Are you someone who keeps spraining their ankle? Are you tired of easily rolling your foot?
Here at the Movement Mill, we are specialists at ankle sprain rehabilitation. Ankle sprains are one of the most common injuries for both athletes and non-athletes. Up to 70% of people will experience at least one ankle sprain in their lifetime.
After your first ankle sprain, the chance of another sprain increases up to 70%. Rehabilitation for ankle sprains is crucial to reduce the chance of future sprains. If these sprains are reoccurring, you may develop chronic ankle instability. This is where your ankle ligaments are not properly healed, leading your ankle easily giving way and always rolling your ankle.
Ankle pain can also lead to future knee pain if full rehabilitation is not completed. Most people tend to alter gait patterns with compensations such as limping. This can place excessive pressure on the knee, leading to knee pain.
Pain is not an accurate indication for recovery. No pain does not mean your ligaments are fully recovered. Objective measures such as strength, range of motion, balance and plyometric ability are tracked to determine recovery progression. Full, safe recovery or return to sport is based on hitting measurable milestones. Ankle sprain recovery generally ranges from 3 weeks to 3 months+, depending on the severity.
What exactly is an ankle sprain?
Most ankle sprains occur when you forcefully twist your ankle in towards your body, while twisting outwards is less common. This twisting movement causes your ankle ligaments to stretch or tear. The level of ankle sprain is classified into 3 grades.
Grade 1 – Mild stretch, no ankle instability
Grade 2 – Partial tear, some ankle instability
Grade 3 – Full tear/rupture, marked ankle instability
Common symptoms
- Swelling
- Bruising
- Giving way/instability
- Pain with walking
- Weakness
- Limited movement
Treatment
Initial stage – Manage pain and swelling (first few days)
Right after spraining your ankle, the PEACE protocol is recommended for early management.
Protect: Minimize movement for 1–3 days to prevent further aggravation, but avoid prolonged rest.
Elevate: Raise the injured area above heart level to help reduce swelling.
Avoid anti-inflammatories: Do not use anti-inflammatory drugs or ice as they may interfere with the natural healing process.
Compression: Apply an elastic bandage or tape to help control swelling.
Education: Understand your injury and recovery process to set realistic expectations.
Early stage – Ankle flexibility (weeks 1-2)
The next step is regaining full ankle movement. Flexibility and stretching exercises circulate blood flow and reduce stiffness. A compression stocking is also recommended to reduce swelling, making the ankle easier to move. This stage is critical – if flexibility isn’t addressed early, the ankle can become stiff, making it much more difficult to restore full movement later on. Flexibility exercises should be ongoing to maintain movement, however this is a priority especially in the first 1-2 weeks.
Early to mid stage – Strengthen ankle, improve balance (weeks 2+)
The next stage is to strengthen the muscles supporting the ankle. Often after an ankle sprain, the ankle becomes unstable and balance ability is impaired. Weighted and resistance exercises strengthen the ankle to improve stability. Balance exercises improve coordination of the ankle muscles and improve the awareness of the body in space (proprioception). Proprioception is important as this directly affects balance and stability.
Late stage
Late stage rehabilitation usually involves return to sport and more complex movements. Plyometric and agility based exercises increases the ankle’s tolerance to faster movements, such as running and jumping. Balance and strength exercises will be completed simultaneously and progressed. Depending on your goals, sports specific drills can be implemented.
Example safe to return to sport criteria
- Full range of movement
- Ankle strength L = R
- Balance L = R
- Able to hop with no pain L = R
- Able to tolerate running with no issues
- Able to tolerate 2 training sessions with no issues
Once all criteria are fulfilled, full rehabilitation is completed and the chance of a recurrent ankle sprain is significantly reduced.
