Ankle sprains. All too common, all too recurrent. Whether this is your first ankle sprain or your fifth, we can help you out!
The most common type is a lateral ankle sprain (LAS.)
When someone says they “rolled” their ankle, a LAS is most often what they mean. Their foot moved inward, causing stress on the outside of their ankle.
The ankle has a number of ligaments that help with stability and proprioception (your ability to sense where your limb is in space.) On the lateral side of the ankle, you’ll find the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament. Of these, the most often injured is the anterior talofibular ligament.
So, what are the risk factors for a LAS?
- History of a previous ankle sprain
- No use of an external support (i.e. ankle brace)
- Not properly warming up with static stretching and dynamic movement before activity
- Inadequate dorsiflexion range of motion
- Not participating in a balance/proprioceptive prevention program when there is a history of a previous injury
- Decreased hip abduction and extension strength (glutes!)
- Female gender
- Poor performance on hop and balance tests
As you can see, a couple of these risk factors can’t be changed (female or previous ankle sprain), but a lot of them can be! After an ankle sprain, the goal is to get back to previous level of activity but ALSO to bulletproof your ankle so we decrease your risk of future sprains. For those who have had multiple ankle sprains, there is a separate category called “chronic ankle instability,” which is defined as: instability that limits participation in sport/activity for greater than 12 months. Let’s keep you from getting to that point, okay?
While recovery from a LAS can be relatively quick and straightforward for some, I always recommend getting evaluated by a physical therapist even if you’re nearing full function. Reason being, there may be some strength and range of motion components to tweak in order to help decrease the risk of future sprain.
But Kate! I’ve already had an ankle sprain, what do I do now?
Well, there is strong evidence that progressive weight bearing is beneficial. Meaning, you should walk on your ankle after a sprain (if able,) and progressively increase how much pressure you apply when walking.
You may need to take it easy for a few days but should begin walking as normal ASAP because movement and blood flow will be helpful for recovery. Additional solid evidence exists encouraging the use of an ankle brace both acutely as you recover from the sprain and as you get into the return to sport phase to prevent another sprain.
It’s common for an ankle to get “stiff” after a sprain from swelling and decreased use. It’s also common for ankles to stay “stiff” after an ankle sprain if mobility wasn’t addressed in the past. There’s great evidence for the use of joint mobilization (performed by a physical therapist) to assist in regaining “normal” mobility. Lastly, there’s robust evidence for exercise (yay!). “Exercise” includes range-of-motion exercises, stretching, and neuromuscular training (strength & stability.) Following an ankle sprain, we always dose out exercises for the ankle, hip, and knee. Strength in all of those regions will help you recover from both your current sprain and prevent future sprains.
Here are some of our favorite exercises following a LAS:
- Seated Banded Eversion
- Side Plank on Knee w/ Banded Clamshell
- Single Leg STS
- Single Leg Floor Tap on Unstable Surface
We’ve helped tons of athletes and active adults recover from a LAS, whether their goals are getting back to recreational running or high level soccer. The exercises included here are a good start, but ideally you get a personalized exercise program with adequate dosing for you. Reach out if we can help!
Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Sprains Revision. Journal of Orthopaedic & Sports Physical Therapy. 2021;51(4):1-80.