How to Rehab a Sprain Ankle
Ankle sprains are common injuries that can result in long-term problems. Some people with repeated or severe sprains can develop lifelong joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems.
Grades of Ankle Sprains
After the examination, your doctor will determine the grade of your sprain to help develop a treatment plan. Sprains are graded based on how much damage has occurred to the ligaments.
Grade 1 Sprain (Mild)
- Slight stretching and microscopic tearing of the ligament fibers
- Mild tenderness and swelling around the ankle
- In mild cases, you can expect full ligament healing within 2 to 3 weeks, but it will take at least six weeks for full scar tissue maturation.
Grade 2 Sprain (Moderate)
- Partial tearing of the ligament
- Moderate tenderness and swelling around the ankle
- If the doctor moves the ankle in certain ways, there is an abnormal looseness of the ankle joint
In most cases, these injuries result in a recovery period of 4 to 6 weeks. With increasing injury severity, the rehabilitation process becomes more complex and extensive.
All Grade 2 injuries should be thoroughly rehabilitated to enable:
- full range of motion and strength
- full proprioception, power, and agility
- full return to sport-specific drills
Grade 3 Sprain (Severe)
- A complete tear of the ligament
- Significant tenderness and swelling around the ankle
- If the doctor pulls or pushes on the ankle joint in certain movements, substantial instability occurs
The rehabilitation of a Grade 3 ankle sprain normally takes 6 to 12 weeks but is quite variable depending on your specific injury. Your physiotherapist or surgeon will be able to provide you with more specific guidelines and advice.
So what is a sprained ankle?
It’s when the ligaments (which connect bone to bone) stretch or tear. Sprained and strained sound alike and while they are similar a strain refers to the stretching or tearing of the muscle or tendon (connects muscle to bone) versus the ligament. There’s a grading scale between 1-3 depending on how bad the injury is.
The most common area to be injured is the outer side of the ankle, also known as an inversion sprain. This occurs when the foot rolls inward. Less commonly the foot can roll outward and cause an eversion sprain which can impact the arch of the foot. There’s also a “high ankle sprain” which refers to the area above the ankle and specifically to the ligaments between the bones of the lower leg. (Syndesmotic ligaments)
4 Exercises you should be doing for an ankle sprain
- Foam Rolling
- Calves Stretch
- Upper Extremity Reach
- Lower Extremity Reach
Lateral Ankle Sprains: Ankle Stability Exercises
In the video, we will introduce ankle strengthening progressions and neuro-muscular re-education to improve ankle stability.
The personal and posterior tibialis muscles are muscles of the ankle that act as dynamic stabilizers of the ankle. Studies have demonstrated decreased peroneal reaction time up to 6 months following a lateral ankle sprain.
1) Windshield Wipers w/ Therapy Band
Perform this exercise sitting with a Therapy Band around your foot and a towel underneath. Without moving your knees, move your ankle outward and inward like a windshield wiper. 2 set of 15
2) Ankle Inversion
Pull tension on the Therapy Band with your hands, and move your ankle down and inward to activate your posterior tibialis muscle. 2 sets of 15
3) Ankle Eversion
Pull tension on the Therapy Band with your hands, and move your ankle outward to activate the peroneal muscles. 2 set of 15
4) Heel raises with tennis ball squeeze
Perform heel raises while squeezing a tennis ball between your ankle allowing to rise higher onto your toes. Slow and controlled movements. 2 sets of 10
Stretching Mobility exercises should be continued on a daily basis and especially before and after physical activities to help prevent re-injury. Even after ankle is better, continue to strengthen the ankle with strengthening exercises and balance and control exercises several times a week to keep your ankles strong.
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- Fong, D. T. P., Hong, Y., Chan, L. K., Yung, P. S. H., & Chan, K. M. (2007).
- Soboroff, S. H., Pappius, E. M., & KOMAROFF, A. L. (1984). Benefits, risks, and costs of alternative approaches to the evaluation and treatment of severe ankle sprain. Clinical orthopedics and related research, 183, 160-168.
- A systematic review of the ankle injury and ankle sprain in sports. Sports Medicine, 37(1), 73-94.
- Doherty, C., Delahunt, E., Caulfield, B., Hertel, J., Ryan, J., & Bleakley, C. (2014). The incidence and prevalence of ankle sprain injury: A systematic review and meta-analysis of prospective epidemiological studies. Sports medicine, 44(1), 123-140.