Most people can start ankle rehabilitation exercises within three days after the ankle injury, if it’s not too severe. But there’s no set timetable. Listen to your own body, and follow your doctor’s advice.
For the first few days, you’ll need to rest and apply an ice pack to your injured ankle for 10 to 15 minutes every few hours. Don’t let the ice touch your skin and don’t leave it on so long that it burns you.
For many people, the rest period is about three days. After that, you can gradually increase the use of your ankle and begin a program of home exercises or physical therapy.
For non-athletes, doctor-prescribed home exercises alone may be just as good as a supervised exercise program. A 2007 study of 102 people who had sprained ankles showed no major difference to recovery after one year from a supervised exercise program compared to standard care with unsupervised home exercises.
Discuss rehabilitation exercises with your doctor and do your own research to help you decide which treatment is best for you.
Types of exercises for a sprained ankle
- range of motion
- balance and control
These exercises are simple motions you can do up to 5 times per day that can help you maintain your range of motion and flexibility in your ankle.
1. Ankle alphabet
Sit on a couch or comfortable chair. Extend your leg out and trace the letters of the alphabet in the air with your big toe. If there’s no pain, you can repeat this 2 or 3 times. This gentle exercise helps you to move your ankle in all directions.
2. Knee motion
Sit in a chair with your foot flat on the floor. Keeping your foot on the floor, slowly move your knee from side to side for 2 to 3 minutes. This stretches and relaxes the ligaments around your ankle.
3. Towel and tissue scrunches
Place a small towel on the floor in front of you while you sit in a hard chair. With your shoes and socks off, gently grab the towel with your toes, scrunch it up, and count to 5. Then release the towel and repeat. Do this 8 to 10 times— or less if you feel pain.
You can also try this with a tissue.
Your Achilles tendon attaches the muscles of your calf to your heel bone, passing behind your ankle. Stretching your Achilles tendon is the next set of exercises to take up as soon as you can.
4. Towel stretch
Sit on the floor with your leg stretched out in front of you. Wrap a towel or strap around the ball of your foot. Pull back on the towel so your toes move toward you. Hold the stretch for 15 to 30 seconds. Don’t over do it. You only need to feel a mild to moderate stretch on your calf muscle.
5. Standing calf stretch
Stand facing a wall or in front of a countertop and put your hands on it for support. Place your injured ankle about one step back and your good foot forward. Keeping your back heel flat on the floor, slowly bend the knee of your good leg until you feel a moderate stretch in the calf on your injured side. Repeat this 3 times, holding for 30 seconds.
6. Heel raise
Stand with your hands in front of you, resting against a wall, countertop, or chair back for support. With your feet shoulder width apart, slowly rise up on your toes and come back down. Do about 10 of these at first and work up to 20 or more. Remember, you only want a moderate stretch and no pain. When these become easy, you can switch to doing it only with the toes on your injured side.
7. One-leg balance
With your hands on a wall, countertop, or chair back, lift up your good leg behind you so that your weight rests on the leg with the injured ankle. Try to hold this for 20 to 30 seconds. As you get stronger, try doing it only with the support of one or two fingers. When you’re stronger, do this without holding on.
Once you have a good range of motion and can comfortably bear weight on your sprained ankle, it’s time for the next step — strengthening exercises. These exercises require a resistance band. This is a simple elastic band that you can get from a sporting goods store, online, or a physical therapist’s office.
8. Elastic band push
This is a variation of the towel stretch, but with resistance. Sit on the floor. Prop up your ankle with a rolled-up towel or swimming noodle to keep your heel off the floor. Place the elastic band around the ball of your foot and hold the two ends. Now slowly push your ankle forward like you’re pointing your toe. Then slowly bring it back. Repeat this 10 times. Don’t use the band if there is any pain, or if your ankle feels wobbly.
9. Elastic band pull
Tie your resistance band around a heavy object such as a desk or table leg. While sitting on the floor, hook your toes and upper foot into the band. Now, slowly pull your foot back towards you and return it to vertical position. Repeat this 10 times.
10. Ankle out
Tie your resistance band around a heavy object. Sit or stand and hook the inside of your foot into the end of the band. Slowly move your foot to the outside and back. Repeat 10 times at first, and build up to 20 times.
You can also do this while sitting down with your ankle propped up on a rolled towel or noodle. Tie a loop in the end of the resistance band and hook it around your foot. Now arrange the band to also go around your good foot. Your good foot acts as a pivot. Holding on to the end of the band, turn your ankle out. Repeat 10 times at first, and build up to 20 times.
11. Ankle in
With the resistance band tied around a heavy object, hook the inside of your foot into the band. Now slowly move your foot inward against the resistance band and bring it back. Repeat 10 times, and build up to 20 times.
A key part of rehab is regaining control of your muscles. When you have a sprain, nerve fibers are damaged. As you recover strength, your brain has to regain its sense of where your ankle is and how precisely to move it. This sense is called proprioception.
12. Basic balance
Stand on your injured foot, lift the other foot off the floor behind you, and try to maintain your balance. Use a countertop or chair back for support if you feel unsteady. Try to hold this for a few seconds at first. Then build up to 30 seconds and 1 minute, if you can.
13. Balance with eyes closed
Now repeat the basic balance exercise with your eyes closed. This is much harder, because you don’t have visual points of reference to help you balance. Be sure to have something for support. Again, try to work up to 30 seconds and 1 minute, if you can.
14. Pillow balance
Do the same basic balance exercise while standing on a pillow. This is much harder. Even if your ankle isn’t sprained, your foot will wobble around a lot and you’ll constantly need to correct your balance. See if you can get to 30 seconds to 1 minute. Stop if you begin to feel pain in your ankle.
15. Pillow balance with eyes closed
This is the most challenging exercise. See how long you can hold your balance while standing on a pillow with your eyes closed. Be sure to have something available for support. Work up to 30 seconds to 1 minute if you can. But don’t be discouraged if you can’t.
With these exercises you’re retraining and improving the signals between your ankle and your brain.
Your doctor will prescribe a type of ankle brace depending on the type and severity of your sprain.
In the past, hard casts were often used. But research showed that these slowed down recovery in many cases. Now braces are used.
The three types of ankle braces are:
Each of these adds to stability while your sprain is healing. Depending on the brace design, it can also reduce swelling in the early stages.
If you have a very severe sprain, your doctor may apply a short leg cast for two to three weeks.
If you have repeated ankle sprains, ankle stabilization surgery may be an option, especially if conservative treatment like braces and exercises haven’t helped.
There’s evidence that surgery can provide longer-lasting relief and lower the relapse rate more than conventional treatment for people with repeated ankle injuries.
Ankle sprains are very common. The severity can vary greatly. Sometimes you will not know that you sprained it until a few hours later when you see swelling or bruising, and feel increased pain.
You should seek treatment even for minor sprains. Your doctor will determine the best type of brace to use and prescribe an exercise program to suit your specific needs.
You can usually begin movement or very light exercises within three days of the injury. Recovery time depends on the severity of the sprain, your age, and your general physical health.
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