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The Best Methods for Rehabbing an Ankle Sprain and Avoiding Another Injury

By Brittany Risher | March 23, 2018
The Best Methods for Rehabbing an Ankle Sprain and Avoiding Another Injury

Expert recommended hacks to bounce back from an ankle injury and avoid future problems

Did you know that an estimated 25,000 Americans suffer from an ankle sprain every day? Plus, almost half of all sports injuries are ankle sprains. Whether you sprained your ankle walking out the door into a pothole or rebounding on the basketball court—you’re not alone!

But did you know that the steps you take right after experiencing a sprain are some of the most important for your recovery? One study found that 40 percent of sprains are misdiagnosed or poorly treated. And that can lead to re-injury, which makes it harder to go about your daily activities, especially if you play sports or work out regularly.

Luckily for you, the right rehab process will not only help your ankle sprain heal, but it can also help prevent future sprains. Getting your ankle back in action can be quick and easy with some simple methods and exercises. But first, you’ll want to know a little more about ankle sprains in general.

What Causes Ankle Sprains?

Anyone from casual walkers to weekend warriors to professional athletes can experience an ankle sprain. Ankle injuries are most common in those who have:

    • Heels that naturally turn in
    • Weak peroneals (the muscle that runs along the outside of your ankle)
    • Previously sprained ankles

Your ankle is more than just a joint, it’s also a collection of ligaments and tendons that allow your foot to move up and down and side-to-side. So when you overdo a movement to the right or the left, the ligaments that surround and connect your ankle to your foot stretch and sometimes tear, causing an ankle sprain.

Three Types of Ankles Sprains

1. Inversion Sprain

This is the most common ankle sprain. It happens when you roll your ankle outward, injuring the ligaments on the outside of your ankle.

Symptoms:

    • Tenderness and swelling (on the outside of the ankle)
    • Discoloration of the injured area
    • Difficulty putting weight on the foot

2. Eversion Sprain

This is the opposite of the inversion sprain and is less common. It happens when you roll your ankle inward, damaging the inside ligaments.

Symptoms:

    • Tenderness and swelling (on the inside of the ankle)
    • Discoloration of the injured area
    • Difficulty putting weight on the foot

3. High Ankle Sprain

This is the least common ankle sprain. It occurs when your whole foot, not just your ankle, forces outward while your leg goes inward. High ankle sprains cause more damage to the ligaments surrounding the joint and tend to take longer to heal. They are also more common in athletes such as football running backs or basketball players.

Symptoms:

    • Tenderness or swelling over the front or outside of the ankle
    • Pain just above the ankle

Grades of Ankle Sprains

Sprains are also classified into grades based on how much the ligaments are stretched. Based on the grade of your sprain, you’ll have more or less rehabbing to do.

When to Seek Professional Care

While it may seem clear which type of sprain you have, seeking out the help of a healthcare professional is still a good idea. Swelling can mask some of the damage to your ligaments, or even cover your whole ankle, so you may not know exactly what’s going on. Your healthcare professional can help you diagnose the sprain and determine what type of rehab care you may need—whether that’s an at-home program, physical therapy or a combination of the two.

How to Treat Ankle Sprains at Home

Once you understand what type of sprain you’re working with, you can start to treat it at home.

1. Reduce Swelling

The first step to treating an ankle sprain at home has to do with all that swelling. “In an acute ankle sprain, you want to reduce the swelling immediately,” explains Phil Page, Ph.D., PT, ATC, Global Director of Research and Education for Performance Health. A great way to do this is with the RICE method: rest, ice, compression and elevation.

  • Rest means getting off your ankle—it seems simple, but for those of us who love being active, it can be hard to execute. Limit your weight-bearing activities (like walking and moving around) and use crutches if necessary. It’s recommended you rest your ankle for at least 2-3 days, if not 4-5.
  • Ice can be used in 20 minute intervals three to four times a day to reduce swelling. But since bags of ice can melt and drip, another great option is a reusable cold pack that conforms to your ankle, like the TheraPearl Ankle Wrap.“TheraPearl lasts for 20 minutes of cold, which is the typical recommendation for ice—any longer and you might burn or the numb skin,” Dr. Page says. “It also doesn't leak like an ice pack or have condensation. Plus the ankle wrap has a velcro strap to help you hold it on there.”
  • Compression, like an elastic bandage or wrap, can be used to immobilize and support your injured ankle.
  • Elevate your ankle above your waist or heart in the 48 hours after injury. This slows blood flow to the area, helping you combat swelling.

2. Strengthen Your Ankle

Care doesn't end after those first few days, though. “A lot of people with a sprain may go to the doctor and be told to stay off the ankle for a few days. The swelling and pain then goes down, and they may feel better and walk better,” Dr. Page says. “But if they are not doing any rehab exercises, they may re-injure the ankle, which can become a chronic problem.”

Once you’ve rested and reduced the swelling, the best way to prevent future ankle injuries is to follow a rehab program—and specifically one that's focused on increasing ankle range of motion and balance training. “Typically, your muscle strength remains, but what you've lost is your balance,” Dr. Dr. Page explains. “You have to train the muscle, not for strength, but for stabilization.”

Performing exercises with a resistance band, like a TheraBand® CLX™, can help improve both range of motion and stability. In a study of 11 men and 11 women with acute inversion ankle sprains, Mayo Clinic researchers prescribed an at-home exercise program that included daily resistance band exercises. As the study subjects gained strength, they also gained back range of motion necessary for walking—making significant progress in just two weeks.

In another study, both healthy men and women, and those with chronic ankle instability, were split into two groups. One group performed resistance band exercises for four weeks while the others did no exercise. After four weeks, the group that did the exercises showed significant improvements in balance, and they maintained this improvement for four weeks after training.

Doing the exercises with a CLX band is easier than with a regular flat band because of the connected loops. You don't have to tie a knot—you can just put your feet or legs right inside the loops and transition easily from one exercise to the next.

Try the Exercises For Yourself

You can try the same exercise program researchers used, right at home! Use these exercises 1-2 times per day to help build back strength in your ankle. Do each exercise in three sets of 10-20 repetitions.

CLX Ankle Plantarflexion

  1. Sit on the floor with both of your knees extended.
  2. Put one foot in the center loop of the CLX and grab the end loops of the band.
  3. Push your foot down against the resistance of the band.
  4. Slowly return to starting position and repeat.

CLX Ankle Eversion

Ankle-Eversion.gif

  1. Begin in a seated position.
  2. Place one foot inside a loop (it doesn’t matter where on the band) and the other in a loop next to it, grabbing the rest of the CLX with one hand.
  3. Place your feet hip width apart and flex exercising toes toward your body and away from the midline against the resistance of the CLX.
  4. Keeping your heel on the ground and your legs stationary, hold briefly.
  5. Slowly return to your starting position and repeat.

CLX Ankle Inversion

Ankle-Inversion.gif

  1. Sit on the floor with both of your feet extended, legs flat on the floor.
  2. Securely attach one end of the loop to a sturdy piece of furniture near the floor.
  3. Place your exercising foot inside one of the CLX loops.
  4. Keeping your knee steady, pull your ankle inward against the resistance of the band and hold.
  5. Slowly return to your starting position and repeat.

For more ankle resistance exercises, download our ankle rehabilitation exercise handout here.

Another piece of equipment that can help you regain balance after an ankle sprain is a balance board, like a TheraBand® Rocker or Wobble Board. “It's really worthwhile to invest the time into doing balance exercises,” Dr. Page says. “We know that if you do balance training, it helps reduce re-injury rates.”

In a 2007 study, researchers categorized high school football players into four groups: minimal risk, low risk, moderate risk and high risk for ankle sprains. After using the stability trainer for a week, the players with an increased risk of injury saw a 77 percent reduction in the incidence of ankle sprains.

Other research has found that performing balance exercises on a Stability Trainer can also improve balance, function and kinematics in those with chronic ankle instability.

Stability Trainer Single-Leg Balance

  1. Stand on one leg (the one with the injured ankle) and balance on the Stability Trainer.
  2. Keep your back and neck in a neutral position and maintain an upright posture, using support as needed.

Stability Trainer Hop

  1. Place two Stability Trainers about a foot and a half apart.
  2. Stand on one leg (the one with the injured ankle) and balance on one of the Stability Trainers.
  3. Keep your back and neck in a neutral position and maintain an upright posture.
  4. Hop onto the other Stability Trainer.
  5. Stabilize yourself and then return to the neutral position.

For more stability ankle exercises, download a Stability Trainer plan here.

You can use the CLX or Stability Trainer alone, or you can combine the two to tackle your injury from multiple angles. All in all, research supports combining the two methods to prevent and rehab ankle injuries, and many professionals agree.

“Do CLX quick kicks while standing on a trainer on your injured leg,” Dr. Page suggests. “Then stand on the other leg and kick with your injured leg because that helps develop hip strength, which you need.”

CLX Hip Quick Kick

This exercise strengthens the hip muscles and is also great for balance training.

  1. Place each foot into the center loops of the CLX with feet hip-width apart.
  2. With your feet about hip-width apart, lean to one side and gain your balance on that foot, use a chair for added safety if needed.
  3. Keeping your knees straight, use the other foot to kick outwards.
  4. Continue to kick outward without letting that leg touch the ground.
  5. Keep your back straight and avoid leaning or bending over.
  6. Once finished, return to the starting position and repeat with the other leg.

3. Support Your Ankle

Work with your healthcare professional’s instructions to figure out when you can return to activity (and what activities you can actually do). When you get back to your exercise or sports routine, you want to give your ankle adequate support. And kinesiology tape is one option when you’re looking for support and pain relief for your sore muscles and joints.

With Kinesiology Tape

“We use TheraBand® Kinesiology Tape on a case-by-case basis,” Dr. Page says. “It's not going to help heal or accelerate recovery, but it may be useful for providing support.” Watch this video to learn how to apply tape for a lateral ankle sprain:

To learn another taping technique for ankle sprains, use this video:

Your type and grade of ankle sprain will determine how you apply the tape. TheraBand Kinesiology Tape makes it easy to apply the appropriate amount of tension. The tape's XactStretch™ Technology allows you to see when you have reached 25 percent and 50 percent tension. “It also sticks very well,” Dr. Page adds. In fact, it sticks so well, it's been shown to last up to five days, so you can get the benefits of the tape without having to reapply.

With Ankle Supports and Braces

For people who have a history of sprained ankles or who participate in sports, an ankle support, brace or sleeve can be a smart option. This will give you support you need to protect your ankle, as well as the mobility you need to perform. Research suggests that ankle braces effectively reduce the risk of another sprain and are more cost-effective than tape.

The level of support you need depends on the severity of your ankle sprain as well as any activities you’re participating in.

Just remember, no matter the brace you choose, it’s not a cure-all—you still need to work on your balance training. “A brace itself may protect you structurally, but don't just rely on that,” Dr. Page cautions. “Your muscles can develop a dependence so that when you don't wear it, they may not be as responsive to events that may cause a sprain.” Balance training will help your muscles be more prepared to handle unexpected movements (and avoid new sprains), with or without extra support.

4. Use Cryotherapy

Is your ankle injury still bugging you after a long day of work or exercise? Try using cryotherapy (cold therapy) to find relief. Ice is the most traditional form of cryotherapy, but you can also use a topical pain reliever.

Topical pain relievers are applied right to the skin, so you can find relief right where the pain is. When you’re looking for a topical pain reliever, be sure to choose one that is backed by research, like Biofreeze® Pain Reliever. Biofreeze has been shown to last longer than ice and is preferred over ice by patients. “We know that when you apply Biofreeze, it reduces blood flow immediately,” Dr. Page says. “If you just injured your ankle, it can be good to apply Biofreeze, particularly if you don't have access to ice.”

If you want something you can put in the freezer and use over and over, the TheraPearl® Ankle Wrap is another great cold therapy option.

5. Give Your Ankle Time to Heal

One of the worst parts of being injured is taking time off. It’s hard to keep yourself from doing too much, but it’s important if you want to keep yourself healthy and prevent future issues. “Keep in mind that a grade I ankle sprain may take a week or so to heal; grade II sprains may take two to three weeks and grade III may take four to six weeks,” Dr. Page explains.

If you continue to have pain, though, make sure to call your healthcare professional, in case there is an injury in addition to the sprain. “A sprain should heal pretty well, but sometimes you may chip bone off, and then you have lingering pain,” Dr. Page explains. “You need to have an x-ray if you are experiencing persistent pain so you can determine what else is going on.”

How to Prevent Ankle Sprains

Although an ankle sprain is typically an accident (and therefore pretty difficult to prevent), exercise programs can help prevent sprains—especially for athletes and highly active people. In a study published in 2016, Duke University researchers examined 10 ankle injury prevention programs for soccer players. These programs included neuromuscular, balance, strengthening and stretching exercises to prevent ankle injuries. The researchers found that these programs effectively reduced the risk of ankle injuries by 40 percent.

A maintenance program is particularly important if you previously sprained your ankle. “If you really stretched or tore a ligament, it's never going to be as tight as it was. So you need to keep challenging the muscles to take over the role of the stretched out ligaments,” Dr. Page says. He says even standing on one leg while brushing your teeth and adding a few minutes of standing on a stability trainer at the gym can help.

Try some of the exercises above for more moves you can do to keep your ankle stable, strong and flexible. Dr. Page also suggests adding an ankle brace in certain situations. “If you play a sport that increases the risk of ankle injury, strongly consider a brace in conjunction with your exercise program,” he says.

Get Back to Doing What You Love

Ankle sprains can throw a wrench in your routine, making even the simplest movements painful and difficult. But with the right tools and strategies, you can take charge of your injury.

So if you sprain your ankle, take your time coming back—the last thing you want is to try to resume your normal activities and re-injure a weaker ligament. But at the same time, know that ankle sprains are common and curable with the right plan of attack. All you have to do is make a plan customized for you, pick up the tools and products to support this plan, and seek out healthcare professionals to help guide you along the way.

With this plan in place, you can get back to your normal routine, whether that’s playing sports or playing with your kids, all by taking care of your ankles.

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