Question: I sprained my ankle 2 weeks ago and it has improved, but is still swollen and I have not been able to return to running because it hurts. I have sprained the same ankle 2 times in the past. This sprain is the worst and taking longer to get better. Do you have any suggestions? Would physical therapy be helpful?
Answer: First off, you want to make sure you take the right steps to maximize your healing process. The common ankle sprain usually involves both muscular and ligamentous damage. These tissues take a long time to heal completely, approximately 12 weeks in a healthy person. For this reason, you have to be extremely careful to not re-injure the ankle during this time as this will interrupt the healing process. I often recommend complete avoidance of activity and bracing for the first 2 weeks along with ice and elevation several times a day to minimize swelling. After this initial stage you can begin to reintroduce range of motion and gentle stretching over the next few weeks in order to correct for any tightness that may have developed during the immobilization phase.
Finally, somewhere between 4 and 8 weeks you will need to begin strengthening the ankle. Ankle injuries are often looked at as being common and “no big deal” and thus not rehabilitated appropriately. In fact, these injuries can often result in significant functional loss, especially with high level athletic activities. Your ligaments are crucial in giving your brain feedback as to where your body parts (in this case your ankle) are located in space, a phenomenon called “proprioception”. When these ligaments are injured, your proprioception becomes impaired. With an impaired ability to sense our foot positioning we become more susceptible to future sprains, which is what happens to so many young athletes.
Physical Therapy focuses on dynamic balance activities and strenthening in order to restore your proprioception and reduce your risk of re-injury. While not necessary for everyone with an ankle sprain, athletes who desire to compete at their pre-injury level and beyond benefit greatly from proper rehabilitation.
We hope this helps!
Jeff Moore, DPT, MTC
