Ankle Sprain

A Sprain is an Overstretching or Tearing of a Ligament.

Diagram of a foot/ankle in the process of a sprain occurring whereby the ankle is rolling excessively to the outside.


85% of all ankle injuries arelateral sprains, which are caused by rolling the foot inward.

Diagram of a human foot with an arrow pointing to ligaments on the outside of the ankle, that are typically are injured during a sprain in which the ankle is rolled to the outside.


This stretches or tears the ligaments that hold the ankle and foot bones together and can lead to instability and re-injury.


So What?

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

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.

Seated person's foot shown in four positions representing the circle movement. First the foot rests flat on the floor, then while health reamins on the floor, the toes are lifted up and out to the right, then straight up toward the cieling, then down a bit and in to the left before returning to the floor.

Ankle circles

  • 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.
While seated in a chair, cross your injured leg so the upper ankle rests on the opposit knee. Stretch 1: Press on the top of the foot and stretch the foot downwards.  Stretch2: Place hand on the outside of the foot, stretch the outside of the ankle by pulling up and in towards the body. Strech 3: Place hand under  forefoot and pull foot in an upward direction. Stretch 4: Place hand on the inside of foot and push the foot in an outward direction.

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

To strectch the calf muscles, grab a towel and sit on the floor with one leg straight/oustretched in front of you.  Wrap a towel around the forefoot and hold both ends of the towel. Pull the ends of the towel towards you to pull the foot towards you.

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.

Stand, toes facing a wall, with your healthy foot in front of you and your injured foot behind you. Place your hands on the wall for support as you bend your front leg and straighten your back leg. Make sure your back heel stays in contact with the floor as you lean forward towards the wall and stretch the gastroc muscles in the back of the knee.

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.
Stand upright facing a wall, with your injured foot slightly behind you, your other leg bent in front of you. Keep your heels against the floor and feet pointed forward.  Both knees are bent.  Place your hands on the wall for support.  Then drop your body down gradually, bending the back knee further, while keeping the heel down.  This stretch should be felt in the bottom of the leg, close to the ankle.

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

A model is sitting on the floor with her left leg outstretched.  A resistance band is tied with one end around a table leg and the other end wrapped around the top of her foot. She pulls her toes back toward her head, thereby tightening the resistance band and working the leg muscles in the front of the lower leg.
  • 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.
A model is sitting in a chair with a table on her left.  A resistance band is tied with one end around a table leg and the other end wrapped around the middle of her left foot. She rotates her ankle right, pulling towards the inside of her left food (away from the table leg), therby tightening the resistance band. She makes sure to rotate only the ankle and not the entire leg.
  • 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.



A model is sitting in a chair with table on her right. A resistance band is tied with one end around a table leg and the other end wrapped around middle  of her left foot. She rotates her ankle to the left, pulling towards the outside of her left foot (away from the table). She makes sure to rotate only the ankle and not the entire leg.
  • 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.
A model is sitting on the floor with her left leg outstretched, holding both ends of a resistance band which is looped around her left forefoot. She is pushing her foot down against the resistance band, pushing her foot away from her head - working the back part of the lower leg in the calf muscles.
  • 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