Recovering from a lateral ankle sprain is a journey that many individuals undertake with the guidance of a physiotherapist. Ankle sprains are a common injury affecting people of all ages and activity levels. They require a comprehensive rehabilitation process to restore strength, mobility, and confidence. In this blog I will explore the stages of the rehabilitation process following a lateral ankle sprain. It is important to note that some stages overlap throughout the process. For example, the focus on strength continues throughout the entire process and balance can begin as early as Stage 2 if tolerable.
Stage 1: Assessment and Acute Management
Following a lateral ankle sprain, a thorough assessment is crucial to determine the extent of the injury and the patient’s baseline function. This assessment helps in creating a personalised rehabilitation plan, whilst address key factors such as pain levels, range of motion, swelling, and muscle strength. The initial focus is on pain control and swelling reduction. Protection, rest, ice, compression, elevation is encouraged during this stage, along with the use of assistive devices like crutches or braces to protect the injured ankle if required and promote early weight-bearing as tolerated.
Examples of exercises that may be prescribed in this stage are drawing the alphabet with the foot and ankle pumps.
Stage 2: Restoring Range of Motion and Strength
Once the acute phase subsides and swelling reduces, the rehabilitation process shifts towards restoring range of motion (ROM) and strengthening the affected ankle. Controlled movements and gentle stretching exercises are introduced to improve flexibility if lacking. This stage aims to regain full, pain-free ROM in the ankle joint. Subsequently, attention is turned to strengthening exercises that target the muscles surrounding the ankle, improving stability, and providing a solid foundation for further rehabilitation.
The key muscles groups that need to be targeted around the ankle are the Peroneals which play a vital role in ankle stability and control. Their role is to assist with eversion and plantarflexion. Tibialis Anterior is responsible for dorsiflexion and plays a crucial role in maintaining balance. The Gastrocnemius and Soleus together form the calf muscles that are responsible for ankle plantar flexion. These muscles are important for propulsion and power during activities such as walking, running, and jumping. It is not only important to target muscles around the ankle but the entire posterior chain, including the glutes and hamstrings. Focusing on the core is also crucial as this contributes to trunk stability, as well as general functional stability.
Here are some examples of exercises that may be prescribed in this phase:
Single leg bent knee calf raise:
