Ankle sprain exercises and recovery
The information and exercises you to know for a successful ankle sprain recovery.
Ankle injuries involving the lateral ankle complex (outer ankle ligaments) are particularly common and account for 25% of all sports related injuries (Lin et al. 2013). Lateral ankle sprains occur when the foot rolls inwards or inverts and causes damage to the ligaments of the lateral ankle (Petersen et al, 2013). These ligaments include: the anterior talofibular ligament, calcaneofibular ligament and the posterior talofibular ligament.
Image: lateral ankle complex
The injury to these ligaments is normally acute and result in a temporary loss of function however many studies have revealed that those who have suffered an acute lateral ankle sprain will suffer at least one more in their life (Al-Mohrej and Al-Kenani, 2016). It is said that up to 20% will go onto develop chronic ankle instability which leads to difficulty in a variety of weight bearing activities (Al-Mohrej and Al-Kenani, 2016).
Grading the ankle sprain:
Lateral ankle sprains can generally be categorised in 3 Grades depending on severity:
Grade 1: Mild stretching of the lateral ligaments without macroscopic rupture; mild pain or swelling may be present. Typically no bruising or difficulty weight bearing.
Grade 2: Partial rupture of the lateral ligaments; moderate pain or swelling. Pain present when undertaking weight bearing activities, moderate loss of range of motion in the ankle joint.
Grade 3: Complete ligament rupture; severe pain, swelling and bruising present. Severe loss of function and range of motion in the ankle joint. Individuals may not be able to bear weight.
(Petersen et al, 2013) and (Harvard Medical School, 2019)
Ankle sprain treatment
Treatment for lateral ankle sprains differ depending on the grade and stage of the injury. That is, ligaments heal in three main stages: inflammatory, proliferation and remodelling stages.
- During the initial inflammatory stage it is necessary to decrease pain and swelling and protect the site from further injury and that’s why conservative treatments call for RICE (Rest, Ice, Compression and Elevation) during the first 24-48 hours post injury.
- The proliferation stage does vary but normally occurs from the 1st week up to 4 weeks post injury and emphasises restoring ankle function with the aid of braces or taping. During this phase controlled stress on the ligament will promote proper collagen formation (collagen being the building block of connective tissue, in this instance the ligament) for this controlled stress to be executed it is important to protect the ankle against further inversion hence the use of semirigid ankle support. It is important to maintain or improve ankle range of motion during this phase.
- The last phase is the remodelling phase. It is still important to protect against inversion but more importantly to improve endurance and balance in the lateral ankle joint and ligaments. The ultimate goal is to improve weight bearing capabilities and return to daily activities without persistent ankle instability.
Ankle sprain recovery exercises
After the initial inflammatory phase it is important to regain full range of motion in the ankle so that controlled stress can be put on the joint to promote healing and ensure strength training can be conducted.
Mattacola and Dwyer (2002) state that range of motion must be regained after pain and swelling is controlled before progressing to strengthening. It is suggested that resistance exercises with or without a band should be performed in sets of 3 for up to 12 repetitions allowing the ankle to move in all directions.
Some examples include
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acts and figures sourced in this article were interpreted and translated from the following sources:
- Lin, C., Vegaki, K., Coupé, V., Kerkhoffs, G. & Van Tulder, M. (2013) Economic evaluations of diagnostic tests, treatment and prevention for lateral ankle sprains: a systematic review.British Journal of Sports Medicine. 47(18) p. 1144 doi: 10.1136/bjsports.2012090319
- Mattacola, C., & Dwyer, M. (2002) Rehabilitation of the ankle after acute ankle sprain or chronic instability. Journal of Athletic Training. 37(4) p. 413-429
- Petersen,W., Rembitzki, I., Koppenberg, A., Ellerman,A., Lieban,C., Braggemann, G., & Best, R. (2013) Treatment of acute ankle ligament injuries: a systematic review. Arch Ortho Training Surg. 133(8) p. 1139-1141 doi: 10.1007/500402-013-1742-5
- Harvard Health Publishing (2007), Recovering from an ankle sprain. Retrieved from https://www.health.harvard.edu/pain/recovering_from_an_ankle_sprain
- Al-Mohrej, O., & Al-Kenani, N. (2016) Chronic ankle instability: current perspectives. Avicenna J Med. 6(4) p. 103-108 doi: 10.4103/2231-0770.191446
- Dressler, P., Gehing, D., Zdzieblink, D., Oesser, S., Gollhofer, A., & Koenig, D. (2018) Improvement of functional ankle properties following supplementation with specific collagen peptide in athletes with chronic ankle instability. Journal of Sport Science and Medicine. 17(2) p. 298-304
Note: All information in this article is intended for educational purposes and not to be used as a guide for self treatment. For medical advice or treatment you should consult a medical practitioner.