Rehab a Sprained Ankle

Whether you’re an athlete or just active, a sprained ankle is a pain – and you want to get back to your regular activities! Rehabilitating a sprained ankle takes some time and patience, but with the right approach you can be back in action before you know it. Treatment and rehab depend on the severity of the sprain, so see your doctor for evaluation and do not push yourself too quickly. When it’s time, work on stretching, strengthening, and balancing exercises at home.

Steps

Promoting Initial Healing of Your Injury

1. See your doctor to evaluate your ankle injury. Sprained ankles can often be treated at home. However, see your doctor to have your ankle injury evaluated to make sure there are no severe problems like broken bones. Your doctor will also advise you on how to take care of your ankle at home.
   • Ask your doctor, “When can I start to rehabilitate my ankle?” and “When can I go back to my normal activities?” It’s important not to rush this to avoid long-term injury.
2. Take over-the-counter pain medication. Your sprained ankle will probably be weak and painful for a little while. Before you can rehab your ankle to strengthen it, you have to let it rest and heal a bit. Alleviate pain with OTC pain medicine from your local pharmacy or drug store, such as ibuprofen (Advil, Motrin IB), naproxen (Aleve), or acetaminophen (Tylenol).
   • Ask your doctor or pharmacist which medicine is right for you, especially if you have any liver or kidney problems.
3. Use assistive devices. Allow your healing ankle to rest. Relax as much as possible. When moving around, use crutches to keep weight off of your ankle. Or, if your doctor recommends it, use a removable plastic splint to stabilize your ankle while walking.
   • Your doctor will suggest the best device to rest your ankle, and will probably provide the device to you.
4. Ice and elevate your ankle. The swelling and inflammation in your injured ankle have to subside before you can start to rehab it. Whenever possible, sit with your injured ankle propped up on pillows and elevated to a level above your heart. Put an ice pack on your injury for 20 minutes, several times per day. These actions will improve pain, swelling, and inflammation and let you get to rehab sooner.
   • Wrap an ice pack in a towel, don’t put it directly on your skin.
5. Work with a physical therapist. Once the swelling goes down and your doctor recommends it, start working with a physical therapist. They can teach you exercises to improve the strength, stability, balance, and flexibility of your ankle. Ask your doctor for a referral.
   • It’s especially important to work with a physical therapist if your ankle injury is severe or if you have recurring injuries.

Improving Ankle Flexibility and Range of Motion (ROM)

1. Do ankle flexing to improve ROM. Start ROM exercises within 3 days of your injury. Sit flat on the floor with your injured leg stretched out in front of you. Keep your knee straight. Flex your foot back towards your body, pointing your toes to the sky. Hold the position as long as possible.
   • Do this as often as possible for the first 3-10 days after your injury.
2. Improve ROM with the alphabet exercise. Sit in a chair and trace the alphabet with the toes of your injured foot. Do this 1-3 times. This encourages ankle movement in all directions.
3. Work on ROM with the foot press activity. Sit in a chair with your injured foot flat on the floor. Move your knee slowly side to side. Keep your foot stationary and pressed into the floor. Do this for 2-3 minutes.
4. Stretch your calf. Do a basic calf stretch by sitting with your knee straight and looping a towel around the ball of your foot. Slowly pull the towel back towards your body until you feel a gentle stretch in your upper calf. Hold this for 20 seconds. Do NOT bounce your stretch – keep it held steady. Repeat this 6-10 times, 5-7 day per week.
   • Try a more advanced calf stretch once you can comfortably stand. Face a wall and place your hands on the wall. Place your injured foot behind the other, pointing your toes forward. Keep your heels down. Slowly bend your front knee while keeping your back leg straight. Hold this for 20 seconds, repeating 6-7 times.
   • Start stretching once the swelling and pain subside enough so you can do it comfortably – start with very gentle stretches and gradually increase the stretch as you recover.
5. Stretch your heel. This is similar to the basic calf stretch. Sit with your injured leg out in front of you and loop a towel around the ball of your foot. This time, bend your knee slightly. Pull the towel back until you feel a stretch in your heel and lower calf.
   • Hold this for 20 seconds, and repeat 6-7 times; do this 5-7 days per week.
   • Try an advanced stretch once you can stand. Repeat the process for the advanced calf stretch, but bend your back knee instead of your front knee to get a stretch in your back leg.

Strengthening Your Ankle with Exercises

1. Use outward resistance to strengthen the front of your shin. Sit in a chair. Loop an exercise band over the outside of your injured foot, and tie the ends to a sturdy desk or chair. Keep your foot and knee in line. Push your foot outward against the band. Hold the position for 3 seconds, and release. Do three sets of 20 repetitions, 5-7 days a week.
   • If you don’t have an exercise band, simply sit with your foot flat on the floor and push outwards against a wall, cabinet, or other sturdy object. Hold for 3 seconds and release.
2. Use inward resistance to strengthen your inner shin. Switch your position from the previous exercise so that the resistance band is looped over the inside of your injured foot. Keep your foot and knee in line and pull your foot inward (toward the midline of your body). Hold for 3 seconds and release. Do 3 sets of 20 repetitions, 5-7 days a week.
   • Alternately, sit with your feet together flat on the floor. Push your injured foot inward against your other foot. Hold for 3 seconds.
3. Strengthen the front of your shin with resisted flexing. Sit on the floor and loop a resistance band over the top of your foot. Tie the ends to a sturdy object. Keep your leg straight and slowly pull your foot back against the band (into flexion). Do 3 sets of 20 repetitions, 5-7 days a week.
   • If you don’t have a band, sit in a chair and place the heel of your uninjured foot on top of your injured foot. Push down with your top heel to provide resistance, and try to push up with your injured foot. Hold for 3 seconds.

Regaining Your Balance

1. Do the balance test. Because sprains are injuries to ligaments, your ability to balance on your injured ankle may be decreased. This can make it easier to roll the ankle and re-injure it. Do an increasingly difficult balance test, starting at level one. Try to hold your balance by standing on your injured foot for 60 seconds, doing 6 repetitions a day. Once you can accomplish this, move to the next level. If you lose your balance, keep practicing at that level until you can do it. The levels are:
   • Level one: keep your arms out to your sides with your eyes open
   • Level two: fold your arms across your chest, and keep your eyes open
   • Level three: keep your arms out to your sides and close your eyes
   • Level four: fold your arms across your chest, and close your eyes
2. Stand on a pillow. Place a pillow on the floor. Stand on the pillow on your injured leg. Hold this for 10 seconds, rest, and repeat it 10 times.
3. Use a resistance band on your uninjured leg. Stand on your injured leg. Loop a resistance band around your uninjured leg, with the ends tied to a stable object. Pull your uninjured leg forward and back while balancing on your injured leg. Do this 10 times. Start slowly and get gradually faster as you get more comfortable.
   • For a challenge, swing your uninjured leg behind you and then back.

Preventing Re-injury

1. Get medical clearance to participate in physical activities. Ask your doctor or physical therapist when it’s safe to go back to being physical, especially to the activity during which you injured your ankle. Going back to activities too soon is very risky – you can easily hurt your ankle again.
2. Wear a brace or wrap during activities. If you injured your ankle during a sport or activity, protect yourself from injuring it again. Talk to your doctor or physical therapist about this. They may suggest that you wear a brace or a wrap to protect your ankle joint.
3. Continue your exercises indefinitely. Your ankle may never be quite as strong as it was before your injury. To prevent re-injury, continue to do your calf and heel stretching and your strengthening exercises 3-4 days a week indefinitely.

Tips

• Start ROM exercises within 72 hours of your injury. Begin stretching and strengthening exercises in the following weeks to months, based on your level of pain and your doctor’s recommendations.
• You may be able to get a free resistance band from your doctor's office or a physical therapist, or you can purchase one at your local pharmacy or drug store.

Sources and Citations

See also

• Heal Ligaments
• Heal a Skin Tear
• Care for a Bandage or Splint on a Cat
• McConnell Tape Your Knee
• Untrap a Nerve in Your Elbow
• Heal Scabs on Your Face
• Heal Venous Leg Ulcers
• Heal Scratches
• Heal a Split Lip
• Give a Leg Massage

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