An ankle sprain occurs when the strong bands of connective tissue, called ligaments, that support the joint are stretched too far or torn, typically from the foot twisting awkwardly. This injury results in immediate pain, swelling, and sometimes bruising, making bearing weight difficult. Structured, phased exercise is an accepted way to heal the injured ankle, minimize the risk of long-term instability, and prevent future sprains. A rehabilitation plan helps restore the ankle’s mobility, strength, and ability to sense its position in space.
Initial Safety Steps Before Movement
The immediate response to an ankle sprain focuses on controlling swelling and protecting the joint from further damage. The R.I.C.E. protocol—Rest, Ice, Compression, and Elevation—is the standard for managing the acute phase, typically the first 48 to 72 hours. Rest means avoiding activity and not putting weight on the injured foot. Applying ice for 15 to 20 minutes several times a day helps reduce pain and inflammation.
Wrapping the ankle with a compression bandage helps manage swelling, and elevating the ankle above heart level assists fluid drainage. Before beginning any structured movement, seek professional medical advice to rule out a fracture and confirm the injury’s extent. Movement should only be introduced once acute pain and significant swelling have noticeably decreased.
Phase 1: Gentle Range of Motion Exercises
The initial exercise phase starts with non-weight-bearing movements designed to prevent stiffness and promote circulation without stressing the healing ligaments. These exercises should be performed slowly and strictly within a range that causes no pain. A simple yet effective technique is the “Ankle Alphabet,” where the foot is used to trace each letter of the alphabet in the air. This action gently moves the ankle through all its possible ranges of motion.
Another basic exercise involves simple plantar flexion and dorsiflexion, which means pointing the foot down and then pulling it back toward the shin. These controlled motions help to maintain the joint’s natural movement pattern and reduce swelling. Gentle ankle circles, moving the foot clockwise and then counter-clockwise, are also helpful for mobilizing the joint.
Phase 2: Restoring Strength and Resistance
Once the gentle range-of-motion exercises are easily tolerated, the focus shifts to rebuilding the strength of the muscles supporting the ankle. This stage introduces mild resistance, which helps the muscles stabilize the joint and reduce the strain on the healing ligaments. Resistance band exercises are a primary method, targeting the muscles responsible for specific ankle movements. For instance, a light resistance band can be anchored and looped around the foot to strengthen the peroneal muscles on the outside of the lower leg by pushing the foot outward (eversion) against the band.
The band can also be used to strengthen the tibialis anterior muscle by pulling the foot upward (dorsiflexion). To strengthen the calf muscles, simple seated calf raises can be performed. As strength improves, a transition to double-leg supported heel lifts can begin, where the body is slowly raised up onto the balls of both feet while holding onto a stable object for balance. Monitoring pain levels is important during this phase, and any increase in resistance or weight should be managed carefully to avoid re-injury.
Phase 3: Balance and Functional Movement
The final stage of rehabilitation focuses on retraining proprioception, which is the body’s subconscious awareness of joint position and movement. Ankle sprains often impair this sensory feedback, making the joint susceptible to repeated injury. Single-leg standing is the foundational exercise for this phase, starting on a firm, stable surface. The goal is to hold the balance for increasing periods, challenging the small stabilizing muscles around the ankle.
As balance improves, the exercise can be progressed by standing on a less stable surface, such as a folded towel, a pillow, or a foam pad. This increased instability forces the ankle’s stability reflexes to work harder, simulating uneven ground. Simple weight shifting and mini-squats on the injured leg are also introduced to prepare the ankle for functional activities. Consistent training in this final phase is important for minimizing the risk of chronic instability.