While painful, sprained ankle rehab is important to begin as quickly as possible to minimize scarring and limited range of motion. Ankle sprains are one of the most common sports injuries. Depending on the seriousness of the sprain, they are relatively easy injury from which to recover.
Sprained Ankle Rehab
Ligaments are the structures that provide stability and support to joints. While they are strong, they have a relatively low blood supply making them slow to heal. An ankle sprain occurs when a ligament that surrounds the ankle or heel is overstretched or torn. The most common type of sprain is the inversion sprain. Inversion sprains occur when the outside, or lateral, part of the foot rolls outward and the sole turns inward. This results in the outer ligaments of the ankle being damaged.
There is a second type of sprain, called an eversion sprain, which generally occurs only with fractures. The leg and foot turn in to the center, while the sole of the foot turns outward causing the medial, or inner, ligaments are torn. Rehab from this type of injury is much more intense and takes more time.
Ankle sprains are graded from one to three, with one being a minor sprain to three being one that may require surgical repair. Grade one sprains have some stretching or minor tearing with little or no instability in the joint. There may be pain or swelling, but it will be minimal. Generally there is some stiffness, which may cause difficulty walking.
Grade two sprains have moderate tearing of the ligament fibers causing some joint instability. Walking is difficult and the pain is moderate to severe. The joint will be swollen and stiff with minor bruising evident in the area. Grade three sprains are caused by a total rupture of the ligament. The joint is completely unstable and severe swelling and bruising are present. While the pain is severe at the time of injury, it will dissipate and become pain free due to the rupture of the ligament.
If a grade three ankle sprain is suspected, patients need to be seen by a specialist immediately to prevent further injury to the area. Sprains graded one or two can generally be treated at home initially with a follow up with a specialist to ensure no additional damage has been done.
The first eighteen to twenty-four (18-24) hours are critical when dealing with ankle sprains. If proper care is not provided during this time, it will be more difficult to recover.
The first step in sprained ankle rehab is “RICE,” which stands for Rest, Ice, Compression and Elevation. The ankle should be rested for the first day or so to prevent any additional damage to the area. Ice packs should be applied for twenty minutes every three to four hours to minimize swelling. Cold therapy is maximized at twenty minutes and ice applied longer than this can cause cold damage to tissues. Compression also helps minimize swelling and provides stability to the joint. An Ace Bandage can be wrapped from the toes to mid-calf to provide compression. Finally, elevating the injured ankle above the heart draws fluid from the area to reduce swelling and pain. The “RICE” treatment should be done for the first day or two. If there is no significant improvement in pain or swelling, patients should consult a medical professional as there may be additional injuries.
While the ankle is elevated, range of motion, or ROM, exercises can be performed as part of sprained ankle rehab. These ROM exercises, such as ankle circles, will help increase mobility and decrease swelling while the ankle is elevated. Another ROM exercise that can be done during elevation is alphabet writing, which uses the foot to draw letters in the air.
Calf stretches can also be introduced at this stage of sprained ankle rehab, if they can be tolerated. These cannot be done while the ankle is elevated. Calf stretches will keep the muscles supple since they tend to tighten up with this type of injury. Sprains make it difficult to pull the foot back, or dorsiflex, which causes a limp. These static stretches provide gentle pressure to promote dorsiflexion and increase stability.
After the initial forty-eight hours and if the ankle can take some weight bearing activity, sprained ankle rehab can progress to the next stage. Calf stretches can be done against the wall. Toe raises will help increase calf strength as well.
The next step in sprained ankle rehab is to include a Theraband resistance exercise. Therabands are large elastic bands that can be tied to an object to provide resistance. As the ankle flexes in each of its four natural directions (in, out, up and down), gentle resistance is applied. This increases the strength of the joint and surrounding muscles.
To prevent reinjury, many ankle sprain rehab programs include balance exercises. Poor balance is a component of most ankle sprains. Improving balance helps improve the patient’s gait as well, which also decreases the chances of an injury at a later date.
If sprained ankle rehab is being overseen by a doctor, they may prescribe an anti-inflammatory, such as ibuprophen, to help with pain and to decrease inflammation. Many doctors recommend patients see a physical therapist for their sprained ankle rehab so patients can obtain specific treatments that may promote faster healing. Ultrasound therapy helps to increase circulation to the area while decreasing inflammation.
As sprained ankle rehab progresses, many patients choose to see a licensed massage therapist. Massage therapy can decrease scar tissue that can develop as the ligaments heal. Since ligaments have a poor blood supply, they tend to heal with more scar tissue than other tissues of the body. Massage therapy helps to break down the scar tissue and promote healing.
Sprained Ankle Rehab – The Conclusion
One final note concerning rehab: if the patient is part of a sport, they must undergo activity specific training. Both physical therapists and athletic trainers can provide specific programs.
While sprained ankles are painful and annoying, they are relatively easy injury from which to recover. Sprained ankle rehab can help regain flexibility and strength while preventing future injury.