A sprained ankle occurs when the ligaments connecting bones in the joint are stretched or torn beyond their capacity, often resulting from a sudden twist or roll of the foot. Rehabilitation aims to heal the damaged tissue, restore function, and prevent re-injury. This involves a careful, phased progression of exercises designed to regain movement, strength, and balance. Before starting any exercise program, it is essential to seek guidance from a healthcare professional to ensure the exercises are appropriate for the specific severity of the sprain.
Initial Care and Readiness for Movement
The initial phase following an ankle sprain focuses on managing pain and reducing swelling before beginning movement exercises. For the first two to three days, professionals advise a modified R.I.C.E. approach: Rest, Ice, Compression, and Elevation. Limiting activities that cause discomfort allows the damaged ligaments to begin the repair process without further strain.
Applying ice for 15 to 20 minutes several times a day helps reduce inflammation and discomfort. Compression bandages manage swelling, and elevating the ankle above the heart assists in draining excess fluid. Gentle exercises can begin once significant pain and swelling have decreased, and the ankle can tolerate light weight-bearing without sharp pain.
Gentle Range of Motion Exercises
Once swelling has subsided, rehabilitation begins with gentle, non-weight-bearing range of motion exercises to combat stiffness and improve circulation without stressing healing ligaments. These movements are performed while seated or lying down to eliminate the body’s weight from the joint. Improving blood flow supports the repair process.
A common introductory exercise is the “Ankle Alphabet,” where the individual uses the big toe to slowly trace each letter of the alphabet in the air. This guides the ankle through plantarflexion (pointing the toe down), dorsiflexion (pulling the toe up), inversion, and eversion. Simple ankle pumps, involving repeatedly pulling the foot up toward the shin and pointing it away, also improve flexibility. These initial exercises should be performed without resistance and stopped immediately if they cause any sharp increase in pain.
Building Ankle Strength
Regaining muscular strength is crucial, as the muscles surrounding the ankle must compensate for the temporary weakness of the ligaments to ensure long-term stability. This phase introduces light resistance, typically using a resistance band, to target the muscles moving the foot in different directions. Concentrating on these muscles helps create a dynamic support system for the joint.
Eversion strengthens the peroneal muscles on the outside of the lower leg, which are often strained in a sprain. To perform this, loop the resistance band around the foot, anchor it, and slowly push the ankle outward against the resistance. Inversion, the opposite motion, involves pushing the foot inward against the band to strengthen the tibialis posterior muscle.
Dorsiflexion involves pulling the foot up toward the shin against the band, strengthening the tibialis anterior. For each movement, start with two to three sets of 10 to 15 slow and controlled repetitions. As strength improves and pain remains low, the resistance of the band or the number of repetitions can be gradually adjusted. This structured strengthening is crucial for preparing the ankle to handle the forces encountered during walking and running.
Restoring Balance and Coordination
After a sprain, the body’s sense of position, known as proprioception, is compromised because the injury damages nerve receptors within the ligaments. Restoring this neural feedback is a final step in rehabilitation and is a high priority for preventing future re-injury. Proprioception training challenges the ankle’s ability to react and stabilize itself without conscious thought.
The progression of balance drills begins with standing on the injured leg, using a stable support like a chair or wall for assistance. As stability improves, reduce or remove the support, aiming to maintain a single-leg stance for 30 seconds or more. Further progression involves performing the single-leg stance with the eyes closed, which removes visual input and forces the ankle’s internal sensors to work harder. Once static balance is achieved, dynamic exercises like heel-to-toe walking help restore coordination and control for normal movement patterns.