The Best Ways to Improve Ankle Stability and Recover from a Reoccurring Ankle Sprain - Advice from a Physical Therapy Pro.

Ankle sprains are common injuries that can happen to people with all types of activity levels and backgrounds. They mainly occur when your ankle rolls excessively outward (most common) or inward. When this happens you can cause excessive strain or tearing of the ligaments within your ankle. For many, this can be a reoccurring injury. Studies show that if you've experienced a single ankle sprain, the risk of future sprains increases by 40-70%. Other risks include chronic pain, instability and arthritis. Fortunately this can be avoided and managed with some simple stretches, exercises and products to keep our ankles strong, mobile, and functioning properly. First let's break it down into different phases of injury and then discuss what you can work on if you're in this phase. 

1. Acute Phase: This phase is the initial 1-2 weeks after injury. In this phase you may experience sharp pain, swelling, bruising, and difficulty putting weight on the ankle. During this phase, us therapists are saying in our heads 'RICE'. This stands for Rest, Ice, Compression, and Elevation. We follow these recommendations because it is a vulnerable time for your ankle and we need to give it the time and attention in to begin the healing process. Here's how you can 'RICE' at home: 

• REST: Avoid activities that cause impact or strain on your ankle. For a less serious strain this could mean pausing any running, jumping, or sports activities. For a more serious strain, it may mean not putting any weight on it at all and using crutches or a walker. Give your self some time to rest and kick your feet up. You'll be back to activity soon enough. 
• ICE: Apply ice to your ankle to reduce swelling and inflammation. You can fill a zip lock bag with ice from your freezer, or you can invest in a high quality ice pack such as the TheraICE Ankle Ice Pack Wrap. I recommend icing in 15 minute intervals. 

• Compression: Use compression to help manage the pain and swelling of your ankle. You may also feel that this compression helps with the pain and stability. This can be done with a simple elastic bandage, or this Sleeve Star Compression Sleeve with Ankle Strap. I recommend this because it combines a compression sleeve with an added strap to help improve the stability and alignment of your ankle. 

• Elevation: Spend time elevating your foot to manage the swelling. This can be done in a recliner, couch or bed by adding pillows underneath your lower leg and ankle. Do this while you are sleeping as well. Aim to have the ankle higher than your heart. 

Once the symptoms start to subside, you may be able to ease into the next phase that contains active range of motion and gentle exercises. 

2. Subacute Phase: This phase takes place the following 1-2 weeks and is where you begin to restore your range of motion and improve the strength and stability of your ankle. Here are the stretches and exercises you can start with: 

• Range-of-Motion Exercises: Perform gentle movements to restore flexibility. Point your ankle inward, outward, up and down. You can also make it more interesting by spelling your ABC's with your foot. Perform this around 20x periodically throughout the day, within your tolerance. To achieve a greater stretch, perform a belt stretch by placing a belt, strap, or towel around the bottom of your foot and pull back. Hold for 30 seconds at a time. 

• Strengthening Exercises: Begin isometric exercises to activate muscles without joint movement. This means that you will push your foot against resistance that doesn't move. You can use a wall with a towel in between, the side of a couch, or your own body. This will help build the strength and stability of your ankle.

• Proprioception Training: Engage in balance exercises to improve joint stability and positioning. There a variety of balance exercises you can perform if standing on one leg is too challenging or painful in this stage. Check out my blog, How to Improve your Balance at Home for All Skill Levels, to find a balance exercise that's right for you. This category of exercises is essential for restoring your joint strength and preventing future ankle sprains. I recommend you continue to progress your balance exercises long after your injury. 

3. Advanced Phase: This phase typically takes place 2-6 weeks after injury. You can safely move to these activities once the range of motion and isometric exercises can be done pain-free. You will then begin to increase resistance with exercises, and incorporate more variety of movements and impact to your ankle. 

• Strengthening Exercises: Resisted movements of your ankle to improve strength, stability and range of motion. This is most easily done with looped resistance bands, such as the Fit Simplify Resistance Loop Exercise Bands. You can use your hands or other foot to anchor the other end of the band and provide resistance to your affected foot. 

• Functional Training: Begin to perform more functional movements to progress in weight bearing and tension that you apply to the ankle. Begin with forward and lateral lunges. I especially like lateral movements to challenge the lateral muscles on the ankle to keep the ankle stable and prevent from rolling outwards. Start light and gradually increase the depth and weight you apply to the ankle. Here is a list of good ankle strengthening exercises you can perform to help improve it's stability and reduce the risk of future injury. Always focus on keeping proper ankle alignment in each exercise. If the exercises makes it feel unsteady or painful, it may be too soon to perform that exercise. 
  • Forward Lunge
  • Lateral Lunge
  • Step Up Onto Step
  • Lateral Stepping 
  • Squats
  • Heel Raises

• Advance Balance Training: Balance exercises are the best way to improve the stability of your ankle. It strengthens the muscles surrounding the ankle and the deeper stabilizing muscles. This helps protect your ankle from rolling and causing more damage to your ligaments. Continue to make your balance exercises more challenging as you are able to. This can be done by performing them on an unstable surface. You could use items around the house to provide and unstable surface such as a pillow, couch cushion or folded blanket. If you're serious about helping your ankle stay strong and stable long-term, you should look into having one of these balance products at home:
  • ProsourceFit Balance Pad. - This balance pad offers an unstable foam surface that will challenge your ankle muscles to keep yourself balanced. This is a great progression from standing on a flat surface to in order to improve the stability of your ankle and prevent rolling your ankle in the future. 
  • BOSU Ball. - This is a very popular product in gyms and therapy clinics. This looks like a ball that had been cut in half and has a flat surface on one end. It provides a much greater challenge than standing on a flat surface or on the balance pad mentioned above. Standing on one leg on a bosu ball is for more stable ankles and more advanced individuals. However, it can be beneficial to step forward or laterally onto this ball and step off. Encourage yourself to keep your ankle as stable as possible and prevent excessive rolling with using any of these devices.            

4. Maintenance Phase (Ongoing):

• Regular Exercise: Maintain a routine of strengthening and flexibility exercises. The exercises mentioned above will continue to be beneficial over time to prevent future injury. 
• Proprioception Training: Continue balance exercises to sustain joint stability. See the blog  How to Improve your Balance at Home for All Skill Levels for how to continue to advance your balance exercises. Balance exercises are an incredible way to improve the stability of your ankle and prevent it from rolling. 

**Ongoing maintenance is essential to prevent re-injury and maintain ankle health.**

5. Athletic Training Phase: If you play a sport or are involved in an activity that provides more impact onto your ankle, you'll want to slowly progress towards more aggressive activity in your ankle. The best way to begin this is to start to implement more light jumping and faster-paced activity. My favorite introduction to this is the stability hop exercise. 

I hope you find some useful products in this article and that you can start an exercise program for you or your loved one. If you’re looking for a more customized exercise program, see our Personalized Exercise Programs to receive an exercise regimen tailored to you and your goals. 

 

*This blog post contains general information about health and exercise. It is not intended as medical advice and should not be relied upon as a substitute for professional medical consultation. Always consult your physician or a qualified healthcare provider before starting any new exercise program, especially if you have any medical conditions or concerns.

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