEG BALANCE:
Stand next to the counter, in the 90 degree ankle if you have one, with your hands on the counter for support. This one is self explanatory: you will stand on a single leg. Practice on your good leg first to get the idea of it. You will have one foot on the ground, with the other leg bent at the knee so you foot is behind you in the air. When you are ready let go of the counter and balance. Aim to balance yourself without having to use your hands for balance, just using your ankle for support. Practice this 3 times for 30 seconds each time on each leg. Is this one easy? Try it standing on a pillow, or by closing your eyes!
HEEL RAISES:
It’s important to strength your ankle and foot muscles so they can best support your ankle to decrease the chances of it rolling again. My favorite exercise for this is heel raises: You can do this with both feet on the ground (double leg heel raises) or with one leg on the ground (single leg heel raises). I recommend starting with double leg heel raises. Stand next to the counter with your hands on the counter for support. Place both feet on the floor about hip width apart, toes pointing directly forward. Rise up on your toes, lifting your heels as far off the ground as they go. Slowly lower you heels to the ground. Repeat. I recommend progressively increasing from as many as you can do in a row, up to 30 repetitions.
4-way ankle Theraband
These exercises are done with an elastic band for resistance. They strengthen the ankle all the way around. Typically when someone sprains their ankle it’s because they can’t control plantarflexion and eversion (ie not strong enough here to prevent the ankle from rolling)… and all directions are important in rehabbing an ankle sprain injury.
CALF STRETCH:
Finally, end with a stretch. This stretch is for your gastrocnemius muscle, and many people know this stretch as the runner’s stretch because we see runners do this stretch often. Stand in front of a counter, hands on the counter. Place the leg you want to stretch behind you, toes pointing forward and heel on the ground. The front leg will have a bent knee to balance you, and your back leg will be far enough behind you for you to feel a stretch in the calf (the muscle on the backside of your leg, below your knee). You must keep your heel down for this stretch to be effective. Hold this stretch position for 30 seconds, repeat 3 times.
THESE ARE SOME GOOD EXERCISES TO START WITH. PLEASE, REMEMBER THAT THESE EXERCISES ARE MADE FOR SOMEONE WHO HAS BEEN ASSESSED BY A PHYSICIAN OR PHYSICAL THERAPIST WHO DEEMS THEY ARE READY FOR WEIGHT BEARING ACTIVITIES AND DO NOT HAVE A FRACTURE OR ANOTHER DIAGNOSIS. FIND YOUR LOCAL PHYSICAL THERAPIST TO FIND A TAILORED EXERCISE PROGRAM TO FIT YOUR NEEDS.
Citation:
Hubbard TJ, Wikstrom EA. Ankle sprain: pathophysiology, predisposing factors, and management strategies. Open Access J Sports Med. 2010;1:115–122. Published 2010 Jul 16.
This blog was originally posted as 2 blogs in 2019 on my sister site https://mobilept.us
