facebookpixel
Browsing Category

Ankle

Ankle, Health

The Ultimate Sprained Ankle Rehab: Heal Fast and Strong

• By

Treating a sprained ankle the RIGHT way early on, means a stronger ankle, faster recovery and less chance of re-injury. In this series, I will tell you what a sprained ankle involves, the most effective self-treatment and the best rehab exercises to get you back out there!

This post will take you through early, middle and late stage rehab exercises as well as self treatment advice for a lateral ankle sprain so that you can get on with life. Alternatively, you can skip the hassle and get all the extras in one document by downloading our comprehensive Sprained Ankle Recovery Guide


Stage 1: Acute Ankle Sprain, the First 72 Hours

First of all, a little information about what a sprained ankle involves, but if you are in the know about Sprains already, skip the info and scroll down to Self-Treatment.

Sprained ankles are known by a few different names:

  • Twisted ankle
  • Rolled ankle
  • Lateral ankle sprain
  • Inversion ankle sprain
  • Torn lateral ankle ligament

The most common type of sprained ankle is the lateral ankle sprain (85%), and that is what we are going to discuss and sort out today. The other 15% is made up of high ankle sprains and medial ankle sprains and the advice below is quite effective for those injuries also.

As with everything on this website, the rehab regimen does not claim to replace or be better than the best practice of going and seeing a doctor or physical therapist.

Mechanism of injury:

The plain and simple is that a sprained ankle is typically when your foot is forced inwards (inversion) and down at the same time.

This often happens when changing direction, turning and/or on uneven surfaces). This puts the ligaments under too much stress too fast which causes a tear of one or more of your ankle ligaments.

sprained ankle - lateral ligaments

Quick anatomy:

The lateral (outer) ankle has 3 ligaments supporting, with the weakest of these (and so most often injured) being the Anterior Talofibular Ligament (ATFL).

The ATFL is the Ligament at the front of the ankle shown here and in most simple sprains, this is the one torn with or without the ligament below it.

Sprained ankle recovery time:

The general recovery time is 2-6 weeks (if looked after properly). Keep in mind, even if it feels bad now if you do all the right things you will be one of the 95% who returns to sport and activity within 6 weeks.

Not taking ankle rehab seriously often leads to far too many chronic ankles, long-term disability and other injuries so YOU NEED TO TAKE THIS SERIOUSLY!

Note: it is important to rule out fractures early on. An accurate way of doing this is using the Ottawa ankle rules, or going to see your local Physio for a quick assessment – These rules are great for minimizing unnecessary X-rays. If clear of fracture, conservative rehab is typically the way to go – surgery is rarely needed or the first port of call (1).

YouTube player

Sprained Ankle Self-Treatment

Initial management: In the first 72 hours it is very important to follow the RICE and HARM principles – This will take weeks off your recovery.

Summary:

  • Do POLICE
  • Don’t HARM
  • Protect
  • Keep Moving
  • Foot Paddling
  • Footwear

1. Do: POLICE

This has changed from the previous RICE recommendation, see more on this HERE.

POLICE acute ankle sprain treatment heal fast

Note: Don’t wear compression at night time

2. Don’t: HARM

  • Heat
  • Alcohol
  • Running
  • Massage

HARM increases blood flow to the area, worsening inflammation and so causing more secondary damage and a longer healing time.

3. Protect:

Braces have been proven to reduce re-injury rate and improve recovery so check out your options here. Using a functional ankle brace at all times during the day is now a go-to treatment for sprained ankles for the first 6 weeks and then up to a year after injury as needed.

You can see an update on the Clinical Best Practice Guidelines from the British Journal of Sports Medicine HERE if you want more detail on that. Basically, Lace-up ankle braces are a brilliant way to protect the ligaments and reduce re-injury rate and preferred over moon boots or nothing.

4. Keep moving (within reason of course)

It is important not to baby sprained ankles and start weight-bearing through them as soon as possible. This helps to normalize movement and decrease the loss of muscle activity.

If necessary you may need to be on crutches for the first 24-72 hours then move to partial weight-bearing and then full weight-bearing.

5. Foot paddling

This is a great exercise to do in these early days – In sitting or lying, simply point your toes up then down repeatedly in a pain-free range.

You can try doing small circles with your foot also, remember not to push into pain. Do this every 1-2 hours (little and often)

6. Footwear:

Wearing good supportive footwear with heel and arch support(such as your runners) is great as this takes the pressure off the injured ligaments and lets them heal well.

DO NOT WEAR HIGH HEELS (Please!).

Now that you have taken care of your sprained ankle in the first 48-72 hours by doing everything mentioned above. Let’s start on the next stage below.

You can download our comprehensive Sprained Ankle Recovery Guide, with all of this great information.


Stage 2: Early Rehab and Sprained Ankle Treatment

sprain strain self treatment ice rest compress

How to get a sprained ankle stronger, recover quicker and get back out there faster and better than ever!

Note: You still use ice after the first few days whenever it is sore or swollen.

Following on from the stage 1 rehab (above) about what to do in the first 72 hours, here we will cover a comprehensive rehab regime that will help the majority of you recover from an ankle sprain in weeks, not months.

Your body adapts to the forces that go through it. Progressively load your ankle, it will adapt and be better for it!

Sprained ankle treatment needs to include:

  • Proprioception exercises
  • Range of motion exercises
  • Strengthening exercises

1. Proprioception Exercises: Retraining for a sprained ankle

Proprioception is the ability for you brain to know where you body is in space.

If this is decreased, you have poor balance and increased chance of re-injury. Sprained ankles are the worst injury in the body for impaired proprioception and needs to be addressed.

Note: If you aren’t sure what proprioception is – extend one arm out to the side, close your eyes and mirror it exactly with the other arm – you could do this with your eyes closed because of your proprioception.

sprained ankle rehab exercises

Single leg standing (SLS):

Begin by standing on one leg on a solid surface (you can put one finger on the wall for balance if you need to start with) and aim for 1 minute.

When you can do this comfortably for 60 seconds, step it up by performing SLS on a folded up towel.

A Folded towel is great to use as you can easy progress this by doubling it up again and again and then finally rolling it up to make it much harder.

Progressing each time when you can easily do it for 60 seconds.

NOTE: Have a bench in front or to the side to grab onto if need be – but only if you have to!

You can also use Wobble boards, Bosu balls and balance boards when towels become too easy (or boring!)

2. Range of motion Exercises

calf stretch , soleus, gastroc - self treatment for shin splints

Calf Stretch

The best way to do this is by dropping your heel of a step and holding for 1 minute as shown in the picture to the right. Make sure this stretch is within the pain-free range.

Lunge Stretches and accessory glides

See this video for great mobilization techniques. Remember not to push into too much pain!

3. Strengthening Exercises

Heel Raises

Begin using both feet and progress to one foot as pain and strength allows. Perform 30 with one finger against a wall for balance. Also known as Calf Raises.

Single leg Squat, hip stability and strength

Single Leg Squat/Pistol Squats

As soon as you can, begin doing these to maintain and increase the strength in your entire lower limb! do 2 x 12 on each side and begin by only bending a small distance – Give it a go!

Ankle Eversion Training

See this video on how to do this important exercise with a Theraband or similar elastic band.

Stick to this Rehab program for the full 6 weeks for best results and make sure to keep challenging and progressing yourself!


Stage 3: End Stage rehab – “Bulletproofing” after an Ankle Sprain

Research-based and very easy, with great results

You can also head over to our rehab guides page to get all three levels and much, much more in an eBook!

Anmle excursion exercise, balance rehab

These are the rehab exercises that you need to get your ankle 100% and to minimize chance of re-injury which is far too common.

This ankle sprain rehab is aimed at improving range, balance and strength with simple, effective home exercises.

Too many people simply sprain re-injure their ankle is the full rehab isn’t followed through with and actually 33% still have pain remaining after one year!.

On top of this, a history of ankle sprain ( you have injured it before) is the single most predisposing factor for ankle injury.(2,4)

Our bodies are great at healing by themselves but if you don’t push your ankle to regain strength and range – you leave yourself at high risk of re-injury

This means after you have an ankle sprain it is very important to rehab it right as you have a high chance of ongoing symptoms and re-injury. Remember, the research shows that the majority of grades I, II and III lateral ankle ligament ruptures can be managed without surgery – so get started as soon as possible for best results.(3)

First, Some Quick Tests:

Here is a great little test to see if your ankle range is back to it’s best. The other easy test to see if you need to do the level three exercises is to balance on the balls of your foot, one leg at a time – you should be able to do this for at least 30 seconds and you should be even between legs.

Stage 3 ankle sprain rehab has 3 main goals:

  • Achieve full range of motion
  • Have good ankle  and leg control through this range
  • Full strength of the ankle stabilizers

To get there, here are the exercises that you need to do:

Toe balance

ankle sprain balance exercise

This is a great balance exercise to strengthen your ankle in this vulnerable position and better yet, it is simple and you can do it anywhere.

Stand on the ball of your foot. You will most likely need to start with one finger on the wall for balance.

Goal: 1 minute each side

Make it harder: Do some one leg standing and toe balance on one of my favorite rehab equipment: a BOSU Ball

X excursion exercise – Balance re-training

This exercise has come about from a well-used test within the health industry – the Star Excursion Balance Test. The great thing about the tests we use as physiotherapists is that they really do challenge you, which make them great as exercises also as if your body is challenged, it is going to adapt to improve.

YouTube player

Ankle stretch

Ankle stretch exercise

Along with the classic calf stretch, this one is great for getting full range in your ankle and making sure you are even. This only needs to be done if you can’t point your foot down evenly after 6 weeks – you don’t need to do it earlier.

Hold for one minute.

Ankle self-mobilization

YouTube player


In Conclusion

Putting in the time to rehab your ankle fully is so important, not only will it decrease or get rid of any pain but it will improve your mobility and performance. Even just working on retraining your balance decreases your chance of re-injury by 22-33% – nothing to scoff at right!(5)

So write the exercises down, favorite this post and make it a routine.

Return to Sport:

As a simple rule, once both sides are even, you can get back to training and playing. So to test yourself out, see how far you can single leg jump and make sure both legs are within 5cm of each other and then do the X-excursion exercise as above and again, make sure both sides are within 5cm of each other. If they aren’t even, keep working at it.

Also if you are returning to sports such as basketball or volleyball etc that require a lot of jumping, twisting and hopping, or if you have sprained your ankle more than once, it is definitely worth your while looking into getting a good lace-up Ankle Brace.

Yours in health,

Shaun


Ankle, foot pain, Health, Lower limb

Sprained Ankle – Heal Fast and Strong with Self Treatment

• By

Treating a sprained ankle the RIGHT way early on means a stronger ankle, faster recovery and less chance of re-injury. In this series, I will tell you what a sprained ankle involves, the most effective self-treatment and the best rehab exercises to get you back out there!

This post is Level 1 but when you need to step it up after the first 48-72 hours, switch over to the Level 2 and Level 3 rehab exercises. Alternatively, you can skip the hassle and download our comprehensive Sprained Ankle Recovery Guide

First of all, a little information about what a sprained ankle involves, but if you are in the know about Sprains already, skip the info and scroll down to Self – Treatment

Sprained ankles are known by a few different names:

  • Twisted ankle
  • Rolled ankle
  • Lateral ankle sprain
  • Inversion ankle sprain
  • And of course “Oh no!”

The most common type of sprained ankle is the lateral ankle sprain (85%), and that is what we are going to discuss and sort out today.

Mechanism of injury: The plain and simple is that a sprained ankle is typically when your foot is forced inwards (inversion) and down at the same time. This often happens when changing direction, turning and/or on uneven surfaces). This puts the ligaments under too much stress too fast which causes a tear of one or more of your ankle ligaments.

sprained ankle - lateral ligaments

 

Quick anatomy: The lateral (outer) ankle has 3 ligaments supporting, with the weakest of these (and so most often injured) being the ATFL. The ATFL is the Ligament at the front of the ankle shown here and in most simple sprains, this is the one torn with or without the ligament below it.

 

Sprained ankle recovery time: The general recovery time is 2-6 weeks (if looked after properly). Keep in mind, even if it feels bad now if you do all the right things you will be one of the 95% who returns to sport and activity within 6 weeks.

 

Not taking ankle rehab seriously often leads to far too many chronic ankles, long-term disability and other injuries so YOU NEED TO TAKE THIS SERIOUSLY!

Note: it is important to rule out fractures early on. An accurate way of doing this is using the Ottawa ankle rules, or going to see your local Physio for a quick assessment – These rules are great for minimizing unnecessary X-rays.

 

Sprained Ankle Self – treatment

Initial management: In the first 72 hours it is very important to follow the RICE and HARM principles – This

will take weeks off your recovery.

Do: POLICE

This has changed from the previous RICE recommendation, see more on this HERE.

POLICE acute ankle sprain treatment heal fast

Note: Don’t wear compression at night time

Don’t: HARM

  • Heat
  • Alcohol
  • Running
  • Massage

HARM increases blood flow to the area, worsening inflammation and so causing more secondary damage and a longer healing time.

Protect: Braces have been proven to reduce re-injury rate and improve recovery so check out your options here

Keep moving (within reason of course) – It is important not to baby sprained ankles and start weight-bearing through them as soon as possible. This helps to normalize movement and decrease the loss of muscle activity. If necessary you may need to be on crutches for the first 24-72 hours then move to partial weight-bearing and then full weight-bearing.

Foot paddling is a great exercise to do in these early days – In sitting or lying, simply point your toes up then down repeatedly in a pain-free range. You can try doing small circles with your foot also, remember not to push into pain. Do this every 1-2 hours (little and often)

Footwear: Wearing good supportive footwear with heel and arch support(such as your runners) is great as this takes the pressure off the injured ligaments and lets them heal well. DO NOT WEAR HIGH HEELS (Please!).

AND THEN: After the first 48-72 hours of doing this, click over to the next stage of rehab exercises to get started rehabilitating your sprained ankle or skip the hassle and download our comprehensive Sprained Ankle Recovery Guide.

 

And remember you still use ice after the first few days whenever it is sore or swollen.

 


Ankle

The Top Sprained Ankle Treatment | Infographic

• By

Because sprained ankles are so common, every second person you talk to will have a different opinion on what is best and what you should do. So, to help you out we looked at the best research and summarized what is REALLY the best sprained ankle treatment so that there is no room for confusion.

Here is our infographic summary:

Ankle sprain treatment

Explanation:

As you can see, almost all research papers that this systematic review looked at, agreed that physical therapy (physiotherapy) should be trialled before surgery. This is relevant for grade 1, 2 and 3 sprained ankles – so even the high-grade tears. Of course, every injury is different so there is always the exception to this but your physio can guide you better with that after a thorough assessment.

What we found interesting was that ankle braces are now being recommended for at least one-year post injury. They have also been shown over this time to effectively lower re-injury rates and should be a g-to sprained ankle treatment. It is also worth noting that certain treatments that are used very commonly such as ultrasound and manual therapy show little benefit – this isn’t to say that they offer no benefit, they just haven’t been proven to give statistically significant improvements – for some people that can really help and we find manual therapy is very effective for the sprains and fractures (when out of cast) that are particularly stiff.

You can check out one of our most popular posts on ankle rehab HERE. It details some great basic rehab exercises to help guide your ankle back to it’s best as this is far more beneficial than just resting the ankle. Resting won’t get your strength back, it won’t get movement back as effectively and can just lead to more dysfunction.

OR check out our new, full and comprehensive Ankle Rehab Guide – it is downloadable, simple and step by step, not to mention being research-based which means it is proven.

Takeaway point: Active rehab is the key to successful sprained ankle treatment.


Ankle

Do Ankle Braces Prevent a Sprained Ankle? | Research Round-up

• By

Given the high frequency of ankle sprains in everyday life and dynamic sports such as basketball and volleyball, we decided to feature some summaries of research papers that show just how effective different sprained ankle treatments are.

Today we have a great infographic summarizing a systematic review (the highest level of evidence)  that helps answer the question of how to how well do ankle braces really help prevent a sprained ankle:

ankle brace for sprained ankle running

This study effectively shows that ankle braces – lace-up braces specifically – are incredibly effective in reducing the number of sprains that occur in basketball and this can be translated quite well to assume that it has similar effectiveness to prevent a sprained ankle in other sports as well.

If you need an example of a good lace-up ankle brace, here is a good example on Amazon of the DonJoy Ankle Brace and if you want to make sure you rehab your ankle well, which reduces re-injury by 50%, follow our Sprained Ankle Rehab Guide


Ankle, Health

Ankle pain, The Best 3 Support Braces

• By

Our ankles get little reprieve and time to rest so when we get ankle pain we need a way of looking after them while keeping going. We have outlined the best supports and given a guide so that you can find the perfect support for your ankle pain.

Recent research has proven beyond a doubt what the best thing is for ankle pain and it isn’t what everyone would think. In the past, the need for rehab and strengthening ankles up has been pushed as the most important. But actually, what has been shown to be even more effective in recent research, is wearing an ankle brace.(1

Here is a quick summary of the study from YLM Sports Science

Ankle pain support

Why do braces work so well for ankle pain?

They support you, allowing you to keep moving. That is the key.

Often when we have ankle pain, we aren’t as active, we start walking differently and avoid certain activities. But, with the right support, we avoid the muscle dysfunction and stiffness that comes from this. That is why ankle braces and the most popular item in most physical therapy clinics and that is why you have nothing to lose and everything to gain in getting one for yourself.

We have put together a guide for you below of the different types of ankle support to help you decide on what is best for you:

TypeLevel of supportUsed forLink to example product
Compression sleeveMild support- Ankle pain
- Compression in early stage rehab
- Reduction of swelling
- Mild ankle sprains
- mild instability
Support with strapsModerate support- Ankle pain
- Maintaining warmth
- Moderate support
- Mild instability
- Mild and moderate ankle sprains
Lace-up ankle braceComprehensive ankle support- Moderate and severe (grad 2 and 3) ankle sprains
- Moderate to severe ankle instability
- Dynamic sports

For those of you that don’t have a lot of room in your footwear, there are types of low-cut and low profile ankle braces like THIS Mueller brace that are also a great option.

Further information on ankle pain

For those of you that are information orientated, we have decided to go more in-depth into the many causes of ankle pain, why it can hang around and the many more things that you can do to help it as the more we can do to get rid of ankle pain faster, the better right?

Causes of ankle pain:

  • Tendinopathies: Overload injuries to the tendons around your ankle is common, including peroneal tendons, Achilles tendinopathy and more. Note tendonitis is a common term that is still used a lot but research over the last 10 years has shown that the majority of tendon overuse injuries are not inflammatory after the first 1-2 weeks.
  • Broken ankle: Following ankle fractures and subsequent casting you can be left with stiffness and pain for up to a year. An ankle support can really help with this as well as stretching if you don’t have the full range. You can test your range with an easy test in our past blog post here
  • Arthritis: The top two braces above can help a lot with this as they maintain warmth of the joint
  • Plantar fasciitis

The majority of ankle pain can be helped with decreasing the aggravating activity, supporting the area well and strengthening the ankle back again and there are a lot of great exercises in our past blog posts like THIS one that is great for not just ankle sprains but all sorts of issues down below!

Information on ankle sprains

The most common type of sprained ankle is the lateral ankle sprain (85%), and that is what we are going to discuss and sort out today.

Mechanism of injury: The plain and simple is that a sprained ankle is typically when your foot is forced inward (inversion) and down at the same time (often when changing direction, turning and/or on uneven surfaces). This puts the ligaments under too much stress too fast which causes a tear of one or more of your ankle ligaments.

sprained ankle - lateral ligamentsQuick anatomy: The lateral (outer) ankle has 3 ligaments supporting, with the weakest of these (and so most often injured) being the ATFL. The ATFL is the Ligament at the front of the ankle shown here and in most simple sprains, this is the one torn with or without the ligament below it.

Sprained ankle recovery time: The general recovery time is 2-6 weeks (if looked after properly) and keep in mind, even if it feels bad now if you do all the right things you will be one of the 95% who returns to sport and activity within 6 weeks.


Ankle, Health

Quick Ankle Range Test – Must Know for any Athlete

• By

how to improve ankle flexibilityThere are very few tests which are proven predictors of injury AND are accurate on anyone. Whether you’re an amateur, weekend warrior or a pro, good ankle range is a must for many basic movement patterns – this post will benefit you all.

 

If you want to go straight to the ankle range test – skip down the page to The Test.

 

Limited ankle range – namely ankle dorsiflexion, which is where your foot bends up towards your shin, like at the bottom of a squat – affects many of our everyday movements and activities, such as squats, climbing down stairs, landing from and jump and even walking.

Having limited ankle ROM can and will lead to injury.

After a “battery” of musculoskeletal tests, this study found that only ankle dorsiflexion range of movement, measured using the weight-bearing lunge test (what I am showing you today), was significantly associated with sustaining a lower extremity injury. Just a few of these injuries are:

How does a stiff ankle contribute to so many problems? Having one part of the kinetic chain limited, means that other parts (e.g. plantar fascia, hip flexors) need to absorb this lack of flexibility OR you start doing things differently – compensatory patterns, to ignore this problem. It’s unlikely that you would even realize that this is occurring – which is why doing this test regularly is so important! Having limited ankle dorsiflexion has even been shown to be a real risk factor ankle sprains – Which, as we know, are VERY common.

Examples:

1. Compensatory movements

  • Early heel lift (1)
  • Excessive pronation
  • Knee hyperextension

2. Overloads other structures

  • Plantar fascia – Simply due to the heel coming off the ground early – putting earlier and greater stretch on the tissue on the bottom of the foot
  • Knees – Due to hyper-extension and over-pronation of the foot
  • Hips – The hips can actually really affect the ankle, so it works both ways

So what is this all-powerful test?

The Test

As mentioned above, this test is something special. It easily shows whether you are at risk of lower limb injury. It is very reliable and accurate, even when done by novices, AND it is one of the most common tests used in Physiotherapy. The standing lunge test – Also know as the knee-to-wall test – Is demonstrated in the image below: easy ankle range test - ankle stiffness can cause injury Now – If your range is LESS THAN 10cm, that is not good enough and needs to be worked on. Note: if you are naturally a very flexible person, you should be aiming for 15cm. In the next couple of weeks I will be posting on HOW TO IMPROVE your ankle range with three easy self-treatments – So keep in the know by subscribing to email or via social media.

You cannot go wrong with this test as it is very reliable, standardized and easy to test

– and then re-test down the track after you have been working on it!


Get 25% OFF all Rehab Guides for a limited time (use code: TAKE25)

X