Post Ankle Sprains: Getting Back on Your Feet
Surprisingly, ankle sprains comprise of 10 – 20% of the most common injuries. Ask your friends or colleagues about it, and most would have experienced one before.
It may not seem serious if your sprain was a one-off injury. However, if you have sprained your ankle before, you are more likely to sprain it again if you are not careful. Hence, it is important to rehabilitate ankle sprains to prevent future injuries.
Acute Ankle Sprains
For acute ankle sprains, a good rule of thumb to follow is the RICE principle:
- Rest your ankle: Take a rest from too much walking or activity. Increased pressure at the ankle from walking and our weight creates more trauma to the injured area, increasing inflammation and pain.
- Ice around the ankle: Ice the ankle with an ice pack. You can also put some ice cubes and a small amount of water into a plastic bag, contour it around the injured ankle to reduce swelling and inflammation around the area. Ice the area for about 15 to 20 minutes each time, three times a day.
- Compress the ankle: Wrap the ankle with a crepe bandage and put some tissue paper at the area of pain before wrapping it up to give it a focal compression. This is to allow the structures around the area to be at an optimal position for healing. Apply focal compression when not icing.
- Elevate your injured ankle: Elevating the injured ankle helps to reduce swelling at the injury area by allowing the fluid to slowly flow back towards the body.
Rehabilitation Exercises for Post Ankle Sprains
The calf muscles will usually be tight as the foot is in a flexed position as a result of reduced weight-bearing on the ankle. Hence, below are some exercises that will help to stretch the calf out so the foot can resume a normal position for walking biomechanically.
- Calf stretches in sitting:
Use a towel and hook around the ball of your foot while sitting down. Gently pull the foot towards you and you should feel a stretch at the calf. Hold it there for about 20 – 30 seconds, pain-free.
- Calf stretches in standing:
Facing a wall/door/table, place one leg in front and the injured leg behind. With both toes pointing forward, gently bend the front knee and straighten the back leg. You should feel a stretch at the calf of the injured leg. Hold it there for about 20 – 30seconds, pain-free.
Range of Motion (ROM) Exercises
The ankle generally becomes stiff after an ankle sprains as a result of pain guarding and fear of moving the foot too much. This stems from a common myth that one should not move the ankle too much during an ankle sprain. However, it is advisable to start with some range of motion exercises once the swelling and pain has subsided so the ankle does not become stiff. If it does, it will hinder with your gait.
Here is one range of motion exercise that you can try at home:
- “Drawing name” exercise:
Sitting down on a chair, point your foot out. Using the ankle as a “pen”, write out your name in the air slowly and in an exaggerated movement. If there is pain at a certain range, make sure you do not push into the pain. As you do more, the range of motion for the ankle will be increased, pain-free.
Most of the time, when the ankle is sprained, the ligaments holding the joint stable will be strained or injured as well. Ligaments are the primary stabilizers of out joints. When they are strained, the muscles (secondary stabilizers) will be needed to stabalise the ankle joint. Hence, it is important to strengthen the medial and lateral muscles around the ankle joint to prevent any recurring ankle sprains.
Here are 2 exercises that you can try using a resistance band:
- Ankle inversion exercises:
Tie a resistance band of medium resistance to the leg of a table. Sit down and place your injured foot into the band. Wrap the band around the inner border of the ball of your foot, making sure it is taut. Gently point your ankle inwards and there should be resistance coming from the resistance band, and then slowly come back to the resting position. Repeat for a total of 15 repetitions for about 3 – 5 set.
- Ankle eversion exercises:
Tie a resistance band of medium resistance to the leg of a table. Sit down and place your injured foot into the band. Wrap the band around the outer border of the ball of your foot, making sure it is taut. Gently point your ankle outwards. You should feel resistance coming from the resistance band, and then slowly come back to the resting position. Repeat for a total of 15 repetitions for about 3 – 5 sets.
Balance and Proprioceptive Exercises
After an ankle sprain, there will be reduced proprioception at the ankle joint. This means that the sense of your ankle position in space is impaired. Here are two progressive ankle balancing and proprioception exercises that you can try at home. When doing these exercises, always be near a wall or something stable that you can hold on to in case you lose your balance.
- Tandem standing
Position your uninjured foot in a straight line in front of your injured foot (tandem stance), balance. If it is too easy, try closing your eyes. Balance for 30 seconds to a minute and feel for your ankle joint while balancing.
- Single leg balancing:
Stand on your injured foot and balance yourself. If it is too easy, try closing your eyes. Balance for about 30 seconds to a minute and feel for your ankle joint while balancing.
In short, it is always to a good practice to apply the RICE principle immediately when you have sprained your ankle, and start your ankle rehabilitation once the pain and swelling starts subsiding. If there is extreme pain or swelling or you find yourself unable to bear weights, make sure you seek medical attention immediately to rule out any fractures. Check with your physiotherapist or doctor prior to starting any rehabilitation exercises if a fracture in involved.