Ankle sprain strengthening exercises are an often-overlooked part of recovery, but are crucial to proper rehabilitation. We have all been there… stepped down from a curb wrong, came down from a rebound on someone’s foot, or stepped in an unsuspecting pothole! Most people understand the basics for recovering from an ankle sprain including R.I.C.E. (rest ice compression elevation) method; however, not many people understand the potential ramifications or compensations that may occur up the chain or down the road if not rehabilitated properly by utilizing ankle sprain strengthening exercises.
The first step should always be to get your injury assessed to understand the severity. There are multiple grades of sprains.
Grade 1: A low grade ligament stretch/tear with mild swelling and bruising
Grade 2: An incomplete ligament tear moderate swelling and bruising
Grade 3: A complete ligament or multiple ligament tear with severe swelling, bruising, and instability
Some common assessments used at Stretch Affect include:
Ottawa ankle rules: accurate and rapid way to determine the need for radiographic images in acute ankle injuries. A person who presents with 0 of the symptoms is less than 1% likely to have a fracture.
There are 5 components to the test to determine if the sprain includes a potential fracture and whether or not imaging is recommended:
- tenderness/pain of lateral fibula
- lateral malleolus/medial malleolus or edge of tibia
- bony tenderness of the 5th metatarsal
- tenderness of the navicular
- inability to take 4 steps following injury
Anterior drawer test: determines whether ankle mechanical instability or hypermobility in the sagittal plane of the talocrural joint (or upper ankle joint) is present.
Talar tilt test: examines the ankle for injury of the Anterior Talofibular ligament and the Calcaneofibular ligament.
Eversion stress test: evaluates the integrity of the deltoid ligament and aids in determining the degree of instability after a medial ankle sprain.
figure eight girth measurement swelling assessment to evaluate ankle size and ankle joint swelling (edema).
Prior to starting any ankle sprain strengthening exercises the first step is to reduce inflammation, this is where R.I.C.E. (rest ice compression elevation) comes in for the first week or two. While the inflammation is going down gentle mobility can also be started.
Here is the Stretch Affect recommended progression of ankle sprain strengthening exercises. You will notice many of the steps are tied to our Movement Health philosophy that is the foundation of our work.
Alternatives to traditional ice and ace bandages (also offered in the Stretch Affect recovery suite)
Normatec: a type of recovery that uses a series of pulsed air compressions delivered through a device that encompasses the troubled area. This reduces inflammation and swelling, increases circulation, and improves mobility.
Kinesio tape: a therapeutic tape that’s applied strategically to the body to provide support, lessen pain, reduce swelling, and improve performance. The tape is a blend of cotton and nylon and mimics your skin’s elasticity so you can use your full range of motion. Kinesio tape can also be used to reduce lymphatic drainage to heal faster. The theory is that when kinesiology tape is applied, it creates extra subcutaneous space, which changes the pressure gradient in the area underneath your skin. That change in pressure enhances the flow of lymphatic fluid.
Cold plunge: Cold therapy is the use of low, sometimes freezing, temperatures to relieve pain and promote recovery. Cold therapy can reduce inflammation and speed up healing.
The next step for ankle sprain strengthening exercises is to get the ankle moving with minimal pain.
Ankle CARs (controlled articular rotations) are great for this!
Voodoo floss can also be added to help with tissue glide and compression with movement.
The following videos show how to correctly do these.
Stability is a big step that gets missed. Once people regain ankle strength, they think they are better and go back to daily activities. BUT this often leads to more chronic injuries… so do not skip this step!
This step includes connecting the ankle back into your system—while trying to recover, your ankle has been “detached” from your normal daily activities, you have avoided putting any stress or pressure on it, and you need to get your ankle used to doing some work again.
But you should be strategic about getting back to your activities.
Some ways to do this include tandem to single leg strengthening. This starts with tandem balance progressing to single leg, once you can hold a position for 30 seconds without pain or falling you can add variation to challenge the joint.
Another variation we love here is balancing on the Vibeplate. Vibrations generated by the machine are transferred to you, and your body naturally reacts in order to keep you stable.
Typically when we think of endurance we think of measuring your body’s cardiovascular or muscular endurance. While this is true, when it comes to recovering from an injury we consider endurance to be the volume of training you can complete, without pain, which improves your tissue tolerance to stress. You can start building up your endurance when you are out of pain and have consistently been implementing mobility and stability exercises.
Once you have improved to full pain free mobility and your swelling is minimal, it’s time to start strengthening! We view strength as the applied combination of mobility, strength, and motor control. It is a measure of how much force we can overcome in different positions and different ranges of joint motion.
This stage is where the tissue really gets challenged. Power is an expression of our strength with speed added. For ankle sprain strengthening exercises this is where plyometrics come in. Some options are plyometric box drops, plyometric jumps with TRX, and ladder drills.
There are a lot variations that can challenge the ankle and ike the Bosu to challenge the ankle in all directions and the Blazepod to help reintegrate agility.
If you are struggling to recover from an ankle sprain, with proper ankle sprain strengthening exercises, Stretch Affect will be able to guide you back to full range of motion and performance.