Lateral Ankle Sprains: Returning to Sport
Following up with our topic of the month of ankle pain, today I’d like to discuss returning to sports following a lateral ankle sprain and what you should consider before returning to the field. Rehabilitating your ankle plays a crucial role in reducing pain, improving function and reducing the likelihood of reoccurring ankle sprains. Here are some areas that I believe are important to focus on.
Range of motion and stretching
In order to reduce loss of flexibility/increased ankle stiffness, range of motion exercises and stretching of the calf muscles should be performed regularly. These exercises can be done relatively soon after an acute ankle sprain and are a good way to slowly introduce a bit of load to the ankle without applying too much. Some exercises I like to prescribe for this include:
- Gastrocnemius and soleus stretching, whether that be a standing stretch or with a towel/theraband
- Drawing the ABC with your toe, moving only your ankle
- With one knee on the ground and the injured foot in front, gently push your body weight forwards onto your front leg, moving your ankle towards its end range of motion
Once you are able to stand and walk with minimal pain it should be safe to start strengthening the muscles around your ankle. This is important to do to regain lost muscle strength as well as strengthen the muscles to make up for ligament damage. Targeted muscles include the gastrocnemius, soleus, peroneals and tibialis posterior. Daily repetitions of 8-12 with 3-4 sets is typically recommended. Some exercised used to strengthen these areas include:
- Resisted ankle inversion and eversion with a theraband
- Resisted ankle plantarflexion with theraband
- Double leg calf raises, slowly progressing to single leg calf raises when ready
- Seated calf raises
It is important to increase resistance in these exercises by either adding weight or using a harder theraband. Doing so makes for a harder workout and inceases the load that these muscles can tolerate.
Proprioception and balance
After a lateral ankle sprain it is likely that you lose a bit of balance on that leg. Building this lost balance back up is important in preventing reoccurring ankle sprains. Balance restoration can begin as soon as you are able to stand with minimal pain. However, if you feel that you are a falls risk it could be beneficial to seek professional advise before beginning these exercises. Some simple exercises include:
- Balancing on one leg for 30 seconds, repeating 3-4 times daily. To make this harder you can close your eyes and/or add a folded pillow underneath your foot. If you have access to a balance/wobble board then this can be used to increase difficulty.
- Tandem walking
- Single leg star excursion. Standing one leg with 8 points marked around you, slowly touch each point with your other foot while keeping balance
If you would like to maintain fitness while you are unable to weightbear it may be beneficial to seek alternative options to running, such as cycling.
Once you’re able to weightbear with minimal pain it should be okay to return to running exercises at training whilst trying to avoid lateral movements.
When returning to sport for the first few weeks while you’re building up your strength, locking your ankle joint with either an ankle brace or sports tape could help reduce the likelihood of spraining it again. While these can help initially, ideally we would want you to not rely on it once fully rehabbed.
If you would like to have your ankle looked at feel free to come and see us at TFC Podiatry. We are able to offer you personalised rehabilitation programs as well as alternative secondary treatment options, such as dry needling, shockwave therapy and orthotic intervention.