PT Resources

Ankle Sprains




Ankle sprains most often occur during activities which have some degree of impact or cutting and pivoting involved. Non-contact injuries occur when the foot either plants on an uneven surface or gets caught as a change in direction takes place. Contact injuries are as a result of some outside force causing the person to get caught off balance and the ankle twists trying to compensate for this position.

The most common kind of ankle sprain is the inversion sprain where the foot is turned inward relative to the ankle. This may coincide with a “pop” being heard at the time of the injury. Pain and swelling are usually immediate.

After suffering from a twisting injury to the ankle, the main stabilizing ligaments on the outside of the ankle have been stretched. The amount of swelling, pain and immobility often reflect the degree of the sprain. Once a sprain has occurred, immediate application of ice for 15 minutes 3-5 times a day coupled with elevation above the level of your heart is imperative to reduce swelling and inflammation. It is important to follow-up with a physician to make sure that there is not a fracture and to discuss the best immobilization approach.

These exercises are for a Grade I-II sprain without any visible sign of associated fracture.

* Gradually progress weight bearing with the use of a splint or walking boot as tolerated. As soon as full weight bearing is comfortable without signs of a limp, then wean off the crutches. Use them to assist in walking the meantime.

* 5 – 10 times a day, these exercises can be performed inside or outside of the boot/splint, sitting in a chair and with the heel on the ground. Hold each for 5 seconds and repeat 10-20 times:

  • Toe curls and toe spreads
  • Actively lift toes and the front of the foot upwards.
  • Using your opposite foot as resistance, keep your heel on the ground and turn the front of your foot inward.
  • Using an immovable object as resistance (i.e. table leg), keep your heel on the ground and turn front of foot outward against it.

* Seated, keeping knee bent 90 degrees, pick up pencils/marbles with toes and place down next to you.

* Seated in a chair on a hardwood or slick surface, keeping knee bent 90 degrees and a towel under your foot, curl the towel under your foot 5-10 times. Repeat the same with the knee bent about 60-50 degrees.


  • Stationary cycling, upper body workouts or pool exercises in boot or splint are



Michael J. Mullin, ATC


This group of exercises are to be performed 2-4 weeks after a Grade I-II sprain and clearance from your physician.

Calf stretches: standing with one leg behind you pointed straight ahead and heel on the ground, slowly lean forward until a stretch is felt in the calf muscle / hold 20 sec. / 3 times

  • -perform with leg straight
  • -perform with leg slightly bent

Calf raises: standing with balls of your feet on a step, go up onto toes and then lower heels below the level of the step / perform 2 sets of 15 reps and progress to single leg raises as able

Theraband: band wrapped around forefoot with heel on the ground

  • -turn ankle inwards against band
  • -with knee bent 90°
  • -with knee bent 20°
  • -turn ankle outwards against band
  • -with knee bent 90°
  • -with knee bent 20°

Calf raises with theraband: perform a single leg calf raise on the ground

  • -with band around ankle / pulling heel inwards
  • -with band around ankle / pulling heel outwards

Balance exercises:

  • -single leg balance on a folded fleece blanket or couple of pillows hold 20-30 sec. and repeat 5 times in varying knee angles
  • -progress to performing with your eyes closed
  • -single leg balance and pulling a band across the front of the body in a diagonal pattern with arms straight / both directions

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