Physical Therapy for Ankle Sprains

Photo of woman's ankle on treadmill.
Your PT can help prescribe the right exercise program for your ankle. Images

Ankle sprains are one of the most common types of sports injuries. A sprained ankle results when the ligaments of the ankle joint are overstretched. This results in a small or complete tear of the affected ligament. Most ankle sprains occur during sport events that include running, jumping, or walking.

Initial symptoms of a sprained ankle include:

  • pain and tenderness around the ankle
  • swelling
  • bruising
  • an inability to walk or stand on the joint
  • joint stiffness

Initial management of an ankle sprain includes the first aid technique known as RICE:

  • Rest: Rest and protect the injured area. If it hurts to bear weight on the injury, use crutches. If it hurts to move the area, immobilize it with a splint.
  • Ice: Apply ice or a frozen object, such as a bag of corn, to the injury. The cold will reduce swelling and pain at the injured site. This step should be done as soon as possible. Apply the frozen object to the area for 20 minutes three times a day for the first 48 hours.
  • Compression: Compress the injured site by applying an Ace bandage. This will decrease swelling of the injured region. Although the wrap should be snug, make sure it is not too tight as this can cause numbness, tingling, or increased pain.
  • Elevation: Elevate the injured area above the level of the heart as much as possible. This technique will also assist in reducing the amount of swelling to the injured site.

This treatment combination helps reduce the pain and swelling that occurs after initial injury. Some PTs argue that patients take the "rest" portion of RICE too far and rest too long, leading to significant loss of range of motion and functions. Many advocate using the POLICE principle. This acronym stands for protection, optimal loading, ice, compression, and elevation. Protection is done initially to procect your ankle, and optimal loading helps you get it moving as it heals to avoid long-term immobilization.

Depending on how severe the sprain is, you may have to rely on crutches for a while to assist with walking. By using crutches, you will be able to decrease the amount of weight you place on your sprained ankle. This will rest the ligaments of the ankle and allow them to heal. It will also relieve the pain experienced with walking on the affected leg.

When permitted by your physician, you should start a gentle exercise program to improve the strength and motion of your ankle. Initial exercises should be performed without placing any weight on the ankle. With time, the exercises can be advanced to become more challenging. A standard exercise program after ankle sprain involves the following exercises:

  • Range of Motion Exercises: These gentle exercises will help loosen your ankle. Often after an ankle sprain, the joint becomes stiff from lack of motion. It is important to regain the motion that may have been lost during the healing process in order to prevent future injury.
  • Isometric Exercises: Isometric exercises allow you to build strength around your ankle joint without moving your joint against resistance. This is done early in the rehabilitation process when you want to become stronger, but still suffer from discomfort with movement of the ankle joint.
  • Resistance Exercises: Resistance exercises are performed by moving the joint against a force in the opposite direction that you are moving. These exercises work to strengthen the muscles around your ankle to provide additional support to the joint.

With time, your ankle will fully recover and you will be able to perform the same activities that you enjoyed prior to your ankle sprain. If you have a sprained ankle, check in with your doctor and physical therapist to help you quickly and safely get back to your normal activity level.

Edited by Brett Sears, PT