Ankle Sprain and Athletic Activity

The ankle joint is one of the most injured joints in the body. An ankle sprain typically occurs due to the “rolling” of the foot when running, pivoting, or jumping and landing on an uneven surface. Most often, the outside ankle ligaments are injured when the foot/ankle turns or rolls inward (inversion ankle sprain).

Indicators

Ankle sprains are often graded according to the level of severity (see muscle/ligament injuries) with varying degrees of swelling, discoloration, pain, and instability (ligament damage). If swelling and pain are severe, seek a physical to rule out a fracture. Many orthopedic physicians recommend sending a young athlete for x-rays. There is a chance of disrupting a growth plate rather than spraining a ligament when a young athlete (pre-adolescence through adolescence) sustains an ankle injury. If the athlete cannot walk without a limp, crutches are highly recommended to allow the joint to begin the healing process.

Treatment

Phase I

(0-3 days). Follow the R.I.C.E. principle with rest, ice, compression, and elevation. After the first day of injury, early PAIN FREE movement of the ankle is important, even if the movements are small:

1. Write out the ABCs with the toe, working towards large letters
2. Crunch a towel or pick up tissue paper with the toes while sitting on a chair
3. Crunch a towel and move it in and out along the floor with the heel being the pivot point

Phase II

This phase begins when the athlete can begin to bear full weight with minimal discomfort. The goal of this phase is to restore normal range of motion and strength. Again, there should be no pain when doing all exercises. “No Pain, No Gain” is NOT AN APPROPRIATE slogan to follow here.

Consult a Certified Athletic Trainer (ATC) or physical therapist (PT) for appropriate exercises for the injury. Ice after exercise, accompanied with a wrap may still be recommended if soreness and swelling still exist.

Some possible exercises may included:

1. Continuation of exercises from Phase I with weights added to towels.
2. Heel raises / slant board
3. Strengthening exercises using stretch cords, partner, or weighted object (see shin splint exercises)
4. Swimming pool work
5. Wobble board
6. Stationary bike

Phase III

This phase works on restoring functional strength, agility, and sport/exercise specific activities. Again, consult a Certified Athletic Trainer or physical therapist for appropriate exercises.
Some possible exercises may include:

1. Increase exercises from Phase II.
2. Slide board
3. Running/jumping/ agility work
4. Continue cardiovascular training

The ankle should be taped or the athlete should wear an ankle brace during this phase.