Ankle Sprain Rehab

If you want to know what to do in the first few days following an ankle sprain, then read my blog here. The blog covers the use of ice, pain killers, nutrition, ankle braces and initial  non-weight bearing exercises. If your ankle sprain is really bad, you may need an x-ray, but over 95% heal without need for surgery.

Once you’ve got through the initial recovery phase, you can begin the secondary recovery phase that introduces controlled weight-bearing balance and muscle strengthening exercises for the injured ankle.  Research has shown that the quicker you can resume some weight-bearing activity after an ankle sprain the better. 

This phase is important. If you skimp on it, you may get ongoing problems with your ankle.  Research has shown that often ankle sprain rehab is done poorly and patients have lingering problems for up to 18 months after their injury.

Balance Exercises

Numerous studies have shown that balance exercises using wobble boards are effective at rehabilitating unstable ankles after sprains. 

This is what a wobble board looks like. They are inexpensive and easy to get hold of online.

Wobble Board

To start with, you can use the wobble board from a seated position so there’s not too much weight going through the ankle. From there you can start working your way through the  more difficult exercises, ending up with the one leg balances if you are brave.

The reason why wobble boards are important is that often when the ligaments are damaged during sprains, small nerves within them (afferent sensory fibres) are also damaged. These nerves need to be ‘re-educated’ to report ankle movements to the brain, and wobble board exercises help establish this ligament to brain proprioceptive link. It has even been shown that ankle sprains can lead to micro-structural changes in areas of the brain that control posture! Yes, ankle sprains give you brain damage.

The video below shows a suggested exercise progression for the wobble board. I would recommend not moving on to the more difficult exercises until you are comfortable with the easier ones. Research has shown that it is best to do these exercises at least 3 times a week for 4-6 weeks. 

Pain permitting, simply standing on one leg (the injured one) for a few seconds at a time is also a good introductory balance exercise. You can stand near a wall and support yourself with your hand if you need to. Even doing this simple exercise will put some beneficial stress through your ankle ligaments.

Strengthening exercises

Many studies have shown that repaired ligaments are never quite as good as the original ones. To compensate for this, you can build up key leg muscles to improve the stability of the injured ankle. An effective way of doing this is by using inexpensive resistance bands, which can be  purchased online.  

Below is a short video showing you how to use the resistance bands for the injured ankle.

Research has also shown that certain hip strengthening exercises can help to stabilise ankles following injury. It was found that increasing the strength of hip abductor and external rotator muscles led to improved ankle balance. 

A simple exercise that will strengthen these hip muscles is the clamshell, which can be done using glute bands to make it more difficult.  

In addition to the general rehab exercises shown, towards the end of your rehab timeline you should start slowly introducing some sport-specific movements to prepare your ankle for a return to play. For instance, controlled sideways (lateral) movements for sports where this is a key component, or progressive running drills that work up to full speed sprinting. I covered one of these programs in this article here. 

For information about when to return to sport and how long to wear an ankle brace when playing sport, please see my blog here.

Osteopathy

Finally, there is a role for osteopathic treatment in the ankle sprain rehab process, particularly when it comes to trying to prevent repeat strains. I like to assess what is going on bio-mechanically with patients who have had ankle sprains, particularly what’s happening in the ankle joint and within the affected foot. Several of the small bones in the foot can become malpositioned or misaligned following ankle sprains and may need treatment. 

In addition, it’s important to assess the  mobility and function of the lower back, hips, knees and feet, as they can all have an effect on ankle function.

If you live in the East Grinstead or Forest Row area and have suffered an ankle sprain, and want help getting back to sport, then book an appointment to see me at Osteo Studio.

Cliff Russell, Registered Osteopath