How to Strengthen Your Ankle After a High Ankle Sprain
High ankle sprains are an injury that you’ve heard about happening - to football players, rugby players, soccer players, and runners alike.
What is a High Ankle Sprain?
It’s a sprain or stretch of the syndesmosis in the lower leg, which is made of several connective tissue ligaments that connect the tibia and fibula bones.
This injury happens when the foot is forcefully turned inward or outward relative to the ankle with the foot dorsiflexed up toward the knee. Usually accompanied by pain, swelling, and sometimes discoloration, a high ankle sprain will make it difficult to walk due to pain in the lower leg and ankle.
What we'll cover in this blog: How to strengthen your ankle after a high ankle sprain, how to get the best treatment for a high ankle sprain, and some specific exercises to add in to your training.
Getting the Best Treatment for a High Ankle Sprain
A high ankle sprain can require a little more healing time, but the good news is that it tends to respond well to physical therapy treatment. While the mechanism of injury is a good indicator of a potential high ankle sprain, there are quite a few different tests and measures that a physical therapist can do to confirm and get you started on the best course of treatment. Two of the most common tests for a high ankle sprain are the dorsiflexion with external rotation test and the squeeze test, which your therapist will likely do.
What Could Prolong Healing for A High Ankle Sprain?
Ignoring the injury and trying to “play through” the pain. This won’t fix the problem and it might even make it worse. The joints around the ankle can stiffen up and it can perpetuate inflammation in the lower leg. By continuing to play despite injury you’re setting yourself up for increased risk of other injury, repeated ankle sprains, and an ACL tear.
Complete rest for two weeks (or more) and just hoping that it magically heals. Here’s the deal, I’m not saying you need to go bananas with your training. But absolute rest usually isn’t the solution either because it doesn’t address the stability or mobility of the surrounding joints. Getting some movement, as prescribed by your physical therapist, is a great way to increase circulation, maintain your range of motion, and gradually load the ankle so that you can return to your sport when you’re ready
Ideally, you're maintaining range of motion early on for the sprained ankle by tracing the letters of the alphabet (literally called ankle alphabets) multiple times a day and then adding gentle strengthening, too.
How To Strengthen Your Ankle After a High Ankle Sprain
You get the idea - get physical therapy treatment ASAP after a high ankle sprain so that you’re on the road to recovery without wasting time. But once you’re a few weeks down the road and pain is reduced significantly, you can start doing more exercises to help strengthen your ankle and reduce the risk of reinjury.
Balance and unilateral exercises are key to help strengthen, increase endurance, and improve proprioception (your body’s ability to sense movement or action and know where the body is at in relation to other things), all of which help to decrease your likelihood of further injury.
These are some of my suggestions for strengthening your ankle after a high ankle sprain:
Always work on single leg standing balance exercise
Unilateral strengthening exercises
Work on agility exercises
Add plyometric movement and jumping
Always Include Balance Exercises
This element is crucial and often overlooked in strengthening programs. It helps to build proprioception in the ankle and foot, improve muscle reaction time, and helps to stabilize and build endurance in the ankle.
Start with single leg standing balance exercise flat on the floor and then advance to using a foam pad, Bosu ball, balance disk, inclined or declined surface as you improve. Make it challenging! On a Bosu ball you can also do other stabilization exercises such as double leg squats, single leg squats, and glute bridges to add a little variety.
Single Leg Strengthening
I’ve said it before and I’ll say it again, single leg strengthening is one of the best things you can do in your program to supplement the other bigger lifts that you’re already doing. It also has the added benefit of reducing your risk of future injury.
Here are some of my favorite single leg exercises:
Bulgarian split squats
Single leg squats
Lunges (multidirectional)
Single leg press on the machine
Single leg RDLs
Single leg glute bridges
Introduce Agility and Add Plyometrics
Start with a little more controlled jumping and loading for the ankle, then progress it from there. I like to empower patients with success in their program and make advancements as they improve toward their goals.
Plyometrics and agilty really focus on maintaining strength and balance on both legs, as well as ensuring that the Achilles tendon and your calf muscle are ready to go back to sport.
These are some of the exercises you might advance through in your plyometric program:
Mini bounces and jumping in place
Pogo jumps
Ski jumps - side to side, forward and backward
Depth jumps
Single leg hopping for height
Single leg jumping - side to side, forward and backward
Bounding
Final Thoughts
High ankle sprains can be a real bummer, but there’s a lot you can do to ensure you maximize your recovery. Start with looking into physical therapy with a sports physical therapist, where they can supplement your exercises with manual therapy interventions to make sure the ankle and surrounding areas are moving as they should.
The hands-on manual therapy treatment is the one thing that you can’t really do yourself.
Strengthening exercises after a high ankle sprain should include elements that address balance, single leg strength, agility, and of course, progression toward plyometric exercises and jumping.
I hope this program helps you make a speedy recovery after your high ankle sprain.
Happy healing!
Where to get treatment for a high ankle sprain
At Game Changer PT, I work with athletes of all kinds: soccer players, football players, hockey players, the active adult, runners, and more. I’d love to help you recover from your high ankle sprain. Feel free to schedule your free discovery call today to get started.
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