How to rehabilitate a sprained ankle. What are the most effective exercises for ankle sprain recovery. Why is proper rehabilitation crucial after an ankle injury. How long does it take to fully recover from an ankle sprain. What are the best techniques to prevent future ankle sprains.

Understanding Ankle Sprains: Prevalence and Importance of Rehabilitation

Ankle sprains are surprisingly common, accounting for 10-20% of all injuries. Most people have experienced an ankle sprain at some point in their lives. While a single sprain may seem insignificant, it’s crucial to understand that once you’ve sprained your ankle, you’re at a higher risk of future sprains if proper care isn’t taken. This is why rehabilitation after an ankle sprain is so important – it not only aids in recovery but also helps prevent future injuries.

The RICE Protocol: Immediate Care for Acute Ankle Sprains

When dealing with an acute ankle sprain, the RICE principle is a widely recommended approach:

• Rest: Avoid putting excessive pressure on the injured ankle. Limit walking and other activities that may exacerbate the injury.
• Ice: Apply ice to the affected area for 15-20 minutes, three times a day. This helps reduce swelling and inflammation.
• Compression: Use a crepe bandage to wrap the ankle, providing support and reducing swelling.
• Elevation: Keep the injured ankle elevated to promote fluid drainage and reduce swelling.

Implementing the RICE protocol immediately after an ankle sprain can significantly improve the healing process and reduce recovery time.

Flexibility Exercises: Restoring Range of Motion

After an ankle sprain, the calf muscles often become tight due to reduced weight-bearing on the injured foot. Stretching exercises are essential to restore normal range of motion and improve walking biomechanics.

Seated Calf Stretch

This exercise targets the calf muscles while sitting down:

1. Sit on the floor with your injured leg extended.
2. Loop a towel around the ball of your foot.
3. Gently pull the towel towards you, feeling a stretch in your calf.
4. Hold for 20-30 seconds, ensuring the stretch is pain-free.
5. Repeat 3-5 times.

Standing Calf Stretch

This variation provides a deeper stretch and helps improve balance:

1. Face a wall, door, or table for support.
2. Place your injured leg behind you, keeping both feet pointing forward.
3. Bend your front knee while keeping the back leg straight.
4. Lean forward until you feel a stretch in the calf of your injured leg.
5. Hold for 20-30 seconds, ensuring the stretch is pain-free.
6. Repeat 3-5 times.

Range of Motion Exercises: Combating Ankle Stiffness

Contrary to the common belief that an injured ankle should be immobilized, gentle range of motion exercises are crucial once the initial swelling and pain have subsided. These exercises prevent stiffness and improve overall ankle function.

The “Name Writing” Exercise

This simple yet effective exercise helps improve ankle mobility:

1. Sit in a chair with your injured foot elevated slightly off the ground.
2. Imagine your foot is a pen and your ankle is the pivot point.
3. “Write” your name in the air using exaggerated movements.
4. Move slowly and avoid pushing into pain.
5. Repeat this exercise several times throughout the day.

As you practice this exercise regularly, you’ll notice an increase in your ankle’s pain-free range of motion.

Strengthening Exercises: Stabilizing the Ankle Joint

When an ankle is sprained, the ligaments that provide primary joint stability are often strained or injured. To compensate, it’s crucial to strengthen the muscles around the ankle joint, which act as secondary stabilizers. This helps prevent future ankle sprains and improves overall ankle function.

Ankle Inversion Exercise

This exercise targets the muscles on the inner side of the ankle:

1. Secure a resistance band to a stable object.
2. Sit with your injured foot placed inside the loop of the band.
3. Wrap the band around the inner border of your foot, ensuring it’s taut.
4. Slowly point your ankle inwards against the resistance.
5. Return to the starting position in a controlled manner.
6. Perform 3-5 sets of 15 repetitions.

Ankle Eversion Exercise

This exercise strengthens the muscles on the outer side of the ankle:

1. Set up the resistance band as in the previous exercise.
2. This time, wrap the band around the outer border of your foot.
3. Slowly point your ankle outwards against the resistance.
4. Return to the starting position in a controlled manner.
5. Perform 3-5 sets of 15 repetitions.

Balance and Proprioceptive Exercises: Restoring Spatial Awareness

After an ankle sprain, proprioception – the sense of your ankle’s position in space – is often impaired. This can lead to an increased risk of future sprains if not addressed. Balance and proprioceptive exercises are crucial for restoring this spatial awareness and improving overall ankle stability.

Single-Leg Balance

This simple yet effective exercise helps improve balance and ankle stability:

1. Stand on your injured leg, keeping your other foot slightly off the ground.
2. Try to maintain your balance for 30 seconds.
3. As you improve, challenge yourself by closing your eyes or standing on an uneven surface.
4. Perform 3-5 sets, resting between each set.

Ankle Alphabet

This exercise combines range of motion with proprioception:

1. Sit or lie down with your injured foot elevated.
2. Use your ankle to “write” the alphabet in the air.
3. Focus on making precise movements and feeling the position of your ankle.
4. Perform this exercise 2-3 times daily.

Progressive Return to Activity: Building Confidence and Strength

As your ankle heals and your strength improves, it’s important to gradually return to your normal activities. This progressive approach helps build confidence and ensures your ankle is ready for more demanding tasks.

Walking Program

Start with short walks on even surfaces, gradually increasing distance and duration:

1. Begin with 5-10 minute walks on flat ground.
2. Increase walking time by 5 minutes every few days as tolerated.
3. Progress to uneven surfaces and inclines as your ankle strength improves.
4. Pay attention to your gait and ensure you’re not favoring the injured ankle.

Plyometric Exercises

Once basic strength and balance have improved, incorporate low-impact plyometric exercises:

1. Start with small hops in place, focusing on soft landings.
2. Progress to forward and backward hops, then side-to-side hops.
3. Advance to single-leg hops as strength and confidence improve.
4. Always prioritize proper form and landing technique over quantity.

Preventing Future Ankle Sprains: Long-Term Strategies

While rehabilitation is crucial after an ankle sprain, it’s equally important to implement strategies to prevent future injuries. Here are some long-term approaches to maintain ankle health and reduce the risk of recurrent sprains:

Footwear Selection

Choosing appropriate footwear can significantly impact ankle stability:

• Opt for shoes with good ankle support, especially during physical activities.
• Ensure proper fit – shoes that are too loose or tight can compromise stability.
• Replace athletic shoes regularly, as worn-out soles can reduce traction and support.

Ankle Taping and Bracing

For added support during high-risk activities:

• Learn proper ankle taping techniques or use supportive ankle braces.
• Use taping or bracing during sports or activities that involve quick directional changes.
• Gradually reduce reliance on external support as ankle strength improves.

Ongoing Strength and Balance Training

Incorporate ankle-specific exercises into your regular fitness routine:

• Continue with balance exercises, even after full recovery.
• Include calf raises and resistance band exercises in your workout regimen.
• Practice sport-specific drills that challenge ankle stability.

By implementing these preventive measures and maintaining a consistent focus on ankle health, you can significantly reduce the risk of future sprains and enjoy improved overall ankle function and stability.

Rehabilitation Exercises for Post Ankle Sprains » Raffles Rehabilitation Centre

Surprisingly, ankle sprains comprise of 10 – 20% of the most common injuries. Ask your friends or colleagues about it, and most would have experienced one before.

It may not seem serious if your sprain was a one-off injury. However, if you have sprained your ankle before, you are more likely to sprain it again if you are not careful.  Hence, it is important to rehabilitate ankle sprains to prevent future injuries.

Acute Ankle Sprains

For acute ankle sprains, a good rule of thumb to follow is the RICE principle:

• Rest your ankle: Take a rest from too much walking or activity. Increased pressure at the ankle from walking and our weight creates more trauma to the injured area, increasing inflammation and pain.
• Ice around the ankle: Ice the ankle with an ice pack. You can also put some ice cubes and a small amount of water into a plastic bag, contour it around the injured ankle to reduce swelling and inflammation around the area. Ice the area for about 15 to 20 minutes each time, three times a day.
• Compress the ankle: Wrap the ankle with a crepe bandage and put some tissue paper at the area of pain before wrapping it up to give it a focal compression. This is to allow the structures around the area to be at an optimal position for healing. Apply focal compression when not icing.
• Elevate your injured ankle: Elevating the injured ankle helps to reduce swelling at the injury area by allowing the fluid to slowly flow back towards the body.

3 Rehabilitation Exercises for Post Ankle Sprains

Flexibility Exercises

The calf muscles will usually be tight as the foot is in a flexed position as a result of reduced weight-bearing on the ankle. Hence, below are some exercises that will help to stretch the calf out so  the foot can resume a normal position for walking biomechanically.

Calf stretches in sitting: Use a towel and hook around the ball of your foot while sitting down. Gently pull the foot towards you and you should feel a stretch at the calf. Hold it there for about 20 – 30 seconds, pain-free.

Calf stretches in standing: Facing a wall/door/table, place one leg in front and the injured leg behind. With both toes pointing forward, gently bend the front knee and straighten the back leg. You should feel a stretch at the calf of the injured leg. Hold it there for about 20 – 30seconds, pain-free.

Range of Motion (ROM) Exercises

The ankle generally becomes stiff after an ankle sprains as a result of pain guarding and fear of moving the foot too much. This stems from a common myth that one should not move the ankle too much during an ankle sprain. However, it is advisable to start with some range of motion exercises once the swelling and pain has subsided so the ankle does not become stiff. If it does, it will hinder with your gait.

Here is one range of motion exercise that you can try at home:

“Drawing name” exercise: Sitting down on a chair, point your foot out. Using the ankle as a “pen”, write out your name in the air slowly and in an exaggerated movement. If there is pain at a certain range, make sure you do not push into the pain. As you do more, the range of motion for the ankle will be increased, pain-free.

Strengthening Exercises: Most of the time, when the ankle is sprained, the ligaments holding the joint stable will be strained or injured as well. Ligaments are the primary stabilizers of out joints. When they are strained, the muscles (secondary stabilizers) will be needed to stabalise the ankle joint. Hence, it is important to strengthen the medial and lateral muscles around the ankle joint to prevent any recurring ankle sprains.

Here are 2 exercises that you can try using a resistance band:

Ankle inversion exercises: Tie a resistance band of medium resistance to the leg of a table. Sit down and place your injured foot into the band. Wrap the band around the inner border of the ball of your foot, making sure it is taut. Gently point your ankle inwards and there should be resistance coming from the resistance band, and then slowly come back to the resting position. Repeat for a total of 15 repetitions for about 3 – 5 set.

Ankle eversion exercises: Tie a resistance band of medium resistance to the leg of a table. Sit down and place your injured foot into the band. Wrap the band around the outer border of the ball of your foot, making sure it is taut. Gently point your ankle outwards. You should feel resistance coming from the resistance band, and then slowly come back to the resting position. Repeat for a total of 15 repetitions for about 3 – 5 sets.

Balance and Proprioceptive Exercises

After an ankle sprain, there will be reduced proprioception at the ankle joint. This means that the sense of your ankle position in space is impaired. Here are two progressive ankle balancing and proprioception exercises that you can try at home. When doing these exercises, always be near a wall or something stable that you can hold on to in case you lose your balance.

Tandem standing: Position your uninjured foot in a straight line in front of your injured foot (tandem stance), balance. If it is too easy, try closing your eyes. Balance for 30 seconds to a minute and feel for your ankle joint while balancing.

Single leg balancing: Stand on your injured foot and balance yourself. If it is too easy, try closing your eyes. Balance for about 30 seconds to a minute and feel for your ankle joint while balancing.

In short, it is always to a good practice to apply the RICE principle immediately when you have sprained your ankle, and start your ankle rehabilitation once the pain and swelling starts subsiding. If there is extreme pain or swelling or you find yourself unable to bear weights, make sure you seek medical attention immediately to rule out any fractures. Check with your physiotherapist or doctor prior to starting any rehabilitation exercises if a fracture in involved.

Tips to Strengthen Your Ankles & Avoid A Sprain

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Ankle sprains create a lot of pain and discomfort that can be hard to tolerate, and many people try to handle the sprain on their own. However, if left untreated, a sprained ankle can lead to decreased range of motion and other complications that worsen over time. This is why our foot and ankle specialists at EVFAS believe you need to fully understand this problem along with why range of motion matters, what exercises can help, and when to visit a professional.

Why Ankle Range of Motion Matters

Whether you’re certain you’ve experienced an ankle sprain or unsure, it is important to get medical attention. The sooner the better! An untreated sprain can lead to even worse conditions down the road, and you don’t know the severity without an evaluation. A foot and ankle specialist will help you start rehabilitation exercises as early as you’re able to ensure your sprain heals properly.

After an ankle sprain, the torn ligaments may heal improperly and cause a tightness that limits your range of motion. This problem is serious because your range of motion keeps your ankle strong and stable while you walk or exercise. Reduced range of motion will make your ankle less flexible to these demands and may cause persistent and frustrating pain.

Even worse, decreased range of motion may cause an increased risk of ankle sprains. Improperly healed or stiff tendons and muscles will cause your ligaments to react less adequately to stress and strain. As a result, you need to perform various forms of range of motion exercises — once your podiatrist or physician says you’re ready — to keep your ankle stable and safe from recurring sprains.

How to Strengthen Your Ankles: Ankle Range of Motion Exercises to Consider

Performing ankle exercises after a sprain will help you regain strength and range of motion. If you’re concerned about your ankle’s range of motion, find out how to strengthen your ankles with the exercises below to preserve your flexibility, and even increase it if you perform them consistently enough:

• Ankle alphabet — Move your ankle and foot in the air to write each letter of the alphabet. Keep your leg straight as you perform this activity and enlarge your letters as your ankle heals.
• Pumps — Move your injured food up and down like you’re driving a car and controlling the speed. Increase your range slowly to expand your range of motion further.
• Inversion — Slowly swipe your ankle from left to right on the joint to expand your range of motion. Stop if you feel any excessive pain.
• Toe curls — Hold your foot and ankle still while you flex your toes as far as possible. This activity works muscles in your ankle that are hard to focus on otherwise.

These ankle range of motion exercises are just a few examples of the routines you can utilize to ensure a full and healthy recovery. For example, you can expand to towel curls, slides, ankle dorsiflexion, and much more as your sprain heals. Only expand to more challenging routines if and when your doctor says you are ready.

Do Sprained Ankles Ever Fully Heal?

Recovery time for a sprained ankle depends on the severity and grade. There are three ankle sprain classifications based on the amount of force and severity of the injury. They range from a slight stretching or tearing of the ligament that causes mild tenderness to a complete tear with severe inflammation and pain. After diagnosing the grade of your sprain, our doctors will determine the best treatment option and recovery exercises for your condition.

Typically, an ankle sprain will take between a couple of days to six weeks to fully heal through icing and elevation. For more severe cases, recovery may require crutches and can take up to a couple of months. As for dealing with the pain of an ankle sprain, mild conditions will take a couple of weeks before the patient is able to feel completely comfortable again. If the ligaments are torn, it can take months.

When to See a Doctor for Your Sprained Ankle

If you’ve experienced an ankle sprain or think you may have injured your ankle, and conservative treatment options aren’t working, contact our foot and ankle specialists at EVFAS. It is crucial to treat the sprain as early as possible for a full range of motion and strength recovery. If untreated, more serious conditions such as chronic ankle instability and loss of strength in the leg can occur.

How to Prevent Ankle Sprains & Strengthen Your Ankles

Ankle sprains can happen to anyone, athletes and less active people alike. To prevent an ankle sprain, maintaining strength and flexibility in the ankle is key. This can be done through improving balance, core strengthening exercises, and being sure to acknowledge any ankle pain you may have. In some instances, you may need to get surgery to repair torn tissues and to keep your ankle strong and stable whenever you walk.

Contact the Foot & Ankle Experts at EVFAS to Avoid Future Ankle Damage

If you are experiencing chronic ankle pain after a sprain or you’re worried about your range of motion after an ankle sprain, contact our foot and ankle clinic to learn more. Our foot and ankle specialists will assess the extent of your ankle injury and guide you through the recovery process to get you back on your feet!

Arthrosis of the ankle joint: symptoms, diagnosis and treatment

Arthrosis of the ankle joint is characterized by gradual destruction of cartilage and bone tissue. Pathology is chronic and most often diagnosed in the elderly. Among patients older than 70 years, arthrosis is one of the most common causes of disability. The destroyed ankle joint completely loses mobility, causing severe pain.

Arthrosis is treated by a rheumatologist or orthopedist.

Causes of arthrosis of the ankle joint

The development of degenerative processes is most often provoked by injuries, inflammation, congenital disorders of the musculoskeletal system.

There are also risk factors that increase the likelihood of arthrosis:

• Age. The natural aging of the body is accompanied by a slowdown in metabolic processes. Articular cartilage is gradually destroyed, regeneration resources are no longer enough to compensate for natural wear and tear. The trophism of tissues also decreases. As a result, the joint space narrows and osteophytes form. The first signs of arthrosis of the ankle joint can be seen already after 40 years.
• Overweight. The joints of a person with obesity experience increased stress. The fact of the relationship between excess weight and the formation of arthrosis has been clinically proven.
• Injuries and operations on the joint. Ligament ruptures, dislocations, sprains, cartilage damage disrupt the joint. Even if the injury did not have obvious clinical manifestations, post-traumatic arthrosis of the ankle joint can form over time.
• Genetic predisposition. The tendency to arthrosis is inherited from parents to children.
• Hormonal imbalance. The level of sex hormones matters. With insufficient secretion, the rate of cartilage regeneration decreases. Under load, the joint becomes thinner, osteophytes are formed.
• Overloads. Among professional athletes and people engaged in physically demanding work, arthrosis is a common disease. Signs of destruction of the joint from excessive load may occur at a young age.
• Arthritis. Running or poorly treated inflammation is a serious risk factor. The cause of arthrosis can be rheumatoid arthritis and other pathologies.

Signs of the disease

Arthrosis progresses slowly, symptoms may increase over several years.

When to see a doctor:

• Pain appears. In the early stages, it may just be discomfort, pulling, aching sensations after a long walk. Gradually, the pain intensifies and disrupts the normal functioning of the joint.
• Lameness, change in gait. These are the consequences of the pain syndrome. The person puts his leg in the most comfortable position for him.
• Stiffness of movement. The symptom of arthrosis of the ankle joint is clearly visible in the morning, when after sleep it is not possible to move the leg. After some time, mobility is restored.
• Joint deformity. Visible changes develop in advanced cases and in the later stages of the disease. Osteophytes form on the articular surfaces, which deform the leg.

Degrees of arthrosis of the ankle joint

The most widely used classification – Kellgren and Lawrence:

• Zero stage. There are no signs of arthrosis.
• First stage. The radiograph raises doubts of the doctor. Blackouts are visualized in places of tissue changes.
• Second stage. The picture shows minimal changes in the structure of the joint.
• Third stage. Signs of pathology are expressed, well visualized on the roentgenogram. Cartilage and bone changes are determined.
• The material is sent for analysis for differential diagnosis with inflammatory arthritis, gout, infection.

Treatment of arthrosis of the ankle joint

Therapy is carried out in a complex way. The result of treatment depends not only on the qualifications of doctors, but also on the efforts of the patient himself. The patient’s own work significantly increases the effectiveness of all prescribed procedures.

Lifestyle changes

It is recommended to lose weight and relieve excess stress on the joint. Walking is alternated with a short rest, if possible they do not carry weights, change the mode and type of nutrition, and give up bad habits. You can use a cane to unload an injured ankle joint. Changing lifestyle has a positive effect on the general well-being of the patient.

Drug therapy

The doctor selects drugs to reduce pain, inflammation, to stimulate metabolic processes, to treat concomitant diseases.

For pain relief Non-steroidal anti-inflammatory drugs (NSAIDs) are most often prescribed. The drugs are effective, but require parallel administration of proton pump inhibitors (to protect the gastric mucosa) and histamine H2 receptor blockers.

To restore the function of the ankle, chondroprotectors are prescribed. Means improve the regeneration of cartilage, prevent its destruction. Chondroprotectors take long courses of several months.

In severe cases, local treatment is indicated – intra-articular and peri-articular injections are prescribed. The doctor selects glucocorticoids, hyaluronic acid or anti-inflammatory drugs. Additionally, ointments and gels help relieve symptoms.

Therapeutic physical training (LFK)

Gymnastics is effective in the treatment of arthrosis of any degree, including post-traumatic pathologies. The course of exercise therapy is prescribed after the exacerbation is removed. A set of exercises is compiled by a doctor, taking into account the condition of a particular patient.

After rehabilitation in a specialized center, you can do physical therapy at home on your own. Regular exercise will help maintain joint function and improve mobility.

Physiotherapy

The following procedures are prescribed for arthrosis:

• Electrophoresis. The current improves the penetration of the drug to the diseased joint.
• Phonophoresis. Active substances are delivered to the site of inflammation using ultrasound.
• Magnetotherapy. Inductors act on the affected joint from two sides.
• Thermal applications. Select drugs to stimulate cartilage regeneration. Applications are also performed with paraffin, therapeutic mud.

Surgical treatment

Operations are performed in cases of extreme arthrosis of the ankle joint, when it is impossible to cure the patient with conservative methods.

Arthroscopy

Minimally invasive treatment. A video camera and microsurgical instruments are introduced into the joint cavity. The doctor conducts a thorough examination of the joint, extracts particles of osteophytes, destroyed cartilage, scar tissue. Arthroscopy helps temporarily relieve pain and restore joint mobility.

Endoprosthetics

The operation is indicated for complete destruction of the joint. After the installation of an artificial joint, the mobility and support ability of the limb are restored, the pain syndrome gradually regresses.

Diagnosis and treatment of arthrosis of the ankle joint in Moscow

Comfortable conditions for patients with diseases of the musculoskeletal system have been created in the Kuntsevsky medical and rehabilitation center. We will conduct a comprehensive examination, draw up a treatment program, and provide high-quality rehabilitation after surgery. Call us to make an appointment.

References:

1. Pavlov D.V., Gorbatov R.O., Malyshev E.E., Gorin V.V. CLINICAL AND RADIOLOGICAL EVALUATION OF THE EFFICIENCY OF USE OF VARIOUS METHODS OF ARTHRODESIS AND MODERN FIXERS IN THE SURGICAL TREATMENT OF POSTTRAUMATIC ARTHROSIS OF THE ANKLE JOINT // Modern Problems of Science and Education. – 2015
2. Kaplan, A. V. Causes, symptoms, degrees and treatment of ankle arthrosis / A. V. Kaplan. – M.: Medicine, 1982
3. Kosinskaya, N. S. Degenerative-dystrophic lesions of the osteoarticular apparatus / N. S. Kosinskaya. – L.: Medgiz, 1961
4. Nikolaenko, Z.V. Diseases of the joints / ZV Nikolaenko. – St. Petersburg. : Speciallite, 2009

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Arthrosis of the ankle – symptoms, causes, treatment

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Arthrosis of the ankle joint is a chronic progressive disease characterized by degenerative changes in the articular cartilage, which is then joined by damage to the bone tissue (osteoarthritis). The most common causes of arthrosis include the natural aging process in the body, injuries and excessive physical activity on the ankle.

CMRT specialist tells

Kuchenkov A.V.

Orthopedist • Traumatologist • Surgeon • Phlebologist • Sports doctor • 24 years of experience

Publication date: June 25, 2021

Verification date: January 14, 2023

All facts have been verified by a doctor.

Contents of the article

Causes

Symptoms of arthrosis of the ankle joint

Stages of development of arthrosis

Diagnosis

Research in clinics CMRT

Which doctor to contact

How to treat arthrosis of the ankle

Popular treatments

Rehabilitation

Consequences

Prevention

Treatment and rehabilitation after ankle joint arthrosis in CMRT clinics

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