A sprained ankle is one of the most frequent musculoskeletal injuries, and while initial pain and swelling subside, a lingering stiffness often remains. This restricted feeling is a normal, though frustrating, part of the healing process. Addressing this stiffness actively is important for regaining full function and preventing the ankle from becoming vulnerable to future sprains. Rehabilitation aims to gradually restore the joint’s flexibility and strength, allowing a safe return to all daily activities.
Why Ankle Stiffness Occurs
Ankle stiffness develops due to a combination of biological responses to the injury and subsequent recovery actions. The initial injury involves stretching or tearing the ligaments, which leads to immediate swelling and inflammation within the joint capsule. This natural inflammatory process, while necessary for healing, can also cause the tissues to become guarded and restrictive.
During the early recovery phase, especially if the ankle was immobilized, the normal gliding of the joint surfaces is reduced. Ligaments and the surrounding fascia can form minor adhesions or scar tissue as they repair themselves, limiting movement. Even after swelling resolves, the joint capsule may remain tight, resulting in a loss of range of motion, particularly in movements like dorsiflexion (pulling the foot upward toward the shin).
Active Mobility and Range of Motion Exercises
Active range of motion exercises are the first step in gently breaking this cycle of stiffness without introducing external force. These movements should be performed slowly and deliberately, stopping before any sharp pain is felt.
A simple, effective exercise is the “Ankle Alphabet,” where you trace each letter of the alphabet using your big toe, moving only your ankle and foot while keeping your leg still. Plantarflexion and dorsiflexion movements, often called “ankle pumps,” involve pointing the foot down and then pulling it up toward the body. You can perform inversion and eversion movements, which turn the sole of the foot inward and outward. These gentle, controlled movements stimulate the joint and begin to restore the range of motion.
To increase the stretch during dorsiflexion, a seated towel stretch can be used. Loop a towel around the ball of your foot and gently pull back while keeping the knee straight.
Using Heat and Soft Tissue Techniques
Complementary techniques like heat and manual soft tissue work can prepare the ankle for mobility exercises by increasing tissue elasticity. Applying a moist heat pack for 15 to 20 minutes before an exercise session increases local blood flow, which brings necessary nutrients to the area and helps to relax surrounding muscles. This increase in temperature reduces the stiffness in fascial tissues, making them more receptive to stretching and movement.
Soft tissue mobilization, such as self-massage or foam rolling on the calf muscles, can target areas that have tightened up to guard the injured joint. Addressing this muscle guarding helps to reduce the tension that contributes to overall ankle stiffness. Alternating between warm water and cold water, known as contrast baths, can also be beneficial, as this cycling effect helps stimulate circulation.
Moving Beyond Stiffness: Strength and Stability
Once basic mobility is restored and the stiffness has lessened, the focus must shift to rebuilding strength and proprioception. Proprioception is the body’s sense of joint position and movement in space, a function often compromised after a sprain.
Strengthening exercises often involve using resistance bands to target the muscles that control the ankle in four directions: outward (eversion), inward (inversion), upward (dorsiflexion), and downward (plantarflexion). This progression is important because a stiff ankle is also often a weak and unstable ankle, increasing the risk of re-injury.
Stability training starts with a single-leg stance, progressing to balancing on uneven surfaces like a folded towel or a foam pad. If stiffness persists despite consistent effort, consulting a physical therapist is advised. A professional can provide a tailored exercise plan and use specialized manual therapy techniques to ensure a complete recovery.