When we sprain our ankle we don't just damage the ankle ligaments, we stretch/damage the nerves and musculature of the entire lower extremity. This leads to movement and strength deficiencies that increase the likelihood of experiencing a second ankle sprain.
Remember the goal of rehabbing any injury shouldn't be to simply get out of pain, but to improve confidence and strength of the area in order to prevent longer lasting movement compensations (that lead to future injuries) and improve functional performance.
Taking the rehab beyond symptom management and onto improved function/performance with a progressive exercise plan we can ensure longer lasting results. Let's start from the beginning.
1. Pain Free Range of Motion
Reducing swelling and returning normal range of motion are the beginning goals of any program to rehab ankle sprain. Resisting our temptation to immobilize the ankle. it's important to start PAIN FREE range of motion as soon as possible after suffering an ankle sprain. This helps improve function of our lymphatic system (to reduce swelling), decrease pain, and helps restore range of motion.
2. Banded Strengthening
Rolling our ankle inward (most common) also stretches our lateral leg muscles (the personeals). Isolated strengthening with banded exercises is a good early exercise when suffering an ankle sprain.
3. Eccentric Contractions
Eccentric contractions are the most effective tool to strengthen and retrain muscles and tendons. This can be done with a partner (and bands) or with a step. Eccentric stepfowns are a great way to restrengthen the Achilles and overall ankle strength.
4. Ankle Mobilizations
Missing dorsiflexion causes issues all the way up the kinetic chain and can be limited due to swelling and scar tissue following an ankle injury. A simple ankle mobilization is a key part t rehabbing an ankle after a sprain.
5. Balance Exercise
Ankle sprain have been shown to decrease function of the tibial and peroneal nerves, affecting proprioception and balance. Retraining proprioception will decrease the chance of suffering recurring ankle injuries.
Easily progress from floor eyes open, to floor eyes closed, to AIREX balance Pad, to BOSU.
6. Standing Toes Taps
Ankle Sprains have been shown to decrease neural control to the glute medius and glute max muscles. This, in turn, can lead to poor control of the lower extremities during many functional activities, which can eventually lead to injury.
Standing toe taps are a beginning balance and lateral glute strengthening exercise.
7. Running Man
A more advanced balance and lateral glute strengthening exercise.
8. Jump and Land
It’s now time to progress standard hamstring rehabilitation into performance training. With isolated strengthening of the hamstring muscle complete, it’s important to incorporate strengthening exercises into full body, functional exercises.
Start jumping off of two feet and landing on one foot. The further you jump the more challenging the exercise.
9. Lateral Jumps
A more dynamic ankle challenge. Lateral jumps improve the lateral stability of the ankle joint.
10. BOSU Jumps/Change of Direction
The BOSU provides an unstable surface to challenge the strength and proprioceptive of our body following an injury.
Moral of the Story: If you sprain your ankle, don't just stick it in an ice bucket until the pain goes away. A structured, progressive rehab plan is required to ensure we don't suffer a relapse.
It’s important to note that the exercises described in this article relate specifically to the hamstring. There are almost always contributing factors that play into (deficiencies in core or hip strength, faulty movement patterns, etc). A full rehabilitation plan would incorporate exercises to correct these movement and strength deficiencies as well.
Evolve Performance Healthcare specializes in creating customized conservative medicine and therapeutic to transition our clients from pain to performance.