Understanding Ankle Injuries: Symptoms, Home Care & Rehabilitation

Ankle injuries are no fun but are common for both athletes and everyday, active people. Here, we’ll talk about the different kinds of ankle injuries, their symptoms, home care, and rehabilitation.

Understanding Ankle Injuries: Types, Symptoms, and Grading

An ankle sprain often occurs when the ankle rolls inside toward the midline of the body or toward the outside of the leg, although some sprains can occur from other mechanisms, such as a hard fall or landing.

Ankle sprain injuries can often be graded from mild to severe based on the presentation of symptoms and damage to internal ligaments.

Types of Ankle Sprains

• Mild ankle sprain
  Although pain and swelling are fairly subjective to each person, a mild ankle sprain will involve connecting ligaments of the ankle being minorly overstretched.
  
  
• Moderate ankle sprain
  A moderate sprain will include overstretching, where some fibers of the ligament of the ankle start to tear.
  
  
• Severe ankle sprain
  A severe ankle sprain could involve partial to complete rupture of entire ligaments that hold the ankle together, which could require surgical intervention in some cases.

Ankle Sprain Symptoms

Pain, swelling, and bruising can be common symptoms for most people with any degree of sprain and should not be a source of panic unless they are severe.

A couple of general red flags to keep in mind if you think you might have an ankle injury are

• The inability to take a couple of steps on the affected ankle
• Any kind of deformity or pain that is localized to a bony prominence rather than over soft tissue and joints

All of the above are indicators of needing to seek immediate professional care to rule out a fracture or other serious injury.

Effective Home Care for Ankle Sprains

If your injury is mild, you may be able to care for it at home as it heals, although you should always follow any instructions your doctor or health care provider gives you. Here are a couple of tips for treating minor injuries at home.

• You’re initially going to want to plan to stay off the ankle and allow it to rest as much as possible. (Can you walk on it to the kitchen to get a snack? Probably, depending on your injury. Should you postpone your marathon training for a couple of weeks until your ankle is feeling better? Most likely.)
• Using ice in the first couple of hours/days after the initial injury can help control swelling; icing for 15 to 20 minutes at a time and allowing the ankle to rewarm between icings can be helpful.
• Do not use heat in the initial few days after the injury, as this can increase blood flow, allowing more swelling to arrive in the affected area.
• A warm compress can be added in after several days of icing if you feel comfortable doing so.
• Elevating the affected leg is also going to be helpful with swelling control; keeping leg slightly elevated, such as propped on a pillow, can help accomplish this.
• Use an ace wrap or something similar to provide light compression; this should be tight enough to stay in place without falling off and feel comfortable but not tight enough to impede circulation to your foot or ankle.

Once you’ve passed an initial couple of days on injury and swelling and pain are no longer increasing, one of the most important aspects of caring for an injured ankle is rehab — or strengthening the surrounding muscles and tissue to help the injured joint regain stability.

At-Home Rehab

This critical step is often missed as the ankle begins to feel better, and you are able to functionally return to activity with only minor pain and swelling. However, it is important to continue rehabbing the ankle to help with lingering pain and recurrence of your injury.

For more mild injuries, follow R.I.C.E as a general reminder; this stands for Rest, Ice, Compression, Elevation.

Continuing to add strength and mobility back after an injury, even after the injury has started to recover, will help with returning to activities and injury recurring.

When to Brace your Ankle

Bracing can be another helpful option for some people returning to activity, although some people find that taping the ankle with athletic tape can feel sturdier and help fit into tight shoes, cleats, or other uniform requirements.

• Lace-up brace: If you’re looking for what the best bracing for your injury might be, consider a reusable lace-up brace with semi-firm stabilizers running along the inside and the outside of your ankle. These tend to be accessible and can be found in a variety of online stores as well as many athletic stores and supermarkets. This type of brace can typically fit a wide variety of sizes well due to its lace-up quality and provide excellent support to the foot and ankle.
  
  
• Tape: Well-applied athletic tape can provide similar support but will need an athletic trainer, knowledgeable coach, or other professional to help to tape the ankle.

You can expect a typical mild sprain to last a few weeks in the painful acute phase. Although a severe sprain or serious injuries involving fractures can take much longer and require professional medical attention. It is very important to seek a medical diagnosis if your symptoms are severe or the pain is persistent.

Ankle Rehab Exercises to Try

Below are a few (by no means exhaustive) rehab exercises to try at home; however, if you continue to experience prolonged swelling or extreme pain, please seek out a professional to help you.

Alphabets

Early rehab can begin with light mobility exercises such as using one’s toe as a pointer to write out alphabet letters or simply performing ankle circles.

• The motion should be originating from the foot/ankle with the leg remaining still. It is easiest to sit on a bed with your foot off the edge or on a high stool.
• Repeat this with upper and lowercase letters a few times a day during the initial injury phase to help gain back pain-free range of motion and help manage swelling.
• When this starts to feel too easy, it can be phased out as you move on to more challenging exercises.

Rice/Marbles

This is a great fun exercise that kids can definitely enjoy, as well as grown-ups. The general idea is to use a bucket or bowl of clean uncooked rice. Marbles or small toys can be buried in the rice.

Using your foot to dig through a bowl of rice or pick up marbles can be effective in regaining ankle range of motion and coordination. Here’s how it goes:

• Place clean foot in rice (obviously, we aren’t planning on reusing the rice for eating, just trying not to spread germs).
• Use your foot and toes to dig through the rice in order to find and recover small toys or items in the rice.
• This can be repeated a few times or continued until small items are recovered and reburied.
• Marble pick-ups can function similarly, but spreading marbles on the floor and using toes to grasp and pick up marbles and collect them back into the container.

Ankle Four Ways

Ankle 4-ways are an important exercise in building strength and range of motion after ankle injuries. This involves gradually adding and moving the ankle in all four planes of motion (inward, outward, toes up, and toes pointed), which can be performed with a resistance band.

• To start, you could have your leg straight in front of you, such as sitting on the bed or floor. If you want to use a band, loop it around your foot now and loop the other side around the foot of a piece of furniture that won’t slide out of place, or simply have someone hold the band for you.
• Pick a direction to start with. I like to start flexing my ankle to bring my toes up toward the face and then come back to neutral and repeat for a set of 10 before moving into the next direction.
• If you’re using a band, pull it to tension, going straight out away from your body so that it is providing resistance as your foot flexes towards your body.
• Next, you can move the band so that you can start turning your foot outward away from your other leg and foot (heads up: Most people won’t get a lot of motion going that direction because of the shape of your ankle bone).
• Place the band on the outside of your foot, pulling inward to provide light resistance to this motion.
• Next, you can move into pointing your toes like you’re pressing a gas pedal and back up to neutral; you might find it easiest to hold the band tightly in your hand and looped around the ball of your foot for this motion.
• Finally, move the band so it's running from the inside of your foot near the arch and pulling your foot toward the outside as your turn your foot inward so that the sole is briefly turning towards the other leg and then back to neutral. It’s generally easy to start with one to two sets of 10 going in each direction; if that feels too easy, you might need a heavier band to add resistance, but you can try adding another set if that seems more possible to you.

Plyometrics - Plyometric

Plyometric or jump training can be helpful in the final stages of injury recovery to help with balance and quick motion. This can include activities like

• box jumps
• ice skaters
• quick, controlled motions like ladder drills

By following proper care, utilizing home remedies, and committing to a comprehensive rehabilitation program, you can effectively recover from ankle injuries, regain stability, and return to your active lifestyle.

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