How to Heal a Sprained Ankle
Article by Lucas Rockwood
Have you sprained your ankle? Do you have pain and bruising on the outer edges of your foot? The traditional R.I.C.E. recommendation–rest, ice, compress, and elevate–is aimed at symptom relief, not healing. Worse still, this seemingly good advice can, in some cases, slow down the healing process. If you’re looking for ways to heal your ankle as quickly and as strongly as possible, this guide is for you.
Ankle sprains are graded with a one to three ranking, with a grade one sprain creating mild pain and reduced activity, and a grade three sprain indicated by an inability to walk without limping, lots of swelling, and visible bruising. The more severe the injury, the longer and more carefully you need to heal.
There are three main phases to healing. Phase one is the first five to seven days and involves inflammation and your body mounting its healing responses. During this period you should stay off your foot and do your best to simply leave your ankle alone. Next is the proliferation phase, where your body sends in fibroblasts to heal the affected area. This can last weeks or even months. Last is the remodeling phase that can last up to a year where scar tissue organizes itself and changes from softer, type three collagen into stronger type one.
Joint laxity after an ankle sprain is extremely common, and re-injury is a big risk. Here we’ll reveal the best healing protocol and a five-minute corrective exercise routine you can do every day to help your ankle heal strong and reduce your risk of re-injury.
Anatomy of a Sprained Ankle
Your ankle joint is an amazing structure, offering tremendous range of motion, strength and stability, despite being bent and twisted every which way all in a typical day.
Ankle stability is maintained by ligaments, tendons, muscles, and joint mechanics. Ligaments, such as the lateral and medial ligaments, prevent excessive side-to-side or twisting movements. Muscles, including the calf muscles and lower leg muscles, provide dynamic support and control ankle movement. The bony structure of the ankle joint, particularly the wider top surface of the talus bone, contributes to stability.
Ankle sprains are common due to the ankle’s vulnerability to twisting or rolling movements. An estimated 90 percent of sprains occur when you hyper invert your ankle joint, and one or more of the three ligaments on the lateral side are damaged. Strengthening your ankle muscles, wearing appropriate footwear, and practicing proper body mechanics can help prevent re-spraining.
How Severe is Your Ankle Sprain?
Grade 1: mild ligament damage, mild pain, swelling, reduced activity
Grade 2: moderate ligament damage, moderate pain, swelling, bruising, difficulty walking
Grade 3: severe ligament damage, severe pain, significant swelling, extensive bruising, inability to bear weight
Healing Best Practices
- Rest and wear a boot or brace for the first five days after injury
- Weeks 4-8, wear a brace and move carefully
- Commit to five minutes of daily self-care, range-of-motion (ROM) exercises
- Gradually scale up activities
5-Minute Daily Corrective Exercise Routine
From day six onwards in your healing journey, focus on doing the following five-minute routine every day for at least the first month. Practice on both sides to keep your ankles balanced. Start each exercise from a standing position, either with a wall in front of you or behind a chair and place your hands on the wall/back of the chair for support as needed.
Plantar Flexion Heel Lifts
- Step your right foot forward with a straight leg, and your left foot back behind you – this leg can bend a little
- Point your right toes forward, now lift your heel up and down 10 times
- Switch sides and repeat with your left foot
- The gastrocnemius muscle in your calf will tense as you perform this movement, this is normal
This movement works on the anterior tibialis muscle on the front of your shin.
- Stand with your right leg in front, left leg behind
- Place your right heel on the ground and gently raise your toes
- Repeat this movement 10 times
- Repeat on the other leg
Inversion vs Eversion
Next, we’ll do the range of motion where your ankle rolls to the outside or the sole of your foot turns up. This is likely the same range of motion where you sprained your ankle, so be very careful. Aim for a maximum three or four out of 10 in terms of discomfort. Do not push into pain.
- From standing, place your right leg straight in front, left leg slightly bent behind you
- Very gently invert your ankle to the inside ten times
- Repeat the other way, everting your ankle to the outside 10 times
- You might feel a little cramping in your calf during this exercise, that’s normal
- Switch sides and repeat on your left leg
This exercise works on both dorsiflexion and plantar flexion of your ankle, stressing it in its full range of motion, but with control.
- From standing, bend your left knee just past your big toe
- Point your right foot behind you, resting the top of your foot on the ground
- Find your balance and hold here – use the back of the chair or steeple your hands with your fingers
- Gaze in front of you, press down into the heel of your front foot, and into the tops of your toes on your back foot
- Hold for 30 seconds, then switch sides
Tip: cramping in your calves, in the front of your leg, and in your feet are normal during this pose. Stop and punch out the cramp if needed, then come back into the pose.
Please do not use this video to diagnose or treat a severe injury. If you have black and blue bruising or reason to suspect a full tear or fracture, not just a sprain, see a doctor and get an x-ray.