1. Rule out a fracture:
The Ottawa ankle rules are a series of quick clinical tests to determine the likelihood that someone sustained a fracture after a foot/ankle injury. These rules can be done by yourself or a friend, but if you are unsure of how to administer this test, don’t hesitate to stop by the office of your trusted physical therapist to reduce wait times and potentially unnecessary X-rays in the emergency room.
If ALL OF THESE TESTS do not reproduce your pain, you likely have not fractured your foot/ankle. However, if one of them reproduces pain or your pain doesn’t dissipate within 5-7 days, you should make sure a fracture has been ruled out by getting standard X-rays.
2. Increase your ability to bear weight on the involved foot
Because your foot/ankle are constantly contacting the ground, it’s important to begin to tolerate increased loads through the foot and ankle. Start by sitting down and leaning more and more weight onto the involved extremity, rocking back and forth. Once you are able to tolerate this, stand up and while holding onto something (such as a chair or countertop), perform the same activity: begin to lean side to side gradually increasing the amount of weight placed on your involved foot.
Work to try and get your uninvolved leg completely off the ground (bearing all of your weight on the involved side). We’d recommend trying to do this EVERY TIME you stand up after a prolonged period of sitting or laying down… or roughly every hour. This will help your muscles, ligaments, and bones to tolerate higher loads and thus speed up your ability to walk without increased pain.
3. Perform single leg standing exercises throughout your day.
Studies have shown that after sustaining an ankle sprain, you lose some of the proprioceptive (protective) input that your foot/ankle need to be able to maintain your balance during various activities (i.e. walking on uneven surfaces, jogging, jumping, etc.).
Even more so, other studies have shown that you even lose proprioception on the OTHER FOOT that wasn’t injured, which can predispose the other foot to future injury. In order to combat this, we’d recommend trying to balance on one foot for 2-3 sets of 20-30 seconds several times a day to help promote good balance…and don’t forget to switch sides!
4. Restore your motion and strength through exercise
By performing range of motion and strengthening exercises in multiple directions, you can help the injured ligaments recover by allowing the surrounding muscle groups to “stabilize” the joint and prevent further injury. Strong muscles lead to strong joints so the more you work at this, the better (and more normal) your foot/ankle will feel!
5. Don’t forget the RICE principle!
Just remember that your foot/ankle is still injured and as a result, there will likely be swelling, bruising/discoloration, and pain around the area. By using the RICE principle, you can help reduce the inflammation to the area and jump-start your recovery.
Don’t be alarmed if you are performing some of the balance or strengthening exercises mentioned above and you notice increased swelling to the area. Just make sure you also take plenty of rest throughout your day, elevate your foot ABOVE your heart when you can, and wrap it (snugly) with an ACE bandage or tube sock. Use ice for roughly 20 mins at a time but avoid directly applying it to the skin if you are using a freeze gel-pack.
If you are confused by any of these recommendations or just unsure of the right way to proceed with your ankle sprain, feel free to stop in to Action Potential. We are more than happy to help quickly get you back to your full potential!
1. Holme E, Magnusson SP, Becher K, Bieler T, Aagaard P, Kjaer
M. The effect of supervised rehabilitation on strength, postural sway, position sense and re-injury risk after acute ankle ligament sprain. Scand J Med Sci Sports. 1999;9:104-109. http://dx.doi. org/10.1111/j.1600-0838.1999.tb00217.x
2. van der Wees PJ, Lenssen AF, Hendriks EJ, Stomp DJ, Dekker J, de Bie RA. Effectiveness of exercise therapy and manual mobilisation in ankle sprain and functional instability: a systematic review. Aust J Physio- ther. 2006;52:27-37.