No one goes to physical therapy for a rolled ankle. Which is too bad because despite being able to seemingly bounce back quickly, it can have long term adaptations in how your move years down the road. Once you roll it once, it usually starts a long cascades of recurrent sprains. Since no one thinks it is worthwhile I will give you the keys to the castle so you can rehab your own ankles!
Key #1: Mobility
Restoring mobility after an ankle sprain is huge. Rolling your ankle results in long term changes in the actual shape of the foot. Rolling the ankle results in tearing and stretching of the ligaments on the outside of the ankle. This trauma results in more laxity on the outside of the ankle which results in a more supinated/higher arch foot. People with recurrent ankle sprains often bear more weight on the outside edge of the foot and struggle to lower the arch of the foot. A good place to start is something like ankle CAR's. Goal is to go further and further into deeper ranges of motion.
We also need to re-access the inside edge of the foot (pronation). This is more of a brain exercise as we are teaching the brain that pronation is safe and able to be accessed. It is a longer video but well worth it to understand the importance.
Key #2: Strength
This one is probably the most obvious, yet is one of the more poorly executed. We want to focus on highly stable positions through a full range of motion. On your calf raises we should be getting a serious cramp at the top and a serious stretch at the bottom. We should also be strengthening the ankle isometrically as well.
For example a tall calf isometric:
The same rules apply to the ankle as any other joint. Progressively add load, time or range of motion. Perform consistently 2-3x per week for a couple months. We actually have a foot and ankle program that walks you through this progression and uses the concepts we talk about in this article. You can get access here.
Key #3: Spring
This is the stage that I think is often missing or neglected in traditional rehab. The ankle should functionally serve as a spring that propels you forward. If we never retrain the ankle to act like a spring and be able to absorb and redistribute force than we are missing a big piece of human movement. I like to use extensive plyometrics to help build a solid foundation to do more intense plyometrics later. Extensive plyometrics are small plyometrics performed for higher reps - think jumping rope. We are exposing the ankle to hundreds of little spring reps to prepare it for the more intense spring reps.
Performing these pogos in lots of different planes of movement and with different constraints is crucial to build a strong ankle in multiple planes of motion. I like to make sure my patients are able to perform single leg pogos for 45-60 sec in a wide variety of directions pain free.
There ya have it folks! The three pillars I follow to address ankle sprains. Use it and get better. If you want more guidance I have a program available here!
Till next time!
BIG CAT OUT🦁