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This ankle rehabilitation programme is an example of the progression followed by a professional footballer with a sprained ankle. The principles of rehabilitation apply to all ankle sprain injuries, regardless of the sport. These principles, together with expert input from a healthcare professional can help you recover safely and quickly following a sprained ankle. The progression of the exercises should be based on pain free completion of the previous exercise. All rehabilitation exercises should be preceded by a warm up.
Follow the PRICE protocol:
The injured tissues should be protected from further damage. A Removable Plastic Cast is ideal. It provides the same protection as a plaster cast but it is lightweight and can be removed by the patient. All English Premier League football players use removable plastic casts when they suffer a significant ankle injury. In the case of Grade 3 ankle sprains crutches should also be used.
Rest from sports is essential, but even walking on the ankle, if it is painful, may cause further damage and should be avoided. No weight should be put through the injured ankle and crutches should be used. Pain relieving medication prescribed by a doctor may be necessary.
Ice Packs are applied for periods of twenty minutes every couple of hours (never
apply ice directly to the skin).
The Ice Packs relieve pain and are thought to reduce bleeding in the damaged tissue. The Aircast Ankle Cryocuff is the most effective method of providing ice therapy and is the professional's choice. It can provide continuous ice cold water and compression for 6 hours and significantly reduce pain and swelling.
David Beckham wearing a plastic cast walker following his injury in 2002
A swollen ankle is a sign of a significant ankle sprain. The swelling is caused by bleeding in the tissue and a leaking of cellular fluid secondary to tissue damage. If this swelling is allowed to consolidate it can produce excessive scar tissue which seriously lengthens the rehab period. Compression during the early stages helps to resolve swelling and is essential for a good outcome. Compression is provided by the use of a Removable Plastic Cast which has inflatable air cells to massage out swelling, with intermittent use of an Aircast Ankle Cryocuff to provide ice and compression.
If the ankle is not elevated the effect of gravity causes the tissue fluid to accumulate at the ankle. This can cause increased tissue pressure which is extremely painful. To relieve pain and prevent excessive swelling, the ankle is elevated above waist height.
If the pain allows, the ankle should be removed from the Removable Plastic Cast and gently pumped forward and back 20 times each hour. This is done by sitting down with the leg elevated and pushing the toes forward and back. This facilitates the dispersal of swelling from the ankle. Electrotherapy treatments such as ultrasound and pulsed short wave diathermy are effective in speeding the healing process.
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