Ankle Rehabilitation

Early Rehab

1. Range of Movement exercises – 10 times each direction, 3 times/day. Push hard in all
directions
a. Toe point (flex/ext)
b. Inversion/Eversion
c. Circles
d. Alphabet
2. Stretching
a. Towel Achilles stretch – hold for 30s, repeat 3 times
b. Progress to standing calf stretch and soleus stretch
3. Resistance ROM or 20 reps/5 daily
a. Resisted ankle dorsiflexion. 3 sets of 10
b. Resisted ankle plantar flexion. 3 sets of 10
c. Resisted ankle inversion. 3 sets of 10
d. Resisted ankle inversion. 3 sets of 10
4. Short foot exercise (contract arch muscles)

Start proprioception exercises as soon as pain allows:

1. Balance on affected leg whilst partial weight-bearing. Do for 1 minute followed by rest
period.
a. Make harder by crossing arms; then closing eyes
b. Then add unstable surface eg foam mattress
c. Do reaches in all directions with other leg; do slowly
2. Tri-band kicks (backwards leg swings with resistance band); can put other leg on unstable
surface

When able to stand on injured ankle without pain:

1. Heel raises. Hold for 5 seconds then slowly lower; hold onto chair if needed. Progress to one
leg only. 3 sets of 10
a. Progress from wall to no wall, then standing on a block so hells come lower down
before pushing up. Finally progress to single leg only.
2. Step-up: Stand with the foot of your injured leg on a support (like a small step or block of
wood) 3 to 5 inches high. Keep your other foot flat on the floor. Shift your weight onto your
injured leg on the support straighten your knee as the other leg comes off the floor. Lower
your leg back to the floor slowly. Do 3 sets of 10.
3. Balance and reach exercises
a. Stand upright next to a chair with your injured leg farthest from the chair. This will
provide you with support if you need it. Stand just on the foot of your injured leg. Try
to raise the arch of this foot while keeping your toes on the floor.
i. Keep your foot in this position and reach forward in front of you with the
hand farthest away from the chair, allowing your knee to bend. Repeat this
10 times while maintaining the arch height. This exercise can be made more
difficult by reaching farther in front of you. Do 2 sets.
 ii. Stand in the same position as above. While maintaining your arch height,
reach the hand farthest away from the chair across your body toward the
chair. The farther you reach, the more challenging the exercise. Do 2 sets of
10
4. Jump rope: Jump rope landing, on both legs, for 5 minutes, then on only one leg at a time for
5 minutes.
5. Wobble board exercises:
a. Stand on a wobble board with your feet shoulder width apart. Rock the board
forwards and backwards 30 times, then side to side 30 times. Hold on to a chair if
you need support.
b. Rotate the wobble board around so that the edge of the board is in contact with the
floor at all times. Do this 30 times in a clockwise and then a counterclockwise
direction.
c. Balance on the wobble board for as long as you can without letting the edges touch
the floor. Try to do this for 2 minutes without touching the floor.
d. Rotate the wobble board in clockwise and counterclockwise circles, but do not allow
the edge of the board to touch the floor.
e. When you have mastered exercises A through D, try repeating them while standing
on only one leg (your injured leg).

Once you can stand and balance on the ball of the injured foot for 20 seconds and have regained full
range of motion, begin a jogging program on a flat, smooth surface for up to 20 minutes. When
finished ice the ankle for 20 minutes. When you are able to run on a field or court in a large figure
eight pattern at quarter speed, advance to half speed and then full speed. At that point, you can
return to full activities.

Jogging

 Day 1: Jog 100m, walk 50m, with 6 reps

 Day 2: Jog 150m, walk 50m, with 6 reps
 Day 3: Jog 200m, walk 50m, with 8 reps
 Day 4: Jog 200m, walk 50m, with 12 reps
 Day 5: Jog 2000m

Late Rehab
Once you can jog without pain and comfortable doing plyometric drills – aim to progress to high
intensity. Make sure to warm up before these exercises. Following exercises are a progression and
should be completed at least one day or more apart. See
http://www.physioroom.com/injuries/ankle_and_foot/ankle_sprain_exer5.php for all details. See
also http://www.physioroom.com/injuries/supplements/ankle_plyometrics.php for plyometric drills.

1. Variable pace running with gradual introduction of turns. Run around a 20m diameter figure-
of-eight course. The session should last about 25 minutes.

Wear the brace for the first 2-3 weeks whenever you are putting weight on your injured ankle
Wear the brace during activities for as long as needed

Walk by putting heel on the ground first, then toe