Your Injured Ankle Part 2: Rehabilitation and Prevention

So you've injured your ankle, and after reading my last post (or better yet, seeking actual medical advice), you know what kind of injury it is, and you've taken the appropriate steps to take care of it for the first few days. You're probably wondering, “what's next? How can I get this ankle rehabilitated, and how can I prevent this from happening again in the future?” Fear not, my slightly-limping friend, I've got you covered.

Most of what follows is a mash-up of advice I've either found online or heard from medical and/or fitness professionals. That said, please don't take my word for it! At the end of this post you'll find “Further Reading,” and I urge you not only to check those links out, but to get more info from your doctor or physiotherapist. Also, as we saw last time, sprains are the most common way we hurt our ankles, so much of the information below is geared towards that particular injury. If you're dealing with a strain or fracture, seek the appropriate medical advice.

And so, without further ado (or further disclaimers), here are the steps to take when you're rehabbing an ankle injury, as well as ways to prevent a similar injury from occurring in the future.

Regaining Range of Motion

As long as the pain isn't too severe, you can start the recovery process by walking around a bit. Use crutches to help you bear your weight if you need support. I used my trusty baseball bat as a cane, which was not ideal, but did the trick.

Shortly after your injury (within 72 hours), you need to start working towards regaining the Range of Motion (ROM) in the ankle joint. The most common exercise that comes up for this is called “Tracing the Alphabet with your Toe.” To do this exercise you sit in a supportive chair and, you guessed it, trace the alphabet with your toe. This works because it gets the ankle joint moving in all directions, doesn't put too much strain on the affected area, and allows for progressively larger movements as the pain diminishes. Do the full alphabet 1-3 times. You may want to do this right before you plan on applying ice, since you may want to ice it after anyway.

Another ROM exercise is the Towel Curl, where you place your foot flat on the floor on top of a towel. Use your toes to “scrunch” the towel towards you, then to push it away again.

Stretching

Once your pain has started to subside, it's time for some stretching. The achilles tendon connects your calf muscle to your heel, so stretching this area helps to relieve pressure on the foot/ankle.

Start with a Towel Stretch: Sitting on the floor with a foam roller or folded towel under your foot, loop a towel, belt, dog leash, or something similar around the ball of your foot. Hold an end in each hand and gently pull the toes back towards you, keeping your knees straight. Hold the stretch for 15-30 seconds, and repeat 2-4 times. If you aren't able to feel a good stretch before feeling pain, you may not be ready for this step.

Once you can stand without pain, you can do a standing calf stretch. Stand facing a wall, and lean against it with your hands about head-height. Put the injured foot a step behind the other one, and bend your knee forward with your heel flat on the floor. Again, move slowly and gently, holding for 15-30 seconds and repeating 2-4 times.

Regaining Strength

When ankle sprains are frequent or severe enough, they become a self-fulfilling prophecy. Spraining my ankle has made it weak, which makes me more likely to sprain it in the future. What better time to focus on preventing a sprain than while you're still tender from the last time? In the early stages, therabands or exercise tubes are great tools for providing the appropriate amount of resistance.

Rather than trying to describe these strengthening exercises to you, I'll direct you to an actual physical therapist (and my favourite source for stretching/rehab/therapy advice), Doctor Jo:  

 Preventing Future Injury

Once your ankle is sufficiently healed, you can get back to your regular activities, your training program, and your life in general. Everything's back to normal, right? Sure, but you would do well to add some ankle-specific exercises to your normal routine in order to become more stable. Go easy on yourself at first. It is both easy and unhelpful to overdo it.

Start with standing heel raises. Standing in a stable position, using the wall or a chair for balance if necessary, raise both heels off the ground. To make this more difficult you can do one leg at a time, or hold weights for more resistance. Aim for 10-15 reps, 2-3 times.

Standing on one leg is a great way to work on balance, and it's something you can practice anywhere. Do each leg for 30 seconds (or whatever feels challenging to you), repeating each side a few times. You can scale this up by having a friend lightly push against you to force you to engage the ankle. Another challenge is to throw a basketball back and forth while balancing, working your way up to a medicine ball as you become stronger.

Adding a heel raise to a squat is another easy way to include some balance training. Do a normal squat, but once you come back to standing come up onto your toes. For a great cardio challenge do some squat jumps; get into a low squat, jump straight up, land back into a squat, and do it all over again. Other low-body exercises that challenge the ankle are skater-hops, curtsy lunges, side lunges, and single-leg jumps.

If you're really interested in improving agility, be sure to look into some athletic agility training using ladders, cones, etc. There are many variations, so I'll spare you more of my clumsy exercise descriptions, but if you're looking to get better at sudden changes in speed and direction, athlete-style training might be just the thing.

So there you have it! You're healed up, stronger than ever, and ready to help a friend when they suffer from a similar injury. Now all that's left is to be more careful when doing something crazy like walking down the sidewalk...

Further Reading
http://www.askdoctorjo.com/
https://www.healthlinkbc.ca/health-topics/te7604
​http://www.sportsinjuryclinic.net/sport-injuries/ankle-pain/acute-ankle-injuries/ankle-sprain-treatment-and-rehabilitation