A sprain is a twisting injury to the ankle and 80% are caused by rolling the foot inward. This action commonly stretches the lateral collateral ligaments, the weakest of the ligaments that hold the ankle and foot bones together, and can lead to instability and re-injury. Spraining an ankle can increase your risk of re-injury as much as 40-70%. But proper post-injury care, rehabilitation exercises and bracing can decrease the risk.
What are the signs and symptoms of an ankle sprain?
The classic signs of inflammation are rubar (redness), tumor (swelling), calor (heat), and dolar (pain). Often the ankle will swell considerably but the size of the swelling does not correlate with the seriousness of the injury.
What is the first thing I should do if I suspect a sprained ankle?
Immediately Begin Using ...R-I-C-E
Rest from all activities that cause pain or limping. You may even need to use crutches or a cane until you can walk without pain and limping.
Ice - Place a plastic bag with ice on the ankle for 15-20 minutes, 3-5 times/day for the first 24-72 hours. Leave ice off at least ½ -1 hour between applications.
Compression - Wrap an elastic bandage from the toes up to midcalf, using even pressure (loosen if the toes turn blue or feel cold). Wear until swelling decreases.
Elevate - the ankle above heart-level (hip-level is acceptable during class).
What things can be done to restore normal ankle function?
Be patient. It will often take several weeks for the ankle to feel totally normal. After the initial period of inflammation, stretching exercises can facilitate the healing process. Loosen tight leg muscles. Tightness makes it hard to use stairs, walk, run and jump. Hold each of the following stretching exercises 15 seconds at a gentle stretch. DO NOT BOUNCE! Do 15-20 repetitions, 5-7 days/week
- Pullback. Flex your foot back toward your body. Sit with your knee straight and hold the foot position as long as possible. Do as frequently as possible for the first 3-10 days.
- Calf Stretch. Basic: Sit with your knee straight and a towel looped around the ball of your foot. Slowly pull back until you feel your upper calf stretch. Advanced: Once you can stand, try stretching with your hands on a wall. Place the injured foot behind the other with the toes pointing forward. Keep your heels down and back leg straight. Slowly bend the front knee until you feel the calf stretch in the back leg.
- Heel Stretch. Basic: Sit with your knee slightly bent. Loop a towel around the ball of your foot. Slowly pull back until you feel a stretch in the lower calf and heel. Advanced: Once you can stand, try placing your injured foot behind the other with toes pointing forward. Keeping heels down, slowly bend back knee until you feel heel stretch in back leg.
How do I prevent recurrent injury? In addition to stretching, balance and strengthening exercises may be useful.
Balance An ankle sprain can decrease your ability to balance on that foot and makes it easier to roll the ankle again. As soon as you can stand without pain, try the balance tests below. If you can't balance for 10 seconds without wobbling, practice that level every day until you can. You can stop when you pass the Level 4 test. Balance on your injured foot for 10 seconds, do at least 6 reps/day.Stand 60 seconds without losing balance, then move to next level.
Level 1 - Arms out to side, eye open
Level 2 - Arms across chest, eyes open
Level 3 - Arms out to side, eyes closed
Level 4 - Arms across chest, eyes closed
Strengthening Strong leg muscles help the ligaments hold the ankle together. Do 3 sets of the following strengthening exercises 20 repetitions each, 5-7 days/week.
- Push Out Basic: With your foot flat on the floor, push it outward against a heavy object like a wall, file cabinet or bookcase. Hold three seconds. Advanced: Try pushing out against a band that's tied to a heavy object. Sit with your foot and knee in line, and loop the band over the outside of your foot.
- Push In With your foot on the floor, push it inward against your other foot. Hold three seconds.
- Push Up Place the heel of your other foot on top of the injured one. Push down with the top heel while trying to push up with the injured foot. Hold three seconds.
Is Bracing Necessary? Injured ligaments can take up to 16 weeks or more to heal. An ankle brace helps protect the ligaments not only during recovery but also when returning to sport or exercise activities. However, bracing cannot replace strengthening exercises-strong lower leg muscles provide support to injured ligaments.
We hope you find these exercises helpful return to your normal activities shortly. Please call us with additional questions or concerns.