Ankle Sprains

• Wear proper, well fitting shoes when you exercise
• Stretch gently and adequately before and after athletic or recreational activites
• Avoid sharp turns and quick changes in direction and movement
• Consider taping the ankle or wearing a brace for strenuous sports, especially if you have had a previous injury

Treatment may include:

• Applying ice packs to your ankle for 20–30 minutes every 3–4 hours for the first 2–3 days, or until the pain goes away.
• Elevating your ankle by placing a pillow beneath your foot. Try to keep your ankle above the level of your heart.
• Wrapping an elastic bandage around your ankle to keep the swelling from getting worse
• Wearing a lace-up brace or ankle stirrup (An Aircast or Gelcast)
• Using crutches until you can walk without pain
• Taking anti-inflammatory medication, or other pain medication as prescribed by your physician
• Doing ankle exercises to improve your ankle strength and range of motion. These exercises will help you return to your normal activity or sports
• On rare occasions, severe ankle sprains with complete tearing of the ligaments require surgery. After surgery, your ankle will be in a cast for 4–8 weeks

The length of recovery depends on many factors, including:

• Age
• Health
• Severity of injury, and previous injuries to that joint

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon, you may worsen your injury, which could lead to permanent damage. Everyone recovers at a different rate.

Returning to your sport or activity will be determined by how soon your ankle recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

• You have full range of motion in the injured ankle compared to the uninjured ankle
• You have full strength of the injured ankle compared to the uninjured ankle
• You can jog straight ahead without pain or limping
• You can sprint straight ahead without pain or limping — You can do 45 degree cuts, first at half speed, then at full speed
• You can do 20 yard "figure eights", first at half speed, then at full speed
• You can do 90 degree cuts, first at half speed, then at full speed
• You can do 10 yard "figure eights", first at half speed, then at full speed
• You can jump on both legs without pain, and you can jump on the injured leg without pain

As soon as you can tolerate pressure on the ball of your foot, begin stretching your ankle using the towel stretch. When this stretch is too easy, try the standing calf stretch and the soleus stretch. You can do exercises 4 and 5 when your ankle swelling has stopped increasing. You may do exercises 6 through 10 when you can stand on your injured ankle without pain.

1. Towel Stretch
   Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around the ball of your foot, and pull the towel toward your body. Be sure to keep your knee straight. Hold this position for 30 seconds and repeat 3 times.
    
2. Standing Calf Stretch
   Facing a wall, put your hands against the wall at about eye level. Keep the injured leg back, and the heel of your injured leg on the floor. Turn your injured foot slightly inward as you slowly lean into the wall, until you can feel a stretch in the back of your calf. Hold for 30 seconds. Do this several times a day.
    
3. Standing Soleus Stretch
   Stand facing a wall with your hands on the wall at about chest level. With both knees slightly bent and the injured foot back, gently lean into the wall until you feel a stretch in your lower calf. Once again, slightly toe in with the injured foot and keep your heel down on the floor. Hold this for 30 seconds. Return to the starting position, and repeat 3 times.
    
4. Ankle Range of Motion
   You can do this exercise sitting or lying down. Pretend you are writing each of the letters of the alphabet with your foot. This will move your ankle in all directions. Do this twice.
    
5. Thera-Band Exercises
   A. Resisted Dorsiflexion – sitting with your leg out straight and your foot near a door, wrap the tubing around the ball of your foot. Anchor the other end of the tubing to the door by tying a knot in the tubing, slipping it between the door and the frame, and closing the door. Pull your toes toward your face. Return slowly to the starting position. Repeat 10 times, and do 3 sets of 10.
   B. Resisted Plantar Flexion – sitting with your leg outstretched, loop the middle section of the tubing around the ball of your foot. Hold the ends of the tubing in both hands. Gently press the ball of your foot down, and point your toes, stretching the THERA-BAND. Return to the starting position. Repeat 10 times, and do 3 sets of 10.
   C. Resisted Inversion – Sit with your legs straight out and cross your uninjured leg over your injured ankle. Wrap the tubing around the ball of your injured foot and then loop it around your uninjured foot so that the THERA-BAND is anchored at one end. Hold the other end of the THERA-BAND in your hand. Turn your injured foot inward and upward. This will stretch the tubing. Return to the starting position. Repeat 10 times, and do 3 sets of 10.
   D. Resisted Eversion – Sitting with both legs out stretched and the tubing looped around both feet, slowly turn your injured foot upward and outward. Hold this position for 5 seconds. Repeat 10 times, and do 3 sets of 10
    
6. Heel Raises - While standing, balance yourself on both feet behind a chair. Rise up on your toes, hold for 5 seconds, and then lower yourself back down. Repeat 10 times, and do 3 sets of 10.
    
7. Toe Raises
   Stand in a normal weight bearing position. Rock back on your heels so that your toes come off the ground. Hold this position for 5 seconds. Repeat 10 times, and do 3 sets of 10.
    
8. Single Leg Balance
   Stand without any support, and attempt to balance on your injured leg. Begin with your eyes open, and then try to perform the exercise with your eyes closed. Hold the single leg position for 30 seconds. Repeat 3 times.
    
9. Jump Rope
   Jump rope, landing on both legs for 5 minutes, then landing on only the injured leg for 5 minutes.
    
10. Wobble Board
    This exercise is important to restore balance and coordination in your ankle. Make a wobble board by cutting a circle of plywood 2 feet across. Place it on top of a 5 or 10 pound weight from a barbell set. Stand on the wobble board. Balance first on both legs, then on the injured leg. Do this for 2–5 minutes 3 times a day. You may need to hold on to a chair or table for balance.