Physical Therapy for Ankle Sprains

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 athletic events that include running, jumping, or walking.

Photo of woman's ankle on treadmill with bones highlighted / Getty Images

If you have a sprained ankle, you may benefit from the skilled services of a physical therapist to help you regain normal function. Your PT can work with you to help you return to your previous level of function and mobility.

Symptoms Of An Ankle Sprain

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

If you suspect you have sprained your ankle, visit your doctor or physical therapist to get assessed and start treatment for your ankle sprain.

Early Management Of Ankle Sprains

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 the 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 the 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 physical therapists advocate using the POLICE principle. This acronym stands for protection, optimal loading, ice, compression, and elevation. Protection is done initially to protect 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.

The Physical Therapy Evaluation

When visiting a PT for an ankle sprain, he or she will perform an evaluation of your condition. Components of this evaluation may include:

  • Palpation
  • Range of motion measurements
  • Measurements of joint swelling
  • Strength measurements
  • Functional mobility assessment
  • Balance assessment

Once your PT has compiled data about your condition, he or she will develop a plan of care and an exercise program for your ankle sprain.

Physical Therapy Exercises For An Ankle Sprain

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 the 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.
  • Balance and Proprioception Exercises: As your ankle heals, your PT may work with you to improve your balance and proprioception around your ankle and leg. This can help you prevent future ankle sprains and can be an important component of returning to normal activities and sports.
  • Advanced Plyometric Exercises: When significant healing has taken place, your PT may have you work on plyometric exercises. This includes jumping and landing and explosive power. These exercises can help you prepare for running, cutting, and jumping activities that occur during athletic activity.

Keep in mind that you should not perform any exercise before consulting with your doctor to ensure that exercise is safe for you to do.

When Will Your Ankle Sprain Be Healed?

Most ankle sprains heal within four to six weeks. Severe ankles sprains may take a few weeks longer. In some rare cases, your ankle ligaments may be torn or overstretched to the point where you will experience frequent recurring ankle sprains. If this happens, you may benefit from surgical repair of your ankle ligaments.

A Word From Verywell

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.

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