Ankle Sprain
A sprain is a partial or complete tear in a ligament.

Most sprains are caused by rolling the foot inward.

This stretches or tears the ligaments that hold the ankle and foot bones together and can lead to instability and re-injury.

SO WHAT?
Spraining an ankle can increase your risk of re-injury as much as 40-70%. But proper post-injury care, rehabilitation exercises and bracing can decrease this risk. The information below can help you prevent re-injury.

To Speed Up Recovery
Immediately Being Using…P - R - I - C - E

Protection - Your ankle may be splinted, taped or braced to prevent further injury.
Rest - You should rest from all activities that cause pain or limping. Use crutches/cane until you can walk without pain or limping.
	Ice - Place a plastic bag with ice on the ankle for 15-20 minutes, 3-5 times a day for the first 24-72 hours. Leave the ice off at least 1 1/2 hours between applications.
	Compression - Wrap an elastic bandage from the toes to mid calf, using even pressure. Wear this until swelling decreases. Loosen the wrap if your toes start to turn blue or feel cold.
Elevate - Make sure to elevate the ankle above heart level (hip level is acceptable during class).

To Restore Normal Ankle Function

Range of Motion Exercises - Help you regain normal ankle motion.

Technique: Sit with your knee straight and hold the foot position as long as possible. Do as frequently as possible for the first 3-10 days.

Pullback Flex your foot back toward your body.

Flexibility (Stretching) Exercises
Loosen tight leg muscles. Tightness makes it hard to use stairs, walk, run, and jump.

Technique: Hold each exercise 20-30 seconds at a gentle stretch. Do not bounce!
Frequency: 6-10 repetitions/exercise, 5-7 days per week

Calf Stretch   Basic:  Sit with your knee straight and towel looped   around the ball of your foot. Slowly pull back until you feel your upper calf stretch.

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Calf Stretch    Advanced: Once you can stand, try stretching with   your hands on a wall. Place the injured foot behind the other with your toes pointing forward. Keep your heels down and back leg straight. Slowly bend your front knee until you feel the calf stretch in the back leg.

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Heel Stretch    Basic: Sit with your knee slightly bent. Loop a towel   around the ball of your foot. Slowly pull back until you feel a stretch in the lower calf and heel.

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Heel Stretch    Advanced: Once you can stand, try placing your   injured foot behind the other with your toes pointing   forward. Keeping your heels down, slowly bend your back knee until you feel a heel stretch in the back leg.

Strengthening Exercises
Strong leg muscles help the ligaments hold the ankle together.

Frequency:  3 sets of 20 repetitions, 5-7 days per week.

Front of Shin   Basic - Push Out With your foot flat on the floor, push it outward against a wall, file cabinet or bookcase. Hold for three seconds.

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Front of Shin   Advanced - Band Tie the band to a desk or dresser. Sit with your foot and knee in line and loop the band over the outside of your foot. Push your foot out against the band.

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Inner Shin   Basic - Push In With your foot flat on the floor, push it inward against your other foot. Hold for three seconds.

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Inner Shin   Advanced - Band Tie the band to a desk or dresser. Sit with your foot and knee in line, and loop the band over the inside of your foot. Push your foot in against the band.

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Front of Shin   Basic - Push Up Place the heel of your other foot on top of the injured one. Push down with the top heel while trying to push up with the injured foot. Hold for three seconds.

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Front of Shin   Advanced - Band Tie the band to a desk or dresser. Sit with your leg straight and loop the band over the top of your foot. Slowly pull your foot back against the band.

To Prevent Re-injury

• Continue daily calf and heel stretching, especially after activity (indefinitely)
• Continue ankle strengthening 3-4 days per week (indefinitely)
• Complete the balance tests and exercises (if needed)
• Wear an ankle brace during strenuous activity (indefinitely)

Balance
An ankle sprain can decrease your ability to balance on that foot and makes it easier to roll the ankle again. As soon as you can stand without pain, try the balance tests below. If you can't balance for ten seconds without wobbling, practice that level every day until you can. You can stop when you pass the Level 4 test.

Technique: Balance on your injured foot for 10-30 seconds, do a least 6 repetitions per day.
Goal: Stand 60 seconds without losing your balance, then move to the next level.

Level 1 - Arms out to your side, eyes open   Level 2 - Arms across your chest, eyes open   Level 3 - Arms out to your side, eyes closed   Level 4 - Arms across your chest, eyes closed

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Bracing Injured ligaments can take many weeks to heal. An ankle brace helps protect the ligaments not only during recovery but also when returning to sport or exercise activities.

Common beliefs

• Bracing can replace strengthening exercises - FALSE! Strong lower leg muscles help provide support to injured ligaments.
• Wearing a brace makes an ankle weaker - FALSE, if you continue your strengthening exercises. Plus, a brace can help improve your balance and thus prevent injury.
• Braces won't fit in shoes - FALSE! Professional and college athletes wear them all the time.

This is not a comprehensive reconditioning program, but will get you on your way to recovery.
If your ankle isn't fully functional after one month, contact your health care provider.

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