Sprained Ankle: How to Prevent this Common Sports Injury

Whether you’ve tripped in high heels, landed poorly from a jump, or even just made an award step, almost everyone has experienced injuring or rolling their ankle. One of the most common ankle injuries includes an ankle sprain, where the ligaments of the ankle joints are stretched or torn. This injury can be painful and reduce your mobility. 

In the blog post below, Orthopaedic Hospital of Wisconsin physical therapist Cayla Hoof, PT, DPT, of Cedarburg Physical Therapy, explains ankle sprains and provides her top tips for preventing this common injury.  

What is an Ankle Sprain? 

A sprain occurs when there is a stretching or tearing of the ligaments of the ankle joint. A ligament is a tissue that connects bone to bone and helps to stabilize the joint it surrounds. There are many ligaments in the ankle joint, but the most commonly injured are the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and deltoid ligament complex. 

Most commonly, the ATFL and CFL become injured when the ankle is in a plantarflexed and inverted position (toes pointed and facing inward). Instances that may occur include landing strangely on an opponent’s foot or stepping on the outer portion of the foot on different terrains, such as the edge of the sidewalk. Typically the ATFL is injured first. More severe injuries will affect the CFL. 

The rarest ligament that becomes injured is the deltoid ligament complex. This injury typically occurs 15 percent of the time. The deltoid ligament complex often becomes injured by forced eversion with external rotation (toes facing out). This injury mostly happens with an ankle fracture. 

Common symptoms of ankle sprains include: 

• Swelling and bruising of the medial or lateral aspects of the ankle
• Pain and tenderness on the medial or lateral aspects of the ankle 
• Reduced ankle mobility
• Increased pain with weight bearing
• The feeling of ankle instability

How to Prevent a Sprained Ankle?

1. Always warm up before you exercise: Performing any warm-up, especially one that targets the ankle, can assist in the elongation of the ankle muscles and allow for better muscle activation throughout the exercise to reduce the strain placed on the ligaments.
2. Be aware of your surroundings: By being conscious of your surroundings, you can avoid placing your ankle into at-risk positions, such as stepping off the edge of a sidewalk.
3. Stretch regularly: Increasing the flexibility of muscle tissue around the joint can help to reduce the strain placed on the ligaments during activity. 
4. Implement strength training into workout routines: Strengthening surrounding musculature, including core, hip, knee, and ankle, can help to reduce the strain placed on the ankle while performing higher-intensity exercises and repetitive movements.

Exercises/Stretches to perform to prevent ankle injury:

1. Gastroc – Calf Stretching: Start by standing in front of a wall. Place both hands against the wall in a staggered stance. Keep your back knee straight and lean forward into the wall. You should feel a stretch in your back leg’s calf muscle. Hold for 30 seconds and perform three times on each leg. 
2. Soleus – Calf Stretching: Start by standing in front of a wall. Place both hands against the wall in a staggered stance. Bend your back knee and lean forward into the wall. You may need to bring the back foot closer to your front foot to feel a more intense stretch. You should feel this stretch in your back leg’s calf muscle. Hold for 30 seconds and perform three times on each leg.
3. Ankle Circles/Ankle Alphabet: Start in a seated position. Start by making a circle clockwise with your feet/toes. Try not to move your hip or knee while performing. After completing about 30 times, change directions and perform a circle counterclockwise about 30 times. If this feels easy, you can perform the ankle alphabet in all capital letters or lowercase numbers to add more complex motions to the ankle. 
4. Single Leg Stance: While standing in front of a counter, with a chair behind you for safety, place both hands on the counter. Lift one leg from the floor and balance on one leg for 30 seconds. If you can balance, remove one hand from the counter and continue. Perform on each leg three times. 
5. Calf and Toe Raises: While standing in front of a counter with both hands on the counter, lift both your heels off the floor, standing on your tiptoes. Hold for about 2 seconds and then slowly lower. Perform for three sets of 10 repetitions. Next, all toes from the floor, shifting weight onto your heels. Hold for about 2 seconds and then slowly lower. Perform for three sets of 10 repetitions. Do not push your butt back while performing. 

How to Treat a Sprained Ankle?

For most ankle sprains, treatment at home is all that is necessary. Often, you will not need prescription medications or invasive treatment. 

Treatments to provide at home include: 

• Rest: Avoid activities that can cause overuse or strain on the ankle ligaments for about two weeks; however, this can vary depending on the severity of the injury. 
• Ice: Use a cold pack over the ankle or painful area for about 15 to 20 minutes several times daily. Ensure the cold pack is wrapped in a pillowcase or towel to protect your skin. 
• Over-the-counter pain reliever or anti-inflammatory: Try using Tylenol for pain relief or Advil, Aleve, or Mortin for anti-inflammatory effects. Ensure taking any medication with food to avoid an upset stomach. 

If symptoms worsen or persist, consult a physical therapist for conservative treatment. A physical therapist will further examine what may contribute to the pain and utilize manual therapy skills, a specialized exercise program, and education on proper healing and recovery of the muscles and joints affected. They may also refer to a physician if the injury seems more severe and surgery is a consideration. When symptoms start to improve, they may provide modifications, if needed, to assist in progressing back to return to exercise safely. 

To make an appointment with Cayla Hoof, PT, DPT, or any of our skilled orthopedic specialists, call (414) 961-6800 or go online.