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Physical Therapy for Sprained Ankle: Guide and Exercises


Physical Therapy for Sprained Ankle

An ankle sprain can occur in multiple different situations, from playing sports to losing balance and falling down to stepping in a hole on the street.


Everyone has had at least a scare when the foot suddenly changes direction, twists, and turns close to beyond the normal range of motion. If the foot surpasses it, the ankle ligaments tear or overstretch, resulting in an ankle sprain.


An ankle sprain is a common injury, and no one is protected from it. It's prevalent both among professional athletes and everyone else.


Physical therapy for a sprained ankle is one of the best ways to reduce pain, bring back a normal range of motion, strength, and balance, and recover.


This treatment includes various modalities, such as hands-on therapy, exercises, and patient education.

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What Is an Ankle Sprain?

What Is an Ankle Sprain

Ligaments are fibrous tissues that connect bones with each other. Ankle ligaments keep the ankle bones in the proper position and stabilize the ankle joint.


While very strong, these ligaments can still get strained from minor to complete tears.


An ankle sprain can occur at any age, from children to adults. Most commonly, it happens on the later ligaments on the outer side of the ankle, though the inner ones can be affected too.


An ankle sprain when the foot turns inward is called an inversion injury, and when it turns outward is called an eversion injury.


Often the strains are categorized from grade 1 to 3, one being a mild injury and overstretching, two a moderate injury with a potential partial tear, and three a severe injury with a complete tear.


Depending on the case, the recovery can take a few weeks to a year.


Physical therapy for a sprained ankle is essential for recovery and to prevent a recurring injury which is more likely if the patient has not regained strength and balance.


What are the Signs and Symptoms of Sprained Ankle

What are the Signs and Symptoms of Sprained Ankle

Besides immediate pain, there are a few other signs and symptoms to recognize a sprained ankle.


The person may also experience the following:

  • Swelling

  • Throbbing

  • Bruising & tenderness

  • Instability in the ankle

  • Stiffness

  • Weakness


If the injury is severe, it's possible to hear a popping sound or feel such sensation. The person is also unable to stand or walk on the injured ankle.


However, in any case, it's essential to see a doctor and not take the home-treatment approach to avoid improper healing. It's also possible to miss additional injuries, which increases the risk of complications.


The doctor will also prescribe physical therapy for a sprained ankle.


Diagnosis of Sprained Ankle

Diagnosis of Sprained Ankle

Once you visit a doctor, they will immediately examine your ankle by gently pressing and assessing the pain level. They will also test to see if other parts of the foot or leg are injured.


Such testing may include an X-ray or MRI to rule out additional damage and confirm the diagnosis.


Prepare for answering such questions as what were you doing and how were you injured, did you hear any popping, what's your pain level, and others.


These questions will help a physical therapist prepare the plan for the sprained ankle physical therapy.


How Can a Physical Therapist Help?

How Can a Physical Therapist Help

Physical therapy for a sprained ankle is one of the most important parts of the recovery.


It is established that it speeds up healing and helps regain range of motion, strength, balance, and coordination.


A custom physical therapy program also helps reduce and manage pain and get back to living regular life as soon as possible.


Together with the physical therapist, you will discuss the goals and needs and will be able to build a recovery plan together.


Your treatment program will help you reach your goals safely, fastest, and most effectively.


Sprained ankle physical therapy can help to:

  • Reduce pain and swelling. Using modalities such as massage, ice and heat, electrical stimulation, behavior modification, and others, the physical therapist will help manage pain and reduce swelling.

  • Improve flexibility and motion. Your physical therapist will first use passive movement to move the foot and the ankle, stretch out muscles, and then prescribe physical therapy exercises for ankle sprain at home to increase flexibility. This will help return normal ankle movement.

  • Improve strength, endurance, and balance. Physical therapy for ankle also includes exercises to improve muscle strange. Many sprains occur due to weak muscles, and strengthening them contributes to restoring strength safely and gently. Different exercises will improve balance, and working out with cardio equipment will help increase your endurance.

  • Return to regular activities safely. As the recovery period can take up to a year, it is vital to adapt and learn new techniques for performing everyday activities, so you can return to regular life as soon as possible. The physical therapist will teach you such modifications.

  • Speed up the recovery. Following your prescribed exercise program will help you return to your normal lifestyle and reach your goals faster than you are likely to do on your own.


Can This Injury or Condition Be Prevented?


While nothing is guaranteed, there are ways to reduce the risk of spraining an ankle. Physical therapy exercises for a sprained ankle are essential to prevent a recurring sprain.


Your physical therapist will teach you how to prevent reinjury, as the ankle is more prone to it after being sprained.


It's important to remember that healing properly with physical therapy may reduce such risk immensely.


Other things you can do to prevent a sprained ankle:

  • Being careful and paying attention when walking or running on uneven surfaces and areas with bumps, holes, or, e.g., tree roots.

  • Wearing comfortable shoes suitable for different activities, especially sports, and exercise.

  • Avoiding high heels and using ankle wraps or braces if needed.

  • Always warming up before exercising and not returning to sports too soon after an injury.

  • Maintaining good physical shape, strength, flexibility, and healthy body weight.


What Kind of Physical Therapist Do I Need?


Many people with ankle sprains are often unsure how to find the best physical therapist (PT) for their injury.


While all PTs are trained to treat various injuries, many often specialize in specific injuries.


Firstly, we recommend finding a licensed therapist with an orthopedic focus and enough experience treating musculoskeletal injuries.


You may also consider a board-certified clinical specialist in sports therapy, as they will have extensive knowledge about ankle sprains.


You can ask people for recommendations or use American Physical Therapy Association to find various options.


Before starting work, don't be afraid to ask about their experience with treating ankle sprains and anything else you find important.


How to Do Rehabilitation Exercises for an Ankle Sprain

How to Do Rehabilitation Exercises for an Ankle Sprain

Just like with any other rehabilitation exercises, a professional PT must prepare a program of physical therapy exercises for ankle sprain.


You will start with gentle exercises and move towards more intense ones as you recover.


And while being gentle and conscious of your pain level is important, starting as soon as possible is best. Many patients avoid physical therapy exercises for sprained ankle because they feel sore or stiff, but being active will speed up healing.


It will also help manage the symptoms and strengthen the body to avoid further injury.


Your PT will include four types of exercises in your routine: range of motion, stretching, strength, and balance and coordination.


Make sure you follow their advice and be diligent.


Range-of-Motion Exercises


Range-of-motion exercises are usually the first ones the patient is recommended to do. They help prevent stiffness and slowly return the range of motion to the ankle.


These exercises are simple and gentle, so you can do them pretty much any time - watching TV, working at a desk, or doing any other seated activity.


Here are a few physical therapy exercises for a sprained ankle to increase the range of motion:

  • Circles. While seated, do 5-15 circles with your ankle in one direction and then the other. Repeat a few times a day.

  • Extension. Point your toes away by extending the foot and hold the position for 10-20 seconds; repeat 10-15 times, and keep doing the extensions throughout the day (at least twice at the beginning).

  • Alphabet drawing. This one's fun! Move your foot from the ankle and draw uppercase and lowercase alphabet letters in the air. Do this 2-4 times a day.

  • Flexing. Flex and point your foot towards yourself and hold for 10-15 seconds. Repeat 10-15 times twice a day.


Stretching Exercises


Stretching physical therapy exercises for sprained ankle are as important as range of motion exercises. They focus on the Achilles tendon, which connects the calf muscles to the bone at the base of the heel.


These exercises are recommended as soon as you can do them without feeling too much pain.


Stretching exercises to include in your recovery routine:

  • Seated stretch. Sit with both legs stretched out and wrap a strap or a towel around the ball of the injured foot. Start pulling gently until you feel a calf stretch. Hold for 15-30 seconds and repeat 10-15 times. Repeat a few times a day.

  • Standing stretch. When you reach the point of recovery where you can stand on the sprained ankle, start doing standing stretches. Face the wall and hold your hands against the wall. Step back with the injured foot, bend the front knee, and push the hips back slowly while keeping both feet flat. Feel the stretch and hold for 15-30 seconds. Repeat 10-15 times a few times a day.


Strengthening Exercises


Strengthening exercises are usually recommended once the patient can stand on the foot without pain or swelling.


Discussing this with your physical therapist is important, so you don't start them too soon, yet don't wait too long, as strengthening the muscles is essential to reduce the risk of further injury.


Here are a few commonly recommended strengthening exercises for a sprained ankle.

  • Flexing #1. Put a resistance band on the front of your foot and hold the other side with your hands. Slowly and gently push the ankle and foot down and then release. Repeat 10-15 times and do this 2-3 times daily.

  • Flexing #2. Tie the resistance band around a sturdy, fixed object that doesn't move (e.g., a chair wouldn't work) and warp the other end around the front of your foot. Hold your foot with your toes pointing down and slowly pull up the ankle as much as possible. Release and repeat 10-15 times. Do this exercise a few times during the day.

  • Stretching #1. Use the same object to tie the band and then place the other side on the inner side of your ankle. Move the ankle inwards slowly, release, and repeat 10-15 times.

  • Stretching #2. Prepare the same as for the previous exercise; only place the other side of the band on the outer side of the foot. From a relaxed position, gently move the foot outward, release, and repeat 10-15 times.


Balance and Control Exercises


Lastly, your recovery exercise routine should include balance and control exercises. Your physical therapist will recommend starting them only when you can stand without pain.


It's also important to consider whether you could do these exercises before your injury. If not, there may be other issues (e.g., vertigo), and doing these movements may increase the risk of falling and reinjuring yourself.


Balance and control exercises for your recovery routine:

  • Heel and tippy-toe walks. Walk on your heels and then your tippy toes forward and backward as far as possible.

  • Leg balance. Stand and find your balance on the injured foot for around 30 seconds and increase the time daily. Stand next to a wall or a table in case you need support.


Final Thoughts


An ankle sprain is a common injury among all ages and genders. It can occur during sports, exercise, or everyday activities such as walking on uneven surfaces.


The most common ankle sprains occur on the outer side of the ankle when the foot suddenly turns inward (e.g., during a fall or when stepping into a hole).


In such a situation, the ankle ligaments that keep the ankle bones in position and stabilize the ankle joint get torn. Such tears range from minor to severe.


Physical therapy for sprained ankles helps speed up recovery and helps manage pain, regain range of motion, strength, balance, and return to everyday life.

A custom physical therapy program, like the one that Miracle Rehab Clinic offers, uses various modalities, including ice, heat, electrostimulation, and exercises, to achieve these goals safely and as fast as possible. Contact us to book your appointment.



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