Last time I spoke about ankle sprains in general and how it might happen and different severities of it. Today I’ll be more specific and speak about a Grade I ankle sprain and the different rehabilitation phases and how to manage it.
The overall goal is to initially reduce inflammation, increase range of motion (ROM) and start a strengthening program to improve the proprioception and stability of the ankle and return to sporting activities as soon as possible.
Phase 1 always starts with trying to reduce the amounts of swelling and increase the ROM in a pain free mode. This normally occurs within the first couple days. PRICE should always be used immediately. For those of you that don’t know what PRICE stands for, it is Protection, Rest, Ice, Compression and Elevation. Above as well as taping can be used to help with the inflammation and swelling.
Phase 2 goals are to increase ROM in all planes and start with balancing exercises, always in a pain free ROM. This phase can take up to 2 weeks since initial injury. You may continue PRICE to control amounts of swelling. Strengthening exercises should not only be focused on the muscles surrounding the ankle, but also the small muscles on the foot itself. Full weight bearing exercises should be encouraged as soon as is tolerable.
Phase 3 should see the end of all swelling and pain. Therefore full ROM of the ankle should be restored and more strenuous weight bearing exercises should be tolerated. By the end of the third week of rehabilitation exercises a return to sport program may be started. All exercises should be continued and gradually be made more difficult. Progression from walking to running should be carefully monitored for re-injury to be prevented. Only when running commences completely pain free may you gradually return to all sporting activities.
Next week we will look at a grade II ankle sprain and look at what we should do and what we should avoid.