06/19/2023

Whether you have had recurrent ankle sprains since high school or college sports, or have your first ankle sprain from summer league sports, this article is for you.

Ankle Sprain vs. fracture

There are ranges of severity of ankle sprains so before we get to rehabbing them, let’s discuss how you know it is not an ankle fracture. Ottawa Ankle Rules are a cluster of symptoms to rule in or out an ankle fracture. The short version is the inability to bear weight immediately after injury and for 4 steps when evaluated (or in ER), with various bony tenderness. If the cluster is not present, an ankle x-ray is not required.

Acute Ankle Sprains

Acute means short term, this would be within the first day to a few weeks of your sprain. Rest is out, and early mobility is in. This means weight bearing as tolerated instead of complete rest. Depending on the severity of the injury you may need crutches, or you will just walk in a sneaker. Walking and PT exercises help with regaining range of motion, and aid in swelling management. I will also have clients use compression when they need to be on their feet for work or commuting. Ice, there is a lot of recent evidence on icing, I choose to have clients ice for the first 24-72 hours to help manage swelling but also pain. Ice for 20 minutes at a time.

Exercise Examples:

1. Ankle range of motion in all planes which includes ankle plantar flexion, ankle dorsiflexion, ankle inversion, and ankle eversion.
2. Range of motion exercises should be performed for 15-30reps 3x/day.
3. See my latest reel below for a video of these exercises.

Chronic Ankle Sprain

Chronic is long-term, this is for you all who over a long period of time have sprained your ankle multiple times. Once you have one ankle sprain, you are more likely than someone who has not had one, to have a second. I highly recommend incorporating specific exercises for ankle stability into your workout plan for the long term, especially pre- and in-season. For lifts, I will have clients barefoot to have to rely on their ankle stabilizers instead of the sneakers. Exercises will also depend on the demands of the sport or activities you perform.

Exercise Examples:

1. Single leg ankle stability–> SL RDL variations, advanced balance exercises
2. Strength: Medial/lateral ankle isometrics with other exercises, calf raises, step downs, split squat variations
3. Sport-specific: hopping variations, cutting variations depending on the

Want to return to the activities you love? Schedule an initial evaluation to manage your acute or chronic ankle sprains today by emailing archphysicaltherapyandfitness@gmail.com or text/calling 617-340-9114.