Ankle sprains are a common injury that many basketball players of any playing level suffer, primarily due to the frequent jumping these athletes are required to do. Ankle sprains most commonly occur upon landing from a jump or applying weight to the foot when it is in an inverted (rolled in) or everted (rolled out) position. Ninety-five percent of all ankle sprains involve the lateral ligaments, which results from weight-bearing with the foot plantar-flexed (foot/toes pointed down) and inverted. Ankle sprains are classified by degree of severity as follows:

• Grade One: no loss of ankle function, with minimal disruption/tearing of affected ligaments
• Grade Two: some loss of ankle function, with partial disruption/tearing of affected ligaments
• Grade Three: complete loss of ankle function, with complete tearing of affected ligaments

First steps to take when suffering an ankle sprain:

For immediate treatment of an ankle sprain, an athlete should utilize the RICE method (outlined below) for 24-48 hours to minimize swelling. An over-the-counter anti-inflammatory medication, like Motrin or Aleve, can be taken to help further reduce inflammation in the ankle following injury. For further pain relief the athlete can take Tylenol, which is an over-the-counter Acetaminophen medication. The athlete should seek medical attention as soon as possible if he/she is unable to bear weight through affected ankle. Medical attention should also be sought if swelling or pain has not improved within 48-72 hours.

• Rest: avoid or limit weight bearing activities
• Ice: ice the injured ankle for about 20 minutes every 2 hours
• Compression: wrap the ankle in an ACE bandage starting at the toes and ending at the calf
• Elevation: raise the injured ankle above the hip

Components of ankle rehabilitation:

Goals for ankle rehabilitation are focused on regaining ankle strength, joint range of motion and flexibility, proprioception/balance, agility and sports specific activities. Below are examples of basic exercises that may be used to achieve these goals. These exercises can be used for ankle rehabilitation or prophylactically to maintain ankle stability and mobility throughout an athlete’s season. When performing these exercises for rehabilitation purposes, it is important to remember that they should be pain free.

Strengthening Exercises:

• Step-ups
• Isometric contractions in all planes
• Concentric contractions against Thera-band or resistance tubing in all planes
• Heel and toe raises
• Heel and toe walking
• Towel curl ups

Range of Motion and Flexibility Exercises:

• Standing calf stretch
• Seated towel gastrocnemius and soleus stretch
• Ankle alphabet
• Ankle circles

Proprioception/Balance Exercises:

• Single leg balance (eyes open and progress to eyes closed)
• Single leg balance on unstable surface (eyes open and progress to eyes closed)
• Single leg squats
• Single leg squat and reach
• Balance board squats
• Mini trampoline jumping

Why is rehabilitation important after an ankle sprain?

Complications at the ankle and other lower extremity joints can result from incomplete or lack of rehabilitation after an ankle sprain. Range of motion, flexibility, strength, and proprioceptive impairments as well as pain may persist and become chronic conditions without rehabilitation after an ankle sprain. If these impairments are left unresolved the athlete may experience functional mobility difficulties and difficulty or delay in full return to athletics. Strength and range of motion impairments in the ankle can result in poor lower extremity biomechanics during movement which can lead to inappropriate forces being put through the knee and hip joints. These abnormal forces can result in pain, muscle imbalances, or musculoskeletal conditions at the joints proximal to the ankle. Overall, rehabilitation after an ankle sprain is crucial to maintain appropriate biomechanics throughout the lower extremity and prevent new injuries.

The author of this article is Lauren Mulac, PT, from Athletico Mount Greenwood- Beverly.