Getting Back on Your Feet After an Ankle Sprain

Ankle sprains occur at the rate of 23,000 per day in the United States!  The result is 1.6 million doctor office visits per year.  The direct and indirect costs (e.g., lost days from work) associated with treating ankle sprains exceed $1.1 billion annually.

There are numerous factors that have been associated with the tendency to be prone to ankle sprains.  These factors include having; high arches, impaired balance, tight calves, decreased cardiovascular fitness and being overweight.   Overweight athletes with a prior history of ankle sprains are 19 times more likely to suffer another ankle sprain.  This great increase is because the force centered on the ankle can exceed seven times body weight during athletic activity.  Even a few extra pounds will greatly increase your potential for an ankle sprain.

Previous ankle sprains can result in impaired coordination and calf tightness that can increase your potential for re-injury.  In a three-dimensional study of motion in the foot and ankle while walking, individuals with a prior history of ankle sprain had reduced ground clearance during swing phase and the foot was tilted excessively when it hit the ground.

The following is a popular treatment protocol for managing ankle sprains.  If you want to try this protocol, you should first discuss it with your chiropractor, medical doctor or physical therapist. 

Phase 1: Unable to bear weight

·  Compressive wrap with U-shaped felt balance around fibula. Change every four hours

·  Active abduction / adduction of toes for five seconds; repeat 10 times

·  Write out alphabet with toes, five times per day

·  Stationary bike, 15 minutes per day

·  Ankle rock board, seated (off-weight-bearing), 30 circles, performed clockwise and counterclockwise two times per day. Perform on uninjured ankle while standing for three minutes. This has been shown to increase proprioception in the contralateral limb

·  Mild grade 3 and grade 4 mobilization of the joints of the foot and ankle

Phase 2: Can walk with minimal discomfort; sprained ankle has 90% full range of motion

·  Mobilize all stiff joints in the lower extremity and pelvis

·  Band exercises in all planes; three sets of 25 in each direction

·  Double-leg and then single-leg heel raises on the involved side, three sets of 10 reps, two times per day

·  Standing closed-eye balance, 30 seconds, five times per day

·  Standing single-leg ankle rock board, one minute, five time per day

·  Closed kinetic-chain exercises

Phase 3: Can hop on involved ankle without pain

·  Running at 80% full speed; avoid forefoot touch-down

·  Mini-tramp; three sets of 30 jumps forward, backward and side to side. Begin on both legs; progress to single-limb

·  Plyometrics on a 50 cm and 25 cm box, positioned 1 meter apart. Jump from one box to the ground, then to the other box, landing as softly as possible. Three sets of five reps.

It is also important that problems with balance be addressed. An inexpensive foam balance pad can significantly lessen the risk of injury.  In one study, there was a 77% decrease in the rate of re-injury when overweight athletes with a prior history of an ankle sprain performed balance training on a foam stability pad for five minutes on each leg for four weeks.  Another study from the Netherlands found that individuals treated with balance-board exercises, reduced their subsequent re-injury rates by 47%.

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