Ankle sprains normally involve the lateral ligaments of the ankle. The Grade I sprain is mild with stretching of the ligaments. A Grade II
is moderate with partial tearing of the ligaments but without loss of stability. A Grade III is severe with complete rupture of the lateral ankle ligaments
and instability about the ankle.
Early Treatment Involves RICE:
1) Rest
2) Ice
3) Compression
4) Elevation
For more severe ankle sprains, a compression stocking such as Tubigrip or Ace wrap is often required. To properly immobilize the ankle sprain, an Aircast, gel cast,
ankle brace, or even a walking cast may be needed. Elevation is a critical part of healing; a 30% improvement in healing speed has been observed in a well elevated limb.
Once the ligaments begin to heal, usually within one to four weeks a rehabilitation program is instituted.
The Exercises Include:
1) Ankle range of motion. This involves circular exercise of the ankle, for example doing the alphabet with the foot, at least two to three times a day.
2) Gentle calf stretching with the knee bent and the knee straight. This is done by pushing against a wall as in the typical runner’s stretch.
Strengthening Exercises Include:
1) Heel rises first done with both feet then progressing to single heel rise on the affected side. Two sets of twenty once per day are recommended. Once
you can do twenty single heel rises with minimal pain, you are probably ready to return to sports.
2) Theraband is used to strengthen the outer part of the leg. Place the band around both feet and turn the affected ankle outward twenty times for two sets.
The band can also be used to pull the foot up against resistance.
3) Another method to strengthen the front part of the leg muscles is to walk on the heels for two to five minutes at a time. It is usually recommended that
this be done on carpet or while wearing shoes to avoid bruising the heel.
Proprioception Exercises:
1) Walking in soft sand.
2) Using a balance board. A balance board can easily be made by taking a wooden plate and putting it on top of a tennis ball then moving the plate around
the tennis ball with the foot.
Return to Sports:
Return to sports can be done when the ankle has close to full range of motion without pain, and the person is able to do at least twenty heel rises with minimal discomfort. We usually recommend using a ankle support for three months after a moderate to severe ankle sprain and for four to six months after a second moderate to severe ankle sprain.
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