Ankle Sprain Exercises
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The aim of ankle rehabilitation exercises is to restore full pain free range of motion to the joint, strengthen the surrounding muscles, improve proprioception and prepare the athlete for normal training and competition.
The exercises below form part of an ankle rehabilitation program and consist of mobility exercises, strengthening exercises and functional exercises.
Following an ankle sprain the joint often becomes very stiff and the range of motion at the joint is reduced considerably.
Mobility exercises for the ankle can start very early in the rehabilitation process from day 2 in mild to moderate sprains.
Lateral movements should be avoided in the early stages so as not to put any stress at all on the injured ligaments. Later when pain allows exercises with lateral movements involving sideways motion can be done.
Wobble board mobility
In the early stages of rehabilitation, a wobble board can be used to increase the range of motion at the ankle. Sit on a chair with the feet resting on a wobble board or rocker board. Move the feet forwards and backwards to mobilize the ankle. Avoid sideways or lateral movements early on or if it is painful as this will stress the injured lateral ankle ligaments. Later in the rehabilitation phase as pain allows sideways movements and movements in a circular motion can be performed.
Play wobble board exercise video.
Active plantar flexion and dorsi flexion
This exercise can be done in the early stages and will help prevent the ankle from seizing up. Simply pull the foot up as far as it will go (dorsiflexion), hold for a couple of seconds and then point it away from you (plantarflexion) and hold again. A good method to start with is to perform 2 sets of 20 reps whilst the ankle is iced and elevated. The advantage of this exercise is that the damaged ligaments will not be stressed by sideways movement, the calf and shin muscles maintain strength and the pumping motion helps to decrease swelling.
Play active ankle mobility exercise video.
Active inversion and eversion
This exercise will mobilize the ankle 'sideways' and so starts to stress the damaged ligaments. It should only be started when pain allows and healing is established. Simply turn the feet so the soles point outwards and then inwards. The movement should be gradual and within the limits of pain. Circling the ankle will also move the joint into these positions.
Play active ankle mobility exercise video.
Place the leg to be stretched behind and lean forward, ensuring the heel is kept in contact with the floor at all times. Hold the stretch for 20 to 30 seconds and repeat 3 times. This can be repeated several times a day and should not be painful. A stretch should be felt at the back of the lower leg. If not then move the back leg further back. A more advanced version of a calf stretch is to use a step and drop the heel down off it.
Play calf stretching exercise video.
To stretch the soleus muscle the back leg should be bent. Place the leg to be stretched behind and lean against a wall keeping the heel down. A stretch should be felt lower down nearer the ankle at the back of the leg. If this stretch is not felt then a more advanced version is to place the forefoot of the front leg against the wall with the heel on the floor and push the from knee towards the wall.
Play soleus muscle stretching video.
Ankle strengthening exercises can begin as soon as pain allows. In the early stages of strengthening any exercises which involve sideways movements at the ankle you should avoided.
Resisted plantar flexion
Loop a resistance band around the forefoot and hold onto the ends. Point the foot away slowly allowing it to return to a resting position. Aim for 10-20 reps and 3 sets with a short rest in between. Once this exercise feels easy, you can increase the strength of the resistance band or progress on to full calf raise exercises. This exercise can be repeated with a bent knee to target the soleus muscle lower down the calf area.
Play resistance band plantar flexion video.
Using a rehabilitation band pull the foot and toes up against resistance and then down again. Aim for 10 to 20 repetitions and 3 sets with a short rest in between. This is an important strengthening exercise, however it is important not to over do this one. Remember you will still have to walk on the ankle after the strengthen session so do not take the ankle to fatigue. Over time this may also lead to pain in the front of the shin - less is probably more with this exercise.
Play resistance band dorsi flexion exercise video.
Isometric eversion and inversion
Once you can do so pain free, try exercises involving eversion and inversion to help strengthen the muscles which help to control the 'rolling' action at the ankle. Isometric means there is no movement at the joint throughout the exercise. A partner or therapist can provide resistance with the hands, or use a wall or chair leg.
For eversion the athlete should try turning the ankle out against resistance. For inversion, inwards against resistance. Hold for 5 seconds, rest for 3 seconds and repeat initially 3 times and gradually increase up to 10 times. As strength improves, this can be extended using a partner or therapist into a more dynamic action of the therapist moving their hands against the ankle which much react to prevent it moving.
Play isometric ankle exercises video.
Resisted eccentric inversion
This exercise is particularly important in helping to prevent injury recurring. The athlete attempts to resist the therapist everting or turning the foot outwards. It strengthens the muscles which stabilize the ankle just at the point where it would roll over or sprain. A therapist or partner is needed for this exercise to be done effectively. They should not apply too much resistance initially but gradually build up.
Play resisted eccentric inversion video.
This exercise will strengthen the calf muscles which consist of the gastrocnemius and soleus muscles. Rise up and down on the toes in a smooth movement. You should be able to progress quite quickly with this one but aim for 3 sets of 10 and build up steadily, a few each day.
Once you find this quite easy, start performing the exercise on one leg only. This will feel a lot harder, so start with low reps again and gradually increase. You can also perform these on a step as shown in the video, allowing the heel to drop down past the level of the step.
Play calf raise exercise video.
Functional exercises start to load the ankle in a more sports specific way with more explosive type movements, direction changes and lateral or sideways movements.
- Although mainly a knee exercise, lunges can be used to improve the balance and strength at the ankle joint.
- Stand with the injured foot in front of the other, toes facing forwards.
- Bend the back knee down towards the floor, keeping the back upright.
- Stop just before the knee touches the ground and push yourself back up again.
- Start with a low number of reps, such as 2 sets of 10 and gradually increase.
- This exercise can be made more difficult by performing walking lunges where you move forwards from one lunge to the next.
Play lunge exercise video.
Walking calf raise
- The walking calf raise will strengthen both the calf muscles and improve balance at the ankle.
- Put one foot in front and raise up on to the tip toes.
- Swing the back leg forwards and raise up on to the toes again.
- Repeat this walking across the room.
Play walking calf raise video.
Start standing on a small step.
- Take one leg backwards, touch the foot on the floor and push off with the forefoot to move it back onto the step.
- Alternate legs.
- This can be increased indifficulty by performing on a higher step or at a faster speed.
Play step back exercise video.
- Many variations on hopping exercises are available. Start with a small hop on the spot and gradually increase the height jumped.
- Try hopping to the front, to the side and backwards.
- Try hopping from one leg and landing on the other.
- Equipment such as hoops, agility ladders and minim hurdles can all be used to add further challenge.
Play hopping drills video.
Resistance band jump
- A resistance band is wrapped around the waist and anchored or held behind the athlete.
- They then perform side to side or forwards and backward jumps.
- The resistance from the band provides a challenge to the balance.
- The exercise can be made more difficult by increasing the thickness of the band, or aiming to hop or jump further.
- Numerous exercises can be created using a box or step to jump over.
- To start the athlete may jump sideways over the box, moving rapidly from one foot on one side, to the other foot on the other side. This may also be performed front to back.
- A further progression is high jumps over the box, firstly landing on two feet and progressing to one.
Play box jumps video.
Sports specific drills
- Practice drills that are used in training for your particular sport.
- Start off doing them slowly and under control.
- Gradually pick up the pace and competition level until you're back to full training mode.