An ankle sprain is one of the most common musculoskeletal injuries across all sports; from football to running, from rugby to simply walking. A sprain occurs when the ankle is usually ‘rolled’ (inverted) and can be a contact or non-contact injury. Typically, there is damage to the ligament or ligaments on the outer (lateral) side of the ankle, which helps support the joint.

Justin Yeoh, Sports and Exercise Medicine Consultant who consults at Prime Health in Weybridge, Surrey has treated countless patients, including many professional sports players, for a sprained ankle. Justin advises that while the treatment and management of such an injury can be straightforward, for many patients, ensuring a quick return to activity and minimising any long-term damage, is paramount and their top priority. Here, Justin shares his expert advice and recommendations for treating a sprained ankle and the transition to returning to activity.

How to treat an ankle sprain

If you sprain your ankle, follow these simple steps in the first few days after the injury.

• REST – Avoid any exercise or activities that will aggravate the injury.
• ICE – Apply an ice pack to the ankle injury for up to 10 minutes every 2 to 3 hours.
• COMPRESSION – Wrap a bandage or use a Tubigrip around the ankle to reduce swelling.
• ELEVATE– Keep your ankle elevated as much as possible.

After treating the initial injury, the road to recovery requires patience and caution. As well as needing time to repair the damaged tendons, it is also important to build strength back into the ankle. Returning to activity too quickly may cause further damage. Justin Yeoh shares the exercise which he would recommend to his patients who wish to return to sporting activity quickly and safely.

5 simple tactics to return to activity quickly and safely after an ankle sprain

1. Strength Exercises

Equipment: Resistance Bands

This exercise will help target the muscles on the outer aspect of the ankle. This will strengthen the ankle and help prevent future injuries.

Strengthening eversion (the ankle moved outwards against resistance) can be done with a resistance band, which can be purchased online. You can do 15 to 30 repetitions of resisted eversion twice per day. The difficulty can be increased by using resistance bands with more tension.

In addition, calf raises will help strengthen the ankle. This can be done using a wall or chair for support and going up onto tiptoes 15 to 30 times, twice per day. This is initially done on two feet, but the difficulty can be increased by doing only on the injured side.

These exercises can be started when pain and swelling allow, thus when comfortable to do so, but ideally as soon as possible

2. Balance and Proprioception Exercises

These exercises will be crucial to improve the stability of the ankle. Stand on the affected side balancing for 30 seconds. This can be repeated three times, twice per day. These exercises can also be started when more comfortable, but better as soon as able. The difficulty can be increased by doing the exercises with your eyes closed. This exercise can also be done on an uneven surface or wobble (Bosu) board.

To make the exercise more functional as the stability improves ‘hop and hold’ type exercises can be done. This involves jogging on the spot for a couple of seconds then hopping onto the affected side and ‘sticking’ the landing.

3. Fitness

It is important to keep up your cardiovascular capability. Initially running will not be possible but cycling on a stationary bike can still be done. This will help reduce swelling as well. When running is possible you should aim to achieve the same level of fitness (or ideally better) than pre-injury before returning to sport. Fatigue is a risk factor for injury recurrence, so maintaining fitness when you return to activity will reduce the chance of a repeated issue.

4. Sports Specific Activity

Whatever activity you want to return to, your rehabilitation should incorporate specific aspects of this sport. This may include doing a change of direction work to put the lateral ligament through stress and testing the suitability to return to sport. There should be a gradual re-introduction of sport, for example in football, playing 45 minutes of a match then 60 minutes for the next game leading into a full 90 minutes.

5. Maintenance

When you’ve returned to full fitness it is important to keep doing the basic exercises described above. This will have the aim of preventing a re-injury. Strapping can be helpful to give extra support and is preferable to an ankle brace. You can be taught to do your own strappings. These should be continued for at least 6 months.

A consultation with a Sports and Exercise Medicine Doctor for this injury is very beneficial. When presenting with a recent ankle sprain, a thorough clinical examination will be performed. If appropriate, an ultrasound scan can be done during the appointment to aid diagnosis. This saves waiting for a more advanced imaging scan, such as an MRI. Once a clear diagnosis is made a management and rehabilitation programme can be devised specifically for you and your specific injury. A Sports and Exercise Medicine consultant can guide you through this process, whether it is from the initial injury or at the end stage and getting you back to exercise. This will allow a safe return to activity as soon as is possible and will minimise the risk of future injury.