How to rehabilitate a sprained ankle
Ankle sprains are common yet painful injuries affecting many athletes and non-athletes. Taking part in sports that demand a lot of ankle mobility and strength increases your chances of a sprain. Depending on the severity of the ankle sprain, they can put you out of action for anything from a few days to several months.
Following the right rehabilitation plan is key for quick and full recoveries. We stress “full” because between 10 and 30% of ankle sprains don’t fully heal, leaving sufferers with symptoms for years following the injury. Here’s our guide to the best ankle sprain rehab exercises.
The symptoms of a sprained ankle vary depending on the extent of the ligament damage and are ranked on a grading system.
- Grade 1 means that the ligaments are overstretched or may have suffered a small tear. The area will be swollen and tender to the touch, but you should be able to walk, albeit with a little pain. You’re likely to recover within approximately 2 weeks.
- Grade 2 means that your ankle is considerably more painful and swollen due to a more serious tear. Bruising is likely visible and walking is still possible but it’s very painful. It could take between 4 and 6 weeks to heal.
- Grade 3, the most severe, means that at least one ligament is completely torn. Walking will likely be impossible due to the pain and instability of the ankle joint. Bruising and swelling are significant, and you could be in recovery for up to 3 months.
You can read more about ankle sprains on our injury advice page.
Ankle sprain rehab exercises
An ankle sprain rehabilitation programme has five stages beginning from the moment of injury, all the way to full recovery. The aim is to rebuild the strength and flexibility of the ligaments and muscles in the ankle.
Protection and pain relief
As soon as you sprain your ankle – regardless of the severity – it’s painful so initially, the aim is to reduce this pain and the accompanying swelling.
To do this, you should use the RICE method – Rest, Ice, Compression, Elevate. Rest as quickly as possible following the injury by taking the weight off of your ankle, then apply ice and bandage your ankle, and elevate it to be higher than your heart.
A doctor may prescribe some medication or creams to further help with pain and swelling; we recommend consulting a medical professional before using any medication. Once the swelling has gone down, there’s no need to continue wearing a bandage or any kind of ankle support.
Range of motion
Swelling and tightness are common symptoms of an ankle sprain, so it’s important to start working on regaining your range of motion as quickly as possible following your injury (often within 2-3 days). Failure to do so can delay your recovery significantly.
Exercises at this stage are very low-intensity and are purely aimed at getting your ankle moving and reducing stiffness.
This exercise is simply “writing” each letter of the alphabet with your foot. Whilst seated or lying down, extend your injured foot in front of you and slowly begin to “write” each letter of the alphabet with your toes, keeping your leg as still as possible. This may be relatively painless or very painful, depending on the severity of your injury, so take it slow if you need to.
Place a towel on the floor in front of you and, using your injured foot, try to grasp or scrunch the towel with your toes. Hold the scrunch for 5 seconds before releasing and perform it up to 10 times, depending on how painful it is. Don’t strain yourself – if it hurts too much, then stop. These exercises are purely to help get your ankle moving again.
The next stage of sprained ankle rehab focuses on stretching. This builds on the foundations laid by the range of motion exercises and takes you closer to full mobility.
Sit on the floor with your legs out straight in front of you. Grab a towel and hook it around the ball of your foot, grabbing one end of the towel in each hand. Then, gently pull on the towel and bring the top of your foot towards you. You should only feel a slight stretch in your calf – if you feel anything more, you’re pulling too hard. Hold the stretch for up to 30 seconds, again, adjusting as appropriate depending on the pain you feel. This should become easier over time.
Whilst seated, place your feet flat on the floor approximately shoulder-width apart. Then, gently raise your heels so that only your toes are in contact with the floor, before placing your feet flat on the floor again. Perform between 10 and 20 of these. If this feels very easy, do the exercise while standing. Use a wall or chair to lean forward on for support and raise your heels so that you’re on your tiptoes. Lower your heel again, and repeat up to 20 times.
Once you’ve regained some flexibility, you’ll need to work on strengthening your ankle. It’s amazing how much weaker the ankle becomes after a few weeks of little-to-no use. Strengthening exercises will help to protect you against future injury – which commonly happens when following a poor recovery programme. Where the previous exercises have had virtually no resistance, we now incorporate some low-resistance training.
Resistance band pulls
You’ll need a resistance band for this one. Tie the ends of the resistance band together around a heavy object and hook your foot into the loop. Then, whilst sitting on the floor, pull your toes towards you up to 10 times. If you experience anything more than slight pain in your ankle then stop this exercise and try again in a few days.
Using this same setup, you can change the exercise to strengthen your ankle movement in other directions. For example, if your right ankle is injured, sit with your right side facing the fastened resistance band and, instead of pulling your toes towards you, pull your ankle to the left (it may help to think of it as pulling your ankle “inwards”, also known as “ankle inversion”).
You can do the same on the other side by switching your seating position. Have your left side face the fastened resistance band and pull your ankle to the right (or “outwards”, aka “ankle eversion”). Perform these exercises up to 10 times in each direction. Once it becomes easier, you can increase the resistance slightly – but only slightly, remember, this is about recovery and not a workout!
Balance and control
The fifth and final stage of recovery is regaining your balance and control over your ankle. It’s likely to feel a little alien after a period of inaction, so now you need to regain biomechanic functionality.
For this, you’ll need to try and balance on your injured leg for up to 30 seconds – you can use a wall or chair for support if you’re a little wobbly. The dexterity and strength required to balance on one leg is greatly affected by a sprained ankle, so this may be tricky at first. Once it becomes easier, try not using a wall for support and/or closing your eyes.
Next, try doing it while standing on a pillow. The malleable and uneven surface this creates will put your ankle to work. If you can build up to 1 minute of unassisted balance with no pain, then your ankle is virtually healed.
Following this schedule, you should be able to return to your normal exercise regime very soon. Tightness, swelling, and pain should all have subsided. It may take some time before you feel completely natural again while playing sport, but remember to take your time and ease yourself back in. Rushing back into exercise too soon is a recipe for long-term ankle problems.
As with most things, prevention is better than cure, and one of the best ways to prevent an ankle sprain is appropriate footwear.
Our very own insoles will cushion and stabilise your feet and ankles, minimising the effects of uneven terrain and reducing the impact you experience while exercising. Our patented D3O technology makes us the only insole brand to be endorsed by the likes of the British Armed Forces and world-class athletes like Usain Bolt. Check out our product range and protect yourself from injury today.
Please note that this guide is not a substitute for seeing a doctor. If you suspect that you have sprained your ankle, consult a doctor before performing any exercises.
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