Ankle Sprain

Home Treatment

Ankle sprains take an average of 6 weeks to heal but can take can up to 4 months, depending on the severity. An ankle brace, air stirrup, hiking boots, or other form of ankle support should be worn during this time to protect the ligaments. After the ankle is healed, wearing an ankle brace or taping the ankle may help prevent reinjury.

For more painful and severe sprains, you may not be able to walk, although you might be able to bear some weight while using crutches and a protective brace, such as a brace with a built-in air cushion or other form of ankle support. If pain is severe, use crutches until your doctor tells you that you can begin to bear weight. In general, if your pain is bearable, you should try to walk or bear some weight while using crutches and a protective brace, because these activities promote healing.

Some people with repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems. Rehabilitation exercises for an ankle sprain can be done at home to promote proper healing and prevent chronic pain and instability. When rehabilitation exercises are not followed after a sprain, the ankle can become weak and unstable.

In the case of a minor sprain, rehabilitation exercises begin soon after the injury with walking. Wear hiking boots or other high-top, lace-up shoes for support.¹ But use caution. Don't force your foot into a boot if you feel a lot of pain or discomfort.

Stretching exercises should be continued on a daily basis and especially before and after physical activities to prevent reinjury. Even after your ankle feels better, continue with muscle-strengthening exercises and balance and control exercises several times a week to keep your ankles strong.

The timing and type of rehabilitation exercises may vary according to your doctor's or physiotherapist's preferences. Following are some examples of typical rehabilitation exercises.

Range-of-motion exercises

Begin range-of-motion exercises right after your injury while you have ice on your ankle. Perform a set of exercises by repeating them 10 to 30 times. Do each set 3 to 5 times a day.

Try the following simple range-of-motion exercises:

• Trace the alphabet with your toe, encouraging ankle movement in all directions.
• Sit in a chair with your foot flat on the floor. Slowly move your knee side to side while keeping your foot pressed flat.

Towel curls. While sitting, place a hand towel on a smooth floor, such as wood or tile. While keeping your heel on the ground, curl your toes and grab the towel with your toes to scrunch the towel. Let go, and continue scrunching up the entire length of the towel. When you reach the end of the towel, reverse the action by grabbing the towel with your toes, scrunching it, and pushing it away from you. Repeat, until you have pushed the entire length of the towel away from you.

Stretching exercises

Start exercises to stretch your Achilles tendon as soon as you can do so without pain. The Achilles tendon connects the calf muscles on the back of the lower leg to the bone at the base of the heel.

Towel stretch. If you cannot stand, sit with your knee straight and a towel looped around the ball of your foot. Gently and slowly pull back on the towel for about 15 seconds until you feel your calf stretch. In moderate to severe ankle sprains, it may be to painful at first to pull your toes far enough to feel a stretch in your calf. Use caution and let pain be your guide. A little pain is normal, but you should not feel moderate to severe pain. Do 15 to 20 repetitions of this exercise, 3 to 6 times a day, for about a week. Then, make Achilles stretches part of your daily routine to maintain flexibility.

Calf stretch. If you are able to stand, you can do this exercise by facing a wall with your hands at shoulder level on the wall. Place your injured foot a little behind the other foot, with the toes pointing forward. Keep your heels down and your back leg straight. Slowly bend your front knee until you feel the calf stretch in the back leg. Hold this position for at least 20 seconds, and repeat. Try to do this stretch 3 to 6 times a day.

Strengthening exercises

Talk to your doctor or physiotherapist about the timing of strengthening exercises for the ankle. Generally, you can start these exercises once you are able to stand without increased pain or swelling as long as you do not feel pain while you do them.

These exercises should be held for 3 to 5 seconds. Do 15 to 20 repetitions one or two times a day for 2 to 4 weeks, depending on the severity of your injury.

Start by sitting with your foot flat on the floor and pushing it outward against an immovable object, such as a wall or heavy furniture. After you feel comfortable with this, try using rubber tubing looped around the outside of your feet for resistance.

While still sitting, put your feet together flat on the floor. Press your injured foot inward against your other foot.

Next, place the heel of your other foot on top of the injured foot. Push down with the top heel while trying to push up with your injured foot.

Balance and control exercises

You can usually start balance and control exercises when you are able to stand without pain. But talk to your doctor or physiotherapist about the exact timing. You should not feel pain while doing these exercises. Also, don't try these exercises if you could not have done them easily before your injury. If you think you would have felt unsteady doing these exercises when your ankle was healthy, you are at risk of falling when you try them with an injured ankle.

One of the easiest ways to increase your balance and control is to stand on just your injured foot while holding your arms out to your sides with your eyes open. When you can do this for 60 seconds, try adding the advanced moves in the next level.

Stand on your injured foot only and:

• Hold your arms across your chest with your eyes open.
• Hold your arms out to the sides and close your eyes.
• Hold your arms across your chest and close your eyes.

Do these exercises 6 times for 60 seconds one time a day.

For more information on exercising to strengthen your ankle and prevent reinjury, see:

Rehabilitation exercises for ankle sprain.

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Author:	Douglas Dana Shannon Erstad, MBA/MPH	Last Updated: March 4, 2008
Medical Review:	William M. Green, MD - Emergency Medicine Anne C. Poinier, MD - Internal Medicine H. Michael O'Connor, MD - Emergency Medicine
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