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Physical Therapy for a Sprained Ankle

Rehabbing A Sprained Ankle & Getting Back On Your Feet

The ankles are important parts that play the role of weight bearing and the role of adjusting lower limb movements during walking and exercise, which are important in daily living. The ankles as such are frequently damaged in daily life, sports, and leisure activities. Among ankle damage patients, 20% to 40% progress into chronic ankle instability (CAI) that shows pain and ankle joint instability. CAI patients are highly likely to be exposed to the risk of other injuries when walking on irregular ground surfaces or conducting sport activities.

The unique anatomy to the bones around the ankle provide inherent stability, however the complex of ligaments around the ankle are especially important in maintaining stability. The ankle is not as mobile as some of our larger joints, such as the hip, however due to the need for the foot and ankle to move both up and down but also inwards and outwards, there is an innate tradeoff for stability. The primary stabilizers of the ankle are the ligaments around the ankle however the secondary stabilizers are the tendons that cross the ankle joint. This means that when the ligaments are injured, the tendons often have to work harder to maintain stability, thereby putting them at risk for injury as well.

A sprained ankle is not an uncommon injury, but can be very painful and may require extensive time and therapy to heal. Typically, ankle sprains are categorized as one of the following “Grades,” depending on the severity of the sprain. The extent of physical therapy required to help heal an ankle sprain will depend on how the sprain is graded and whether surgery is required.

Grade I Ankle Sprains

This first class of ankle sprain is the generally the mildest, both in terms of damage to the ankle and the level of pain and discomfort associated with the sprain. In a Grade I injury, the ankle’s supporting ligaments suffer a stretch injury. The ATFL (anterior talofibular ligament) is the most commonly injured in a rolled ankle. Though painful, the ankle itself does not become unstable. By definition, Grade I sprains do not involve fracturing of the ankle bones and rarely require surgery.

Grade II Ankle Sprains

The second class of ankle sprain is characterized by smallor partial tearing of one or several of the ankle’s supporting ligaments (like the ATFL). Though not always, this level of injury can result in some instability of the boney structures in the joint. Frequently, a Grade II sprain will require suspension of activity for some time and will benefit from some level of physical therapy to prevent future ankle injury and restore normal range of motion.

Grade III Ankle Sprains

The third class of sprain is the most severe and usually indicates a full-thickness tear of one or more of the ligaments supporting the ankle. Sometimes, an injury this severe will result in the ligament pulling boney fragments away from the ankle bone as it is torn. These injuries almost always lead to a significant degree of joint instability and cannot be managed with ice, elevation, and rest alone but usually involve extensive rehabilitation, physical therapy, and potentially surgery.

How to Stretch and Strengthen Ankles

Unfortunately, one of the factors that puts you at greatest risk for experiencing an ankle tear is having already suffered an ankle injury. It is incredibly important that you allow sufficient rest and recovery time after any level of ankle sprain before resuming normal physical activities.

Once your therapist approves you for physical therapy activities, they may recommend a number of the following exercises to support, strengthen, and stabilize the joint:

- Range of motion. These may include simple flexion and extension movements, with or without resistance.

- Static and dynamic balance. These exercises will help build strength in the muscles and ligaments surrounding the joint to support ankle stability.

- Plyometrics. Exercises that require proprioception help restore the body’s ability to control balance through muscle memory and are especially effective when an athlete is trying to return to peak athletic performance after an ankle injury.

- Glute activation. Strengthening the gluteus minimus, medius and maximus muscles will help maintain balance and protect the knee and ankle joints from future injury.

Insufficient healing after a sprained ankle can result in permanent loss of range of motion and strength in the joint, leading to disruption of athletic performance and even hindering normal, everyday physical activity.

In addition to seeking physical therapy, wearing appropriate shoes and supportive devices like an ankle brace when training or exercising can be helpful in supporting a sprained ankle during recovery.

Rehab 2 Perform Gets You Back On Your Feet After An Ankle Sprain

Contact Rehab 2 Perform at 301-798-4838 or fill out the contact form to schedule an appointment; don’t let a sprained ankle prevent you from achieving your fitness goals.