Aims of Rehabilitation
Early Stage – first 2 days to 2 weeks depending on severity involves decreasing pain and swelling.
Protect the ankle with rest ice and bandaging or taping.
Rest – this is essential. Use crutches with partial weight bearing to get about with if necessary for the first few days. A healing ligament needs a certain amount of stress to heal properly but overdoing it early on in the rehabilitation process can prevent healing. Full weight bearing should be introduced as soon as pain allows.
Exercises of ankle pulling the foot upwards pointing the foot away can be performed early on so long as they are not too painful. Avoid turning the ankle though as this will stress the injured ligaments.
Ice – for 15-20 minutes every 2 hours initially for the first 2 days in the acute stage ice will constrict blood vessels and further bleeding. Longer term benefits include reduction of pain and muscle spasm.
Compression – use a tubi-grip bandage or taping
Elevation – put your feet up and read all about your injury! Elevating the leg will help swelling drain away from the site of the injury. Elevate the leg while icing and for 10 minutes after.
Rehabilitation Phase -2 days -4 weeks involves regaining movement, balance and returning to sport
Begins when swelling starts to decrease and pain lessens. This means the ligaments have reached the point in the healing process where they are not in danger of being re-injured from mild stress.
Improve mobility and flexibility by moving it up and down then slowly adding writing of the alphabet with your foot.
Attending a physio may involve mobilization of your foot and prescription of exercises using a band or wobble board or BOSU, stretching and taping for return to activity. Often Kinesio tape and acupuncture may be is used to reduce swelling and pain.
Proprioception exercises are thought to be important in avoiding recurrent ankle sprains. The neuromuscular control you have over your muscles will have been damaged when you injured the ankle as these small sensors are located in ligaments and tendons. Balance type exercises can be used to improve this function and help avoid future ankle injuries. WE recommend standing on one leg with your head tilted back for 30 seconds and eyes closed for 30 seconds.
Return to full fitness / functional training
In order to start the functional rehabilitation phase (activity and sports specific training) it is important the athlete has full range of motion and 80 to 90% of pre-injury strength. When you can comfortably do all of the above then you are ready to start phase 3 and begin your return to activity.
Cardiovascular exercise is important and should begin as soon as possible after injury. Stationary cycling, running in water and swimming are all possibilities depending on severity of injury and what pain will allow.
Running may begin as soon as walking is pain free and should begin on a clear flat surface such as a treadmill or footpath. Grass or sand surfaces will increase the risk of re-injury. Gradually increase speed over time to a sprint
Sports specific drills using cones can be introduced. Changing direction, running in a figure of 8 pattern and zig zagging between cones.
TRAIN BEFORE YOU PLAY!!