Ankle Injuries Rehabilitation
Limit Immobilization
Immobilization can cause significant problems after ankle sprains. Patients will feel better if placed in cast or a walking boot, but this can lead to a stiff ankle, delay rehab, and make their ankle prone to re-injury, if the immobilization is carried on for too long.
Injured ankle ligaments will form scar tissue while healing. This scar tissue is tighter, and less organized when patients have their joint completely immobilized. The ligaments heal with tissue that is the appropriate length and of better quality when ankle movement is initiated earlier. When the ligaments scar excessively, normal movements can become painful, and the ankle can be prone to re-injury.
Even if walking is painful out of a boot, patients should remove the boot several times a day to work on mobility exercises. These simple exercises and stretches can help the ligaments heal properly.
Range of Motion Exercises
Some simple exercises can help maintain ankle motion, and stretch the injured ligaments in the ankle joint.
- Achilles stretches
Stretching the Achilles tendon can easily be started soon after sustaining an ankle sprain. While seated or lying down, take a towel and loop it around your toes. Pull the ends of the towel, pulling your toes upwards, and feel the stretch in the back of the ankle. Perform this 3-4 times a day for several minutes. - Alphabet writing
While seated or lying down, write the alphabet in the air with your toes. Make the letters as big as possible. Get creative by trying all uppercase, then lower case, then cursive, etc...
Strength Exercises
The next step in recovery from ankle sprains is strengthening the muscles that surround the ankle joint. By strengthening these muscles, you can help support the ankle joint, and help prevent further injury. Some exercises to perform after an ankle sprain include:
- Toe raises
Stand on a stair or ledge with your heel over the edge. Stand up on your tip toes, then in a controlled manner, let the heel rest down. Repeat 10-20 times (each foot), 4 times a day. - Heel and Toe Walking
Walk on your toes for one minute, then on your heels for one minute. Alternate walking on your heel and toes, and work up in time to a total of 10 minutes, repeating 4 times each day.
Proprioceptive Training
Proprioception is the ability of your body to provide feedback to the brain. After an ankle sprain, the proprioception of the joint can be damaged, leading to problems controlling ankle movements.
The best way to simulate proprioceptive retraining, as well as work on range of motion and strength, is with a wobble board. Read on for information about how a wobble board can help with your rehab from an ankle sprain.
Activity-Specific Training
Activity specific exercises may include simply walking or jogging, or may be more intense for athletes who participate in basketball, soccer, or other sports. The key, no matter what level recreational or competitive athlete you may be, is to progress slowly. Begin at very low intensity, and very low duration of activity, and slowly work up--never suddenly increase either the intensity or duration of your activity.
Here is a sample progression for a soccer player:
- Jogging
Begin at 50% intensity. Jog 100 yards, walk 100 yards. Repeat 4 times. Increase intensity and duration over 2-3 weeks - Figure of Eights
Jog in a figure-of-8 pattern around cones. Begin with the cones near each other. Each day, spread out the cones and increase the speed. - Box Runs
Make a box of cones. Jog forward the first side, side shuttle to the right, run backwards, then side shuttle to the left. Again, increase the size of the box and the speed of the running each day.
Once these activities can be done at full speed with no pain, patients can resume their sport. More sport specific exercises can be given to you by a coach or trainer if needed.