ankle sprain exercise program
An ankle sprain is caused by damage and stretching of the ligaments of the ankle. The most important goal in the first few days after injury is to control the pain by decreasing swelling as much as possible. While you still have pain and swelling, it is best to rest and elevate the foot above the level of the heart as much as possible, take over-the-counter anti-inflammatories as directed by your doctor, and use an ankle brace or wrap to provide compression to the area.1 Ice is also a very good method for decreasing swelling, but there is no agreed upon regimen that is better than any other. Ankles tend to feel better without treatment, but are very likely to re-sprain if not treated. 2 Once you are able to bear weight on your ankle, begin the exercises.
Stretching: 3
All stretches should be 3-5 minutes, held gently to the point of stretch but not pain, and should involve consistent pressure (no bouncing). Do these stretches once daily 3 to 5 days per week.
Gastrocnemius stretch: face a wall and lean diagonally into it, keeping your heel on the ground and your knee completely straight. Make sure your bad leg is out behind you and your good leg is in a knee bent position in front on you. Lean into the stretch so you feel it in the calf of your injured ankle.
Soleus stretch: perform the same stretch as above but bend your knee slightly. You should feel the stretch just at the top of your heel.
Balancing: 4
Start with 15 seconds on the leg, progress to 60 seconds. Once you are able to do 60 seconds easily, progress to the next stage of the exercise. After completing all these progressions start again at the beginning with your eyes closed and try to progress through all the exercises again. Do 3 to 5 sets per week. Do three sets of each balance exercise each time.
Single leg balance:
Stage 1: make sure your knee is slightly bent and balance on your bad leg.
Stage 2: start doing shallow knee bends on your bad leg.
Stage 3: start moving your good leg around in the air in a running motion.
Stage 4: try putting your good leg out in front and swinging it from side to side.
Toe standing:
Stage 1: start by standing on your toes with both feet.
Stage 2: toe walking.
Perform these exercises even if you experience some discomfort, but stop if you have pain. You likely will not get to 3 sets initially, so do not get discouraged. Just do as many as you can.
Follow-up:
Please see your doctor again 6 weeks after starting this program. At that appointment they can check your balance. If your balance is excellent, you are pain free, and you had a mild sprain, your doctor might clear you to return to sport. If your doctor is not sure or feels you may require more advance balancing exercises, it may be useful at this point to see a physiotherapist to assess if you can return to sport safely. When you do return to sport, do so with a stabilizing ankle brace. Remove it only after consulting with your doctor.
1. Seah R and Sivanadian MB. Managing ankle sprains in primary care: what is best practice? A systematic review of the last 10 years of evidence. British Medical Bulletin. 2011;97:105-35.
2. Van Rijn RM, van Os AG, Bernsen R, Luijsterburg PA, Koes BW, Bierma-Zeinstra S. What is the clinical course of acute ankle sprains? A systematic review of the literature. American Journal of Medicine. 2008;121:324-31.
3. Tourne Y, Besse JL, Mabit C, Sofcot. Chronic ankle instability: which tests to assess lesions? Which therapeutic options? Orthopaedics & Traumatology. 2010;96:433-46.
4. Hupperets M, Verhagen E, van Mechelen W. The 2BFit study: is an unsupervised proprioceptive balance board training programme, given in addition to usual care, effective in preventing ankle sprain recurrences? Design of a Randomized Controlled Trial. BMC Musculoskeletal disorders. 2008:9;71-81.
