Immediate care and recovery exercises
About your injury
This injury is commonly termed as a sprained ankle, which means that your ankle ligaments have been overstretched or in some cases torn. This injury can affect one or both sides of your ankle.
This can be a very painful injury and can cause problems with movement and walking in the early stages of injury. It can take several weeks to make a complete recovery.
The most common symptoms are:
- Difficulty putting weight on the injured ankle.
For the first 48 hours it is important to rest with your injured leg elevated on pillows higher than your waist level.
Whilst your leg is rested it is also beneficial to apply ice to the injured area. Put the ice in a sealed plastic bag with a cloth around the bag to protect your skin from ice burns.
Apply the ice-pack every hour for 15 minutes. (For children apply ice for only five minutes every hour).
During the first three days it is also important to take regular painkillers as advised by the nurse practitioner or doctor. This will help to reduce inflammation in some cases and enable you to start moving your ankle which will aid recovery.
During the first 48 hours of your injury it will remain painful to walk on your injured ankle. In most cases this improves after you have rested and applied regular ice packs. Unless you are advised otherwise, it is safe to walk slowly and over short distances without making your injury worse. If you walk too far or for too long your ankle may become more swollen and then in the end take longer to heal.
Whilst you are resting it is helpful to introduce small movements of your ankle, such as – small ankle circles or small pedal type movements.
After 48 hours it is important to try and start to walk.
Try to keep as near normal walking action as possible, do not hop as this is less safe and may cause you to fall.
When you start walking for the first time it can be painful; if so sit with your ankle elevated after each time that you walk.
If you are still unable to put any weight on your ankle after a week, or your condition does not improve, please contact your GP as you may require physiotherapy.
If after a week you are able to start to walk around with little pain it is important to then begin some strengthening and flexibility exercises as this will prevent stiffness in your ankle and will help to avoid re-injury, particularly if you play sport.
Flexibility exercises are aimed at restoring and maintaining range of movement in your ankle and should be performed at regular intervals throughout the day, for approximately two weeks.
As soon as you can tolerate pressure on the ball of your foot, you can begin stretching your ankle using the exercises below:
- Point your toe then pull your foot up towards you as hard as possible.
- Spread out a towel on the floor and try to pick up the towel by gripping it with your toes – repeat this ten times.
- Sit on a hard surface with your injured leg stretched out in front of you.
- Loop a towel around your foot and pull your foot towards you. Hold for 20 seconds and relax for 20 seconds.
- Pull the towel so that your foot moves to the side. Hold for 20 seconds in one direction and then the other.
- Bend your knee to 90 degrees, keep the towel around the ball of the foot and pull back for, put your hands against the wall at eye level. Stretch your injured leg out straight but behind you, move your uninjured leg forwards. Lean forward and push gently against the wall whilst keeping your injured leg heel flat on the floor. Repeat three times. This will improve the flexibility of your achilles and calf areas.
- Pretend you are writing each of the letters of the alphabet with your foot whilst resting. This will move your ankle in all directions. Do this exercise twice.
If you can do the above exercises comfortably, proceed onto the following to add some ankle strength.
- Whilst standing and holding onto the back of a chair for balance, rise up onto your toes, hold for five seconds and then lower yourself down. Repeat ten times. Do three sets of ten.
- Whilst standing in a normal weight bearing position, rock back onto your heels, lifting your toes off the ground. Hold this position for five seconds. Repeat ten times. Do three sets of ten.
- Stand without any support and attempt to balance on your injured leg. Begin with your eyes open and then try to perform the exercise with your eyes closed. Then try it with your knee bent. Hold the single-leg position for 30 seconds. Repeat three times.
Exercises using an exercise band
- Secure an exercise band under the base of a door with the opposite end attached over the front of your foot (see image ‘A’). With the band tense and your leg outstretched pull your toes toward your face (see image ‘B’). Return slowly to the starting position. Repeat ten times. Do three sets of ten.
- Sitting with your leg outstretched, loop the end of the band around your mid foot area, whilst holding the other end of the band with both hands assume a sitting down rowing position. Gently press the ball of your foot down and point your toes, stretching the band. Slowly return to the starting position. Repeat ten times. Do three sets of ten.
- Sit with your legs out straight and cross your uninjured leg over your injured ankle. Wrap the band around the ball of your injured foot then loop it around your uninjured foot so that the band is anchored at one end. Hold the other end of the band in your hand. Turn your injured foot inward and upward with the band under tension. Slowly return to the starting position. Repeat ten times. Do three sets of ten.
- Sitting with both legs outstretched and the band looped around both feet, slowly turn your injured foot upward and outward. Hold this position for five seconds. Repeat ten times. Do three sets of ten.
These exercises should be continued for two weeks.
If the above exercises can be completed without discomfort, you can begin light jogging on the ankle.
This should be done initially on a flat surface and jogging should be done only in a straight line.
Alternate jogging with walking every quarter mile for the first few days and slowly increase jogging time.
NB: Keep in mind that initially exercise may not hurt at the time, but if your ankle is painful afterwards, you are progressing too quickly, and should reduce time and distance until it is comfortable. You can always build up again.
From jogging, progress to sprinting in a straight line for short bursts.
If comfortable then you can start to include cutting and side-to-side actions whilst running. Well-fitting trainers should be worn during exercise.
If all of the above can be done without causing any discomfort during or after the exercises, you can attempt to return to regular sporting activity.
Ensure that you stop if you experience any discomfort. Trying to speed up recovery time before you are ready could increase the time it takes your injury to heal.
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NHS Foundation Trust
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