The process of recovering from an ankle sprain varies greatly from person to person, and can depend on the circumstances leading to the injury and the tissues involved. Injuries that occur when the foot rolls inward generally stress the ligaments and tendons on the outside of the foot. These inversion injuries are very common in both athletes and the general population. On the other hand, injuries that occur when the foot rolls outward are less common and often more severe. Depending on the severity of the sprain, your physician may prescribe a course of physical therapy to help you rehabilitate your ankle. Seeing a physical therapist can also reduce your risk of injuring your ankle again.
When recovering from an ankle injury it’s important to first control the swelling with rest, ice, compression and elevation. You may need to keep it immobilized if the injury prevents you from bearing weight on the foot. Treatment focuses on restoring your normal range of motion, strengthening the injured tissues, improving balance and proprioception (your sense of how your body moves in space), and restoring normal movement patterns.
Range of motion exercises can be performed actively or passively. Passive range of motion exercises involve your physical therapist moving your ankle for you, without any effort on your part. Active range of motion exercises are movements that you can do on your own.
Strengthening can begin with isometric exercises and progress based on your progress.
An isometric exercise is one that doesn’t change the length of your muscle, and during which there’s no visible movement of the joint. For instance, you might use your hand or a doorframe to resist the inward and outward motion of the ankle. Active motion can be resisted with the use elastic bands to further strengthen the muscles.
When weight bearing becomes tolerable, balance activities should be incorporated into the treatment plan. One example would be holding onto a doorframe and beginning to balance on the affected limb. As your balance improves, this exercise can be performed without using external support. Stability of the foot, ankle, knee, hip and trunk are required to perform this exercise with control. Closing your eyes or practicing on soft surfaces can further test the proprioception and balance capabilities of your ankle.
Finally, a note about injury prevention-movement pattern faults or weakness involving your trunk and lower extremities can not only predispose you to ankle sprains, but to all types of non-contact ankle injuries.? An evaluation and treatment plan by a physical therapist that improves your movement, therefore, can improve your performance in whatever sports or activities you do and decrease your risk of future injury.
Matt Pugliese is a Doctor of Physical Therapy with the Joint Mobility Center at Hospital for Special Surgery.
