A Sprain is an Overstretching or Tearing of a Ligament.
85% of all ankle injuries arelateral sprains, which are caused by rolling the foot inward.
This stretches or tears the ligaments that hold the ankle and foot bones together and can lead to instability and re-injury.
Spraining an ankle can increase your risk of re-injury as much as 40-70%. Mismanagement may result in long-term disability, but proper post-injury care, rehabilitation exercises and bracing can decrease this risk. The information below can help you prevent re-injury.
TO SPEED UP RECOVERY
Immediately Begin Using P R-I-C-E
- Protection– Your ankle may be splinted, taped, or braced to prevent re-injury.
- Rest – You should rest from all activities that cause pain or limping. Use crutches/cane until you can walk without pain or limping.
- Ice - Place a plastic bag with ice on the ankle for 20 minutes, 3-5 times a day for the first 24-72 hours. Leave the ice off at least 1 1/2 hours between applications.
- Compression - Wrap an elastic bandage from the toes to mid calf, using even pressure. Wrap tighter around foot, and loosen as you go up ankle and calf. Wear this until swelling decreases. Loosen the wrap if your toes start to turn blue or feel cold.
- Elevation – Make sure to elevate the ankle above heart level as much as possible (hip level is acceptable during class).
TO RESTORE RANGE OF MOTION
Recommendation: Begin stretches and exercises listed here until your appointment with the physical therapist or athletic trainer. If pain worsens from doing them, then stop the exercises.
- Move your ankle in circles one direction, then the other.
- Perform 10 reps, 3-4 times per day, progressing until motion is equal in both ankles.
Stretching with overpressure
- In a seated position, point foot downward, upward, and to both sides, adding a gentle overpressure with your hand to increase the stretch.
- Perform 3-4 times per day, until motion is equal in both ankles.
TO REGAIN CALF FLEXIBILITY
Initially after an ankle sprain, it is difficult to bend the ankle backwards, or dorsiflex. This makes it difficult to walk without limping or to go down stairs. Frequently one will rotate the injured foot outward as you step forward. The following exercise will be helpful in regaining the upwards ankle movement.
Hold the stretch initially for 10-15 seconds, progressing to 30 seconds in a gentle pain-free stretch, for 2-3 sets, 2-3 times per day. Do not bounce!
As bearing weight on the injured foot becomes easier, then the stretches below will be helpful in regaining the lost motion upwards.
To stretch the gastrocnemius muscle:
- Place the injured foot behind the other with your injured foot pointing forward.
- Keep your heels down and back leg straight.
- Slowly bend your front knee until you feel the calf stretch in the back leg.
To stretch the soleus muscle:
- Place the injured foot behind the other with your foot pointing forward.
- Keeping your heels down, slowly bend your back knee until you feel a heel stretch in the back leg.
TO REGAIN STRENGTH
Strong leg muscles help stabilize the ankle and help prevent future injuries.
Frequency: 3 sets of 10 repetitions, 5-7 days per week
- Tie the ends of an exercise band and shut in a door, or tie to a dresser.
- Sit with your legs out in front of you, facing the door/ dresser and loop the band over the top of your foot.
- Pull your foot up toward you, against the band.
- With the band still in place, sit parallel to door/dresser and loop the band over the inside of your foot.
- Pull your foot inward against the band.
- Do NOT rotate entire leg inward, only the ankle.
- With the band still in place, sit parallel with the door/dresser on your other side and loop the band over the outsideof your foot.
- Pull your foot outward against the band.
- Hold onto the end of the band with your hands and loop the band around the bottom of your foot.
- With leg out in front of you, push foot downward against the band.
TO REGAIN BALANCE
It has been found that people with poor balance have 2-3 times the number of ankle injuries compared to those with good balance. Therefore, balance exercises are great for injury prevention!
If you are able to stand on one leg without pain, then begin by simply standing on the leg with the injured ankle with no support. Progress to a 30 second hold. The next challenge is to stand on a pillow for 30 seconds. Standing on a couch cushion, or two pillows is the next progression
This is not a comprehensive reconditioning program, but will get you on your way to recovery.
If you are not progressing steadily, contact your health care provider.
References"Ankle Instability," Sports Medicine & Arthroscopy Review; 2009; Vol. 17(2); p139-145
"Relationship Between Balance Ability, Training and Sports Injury Risk," Sports Med; 2007; 37(6); p547-556