Physical Therapy is Crucial After Ankle Sprains, I’ll Explain...
Have you landed on your foot awkwardly while jumping playing basketball? Rolled your
ankle while playing tennis or pickleball? Stepped into a pothole while running? These are just a
few of the many ways an ankle sprain may occur.
Hi! I’m Dr. Matt Feder, a Doctor of Physical Therapy at ASR Physical Therapy in Miami Beach. This blog post will contain information regarding ankle sprains and why it is crucial to receive physical therapy treatment after experiencing one.
Ankle sprains are caused by an excessive stretching force to the ligaments that provide
stability to the foot and ankle joint. This occurs when the joint is moved past its physiological
end-range of motion. These injuries are typically abrupt in nature and can happen in the blink
of an eye. Ankle sprains are highly prevalent within the population, so don’t feel bad if it’s
happened to you. What’s most important is taking the proper steps following the injury.
First and foremost, we will assess what ligaments of the ankle are involved. If you rolled
your ankle outward and have pain on the outside, it is likely you suffered a lateral ankle sprain.
An inward sprain with pain on the inside would be a medial ankle sprain. In addition, a more
severe type of injury known as a high ankle sprain is caused by a combination of inward and
upward motion of the foot typically coming down forcefully from a jump or in contact sports.
It’s important to also know that ligament sprains are also graded on a scale from I, II, and III
from least to most severe.
A grade I would be an over-stretching of the involved ligaments and may or may
not have coinciding pain, swelling, and bruising.
A grade II may have partial tearing of the involved ligaments, increased pain,
swelling, and bruising.
A grade III would be moderate to full tearing of the ligaments and more severe
swelling, pain, and bruising.
In all three types, you may have difficulty bearing weight through that side
initially.
The good news is these injuries will heal with conservative management in
physical therapy.
More severe injuries may require immobilization in a boot however research has
showed that this may not be necessary. Many studies have advocated for functional treatment
instead of immobilization as it provides a more rapid recovery of ankle mobility, early return to
work and physical activity without compromising stability of the ankle. Very rarely is surgery
needed for an ankle sprain. However, if surgery is indicated your return to full function may
take additional time and require longer treatment supervised under a Doctor of Physical
Therapy. It is important for us to know all the aforementioned details of the injury as the
rehabilitation process may look different for each. We don’t recommend WebMD, YouTube, or
Google exercises as the details of the nature of your injury aren’t understood by those
platforms.
Did you know that Physical Therapists are direct access providers in the state of Florida?
This means that you can see a physical therapist for an initial evaluation and follow up sessions
without a referral. Seeking physical therapy first immediately following an ankle sprain will
speed up your healing process, it will also decrease the likelihood of recurrence and decrease
ankle-related medical costs incurred.
What will we do in physical therapy?
First, I will ask you what your goals are. This includes recreational hobbies, work, caring
for your kids, etc... My ultimate goal is to get you back to doing what you love. If I don’t do
that, it would mean I didn’t succeed at my job. I take that aspect of my job very seriously and
will do everything in my power to make sure you return do what you enjoy doing as fast as
possible. With that said, rehabilitation will initially focus on decreasing pain and swelling
progressing to foundational strength, balance, and stability. Once appropriate, we will work on
more functional training that will re-integrate your body into moving how it would pre-injury.
The late stages of rehabilitation will mimic aspects of the sport, hobby, or recreational
activity you would like to return to. It is vital that you complete a comprehensive return to
activity program under the supervision of a physical therapist to ensure your ankle is prepared
for the demands you will place upon it. The last thing we would want for you is the same injury
to occur again. The longer physical therapy is delayed following an ankle sprain the more
common it is to sprain it again. Strengthening your ankle in physical therapy is the gold
standard to preventing recurrent sprains.
Why is physical therapy crucial to my recovery?
One of the biggest complaints I hear from patients is a feeling of lack of confidence in
the ankle following a sprain. In my experience, this is always correlated to a lack of proper
rehabilitation following the injury. An injury of this nature requires graded exposure to selective
tissue stress to send signals to the body to heal. If this doesn’t occur, compensational patterns
may occur which will result in a loss of function. If this sounds familiar, the good news is that it’s
not too late. Confidence can still be restored in physical therapy.
I will list out some of the many benefits of physical therapy for ankle sprains below for your
appreciation:
1. Pain relief
2. Earlier resolution of swelling and weight bearing
3. Improves stability
4. Improves strength
5. Improves confidence
6. Avoid surgery
7. Avoid pain-killing medication
8. Decrease long-term cost associated with ankle related injuries
9. Prevent recurrent sprains
10. Ensures a smooth return to function and sport
At ASR, we take recovery seriously. You can think of your Doctor of Physical Therapy as a
mentor, but for injury rehabilitation. Whether it’s myself or any other of our highly trained
physical therapists we will guide, motivate, and support you through your recovery journey.
If you have recently suffered a foot or ankle injury, set up an evaluation with us as soon
as possible to begin your return to full function.
Any questions? You may contact me at Dr.Feder@asrphysicaltherapy.com – I would love to
help!
References:
1. Naeem M, Rahimnajjad MK, Rahimnajjad NA,et al. Assessment of functional treatment
versus plaster of Paris in the treatment of grade 1 and 2 lateral ankle sprains. J Orthop
Traumatol. 2015; 16:41–6.
2. Kerkhoffs GM, Rowe BH, Assendelft WJ, et al. Immobilization and functional treatment
for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev.
2002;3:CD003762
3. Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment and prevention of ankle
sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018 Mar 7.
4. Lynch SA, Renstrom PA. Treatment of acute lateral ankle ligament rupture in the
athlete. Conservative versus surgical treatment. Sports Med. 1999 Jan;27(1):61-71.
5. Rhon DI, Fraser JJ, Sorensen J, Greenlee TA, Jain T, Cook CE. Delayed Rehabilitation Is
Associated With Recurrence and Higher Medical Care Use After Ankle Sprain Injuries in
the United States Military Health System. J Orthop Sports Phys Ther. 2021;51(12):619-
627. doi:10.2519/jospt.2021.10730