Chances are you or someone you know has sprained an ankle at some point. This occurs when the ligaments that support your ankle get injured or tear, which can happen during sports (say, a pick-up basketball game) or your usual daily activities (stepping off a curb and “rolling” your ankle).  

While they can definitely be frustrating, most ankle sprains heal well with some simple self-care measures like ice, over-the-counter medication, elevation, and ankle rehabilitation exercises. The last one is especially key. “A mix of ankle exercises that includes strengthening, balance training, and agility will not only help your ankle heal better but can also protect you from potential future injuries,” says Caitlin Shaw, PT, DPT, a physical therapist at Hinge Health. Not only that, but doing simple at-home exercises can help you get more active and return to doing the activities you love.

Here’s everything you need to know about different types of exercises for ankle sprain rehabilitation so you can keep your ankles strong and healthy.

Rehabilitating a Sprained Ankle

There are three types of ankle sprains, says Dr. Shaw, including:

• Grade 1. This means there’s slight stretching and microscopic (tiny) tearing of an ankle ligament. Hearing that your ligament is torn (even slightly) can sound scary. And while you may notice mild tenderness, bruising, and swelling, you can put weight on your ankle and walk around with a grade 1 sprain. You’ll likely be able to return to normal physical activity in a couple weeks, says Dr. Shaw.

• Grade 2. This is a partial tear that causes moderate tenderness, bruising, and swelling, and it’ll hurt to put weight on your ankle. You can usually still walk on a grade 2 sprain, but you’ll probably need to scale back and take it easy with your activities for about six weeks while you do exercises to help the healing process. 

• Grade 3. This is when the ligament tears completely. These sprains can cause more significant tenderness, bruising, and swelling, and they usually require crutches or another assistive device that prevents you from putting your full weight on the ankle. Full recovery can take about 12 weeks, but it’s worth noting that grade 3 sprains are more rare and tend to occur from things like a major sports collision, not everyday activities. 

Most ankle sprains that people experience can be treated with conservative measures and typically don’t need surgery. For the first two to three days, your doctor will recommend some self-care measures: resting the ankle (note: this doesn’t mean zero activity; it means minimizing intense activities), icing and elevating, and taking over-the-counter pain medication as needed. After that, you can start ankle rehabilitation exercises. 

Ankle Sprains: A Hinge Health Perspective

Hearing words like “sprains” and “tears” can be really alarming. And if you’re like most people, you may assume that you need to stay off your injured leg altogether until the pain subsides. The truth is, movement actually helps healing. 

Your ankles are incredibly strong and resilient, and they have the amazing ability to heal. A few weeks of targeted exercises can go a long way. And in the meantime, there are plenty of ways you can continue to move your body — and challenge your ankle to promote healing — without overdoing it (e.g., seated upper body exercises, going for short walks, and swimming). 

Physical Therapy for Ankle Sprains

No matter what type of sprain you have, physical therapy can really help you heal. And while you may be tempted to wait until the pain or swelling has gone away completely, it’s really better to start working with a PT sooner rather than later because research shows that loading it, moving it, and using it is what helps your ankle heal and keeps it strong and healthy over time.

Here are the four types of exercises your PT may recommend:

• Range of motion exercises, which help prevent stiffness. You should start these exercises shortly after your ankle sprain. 

• Strengthening exercises. Once swelling and pain have improved, you should do exercises to strengthen your leg and ankle muscles. For more serious sprains, you may start with water exercises.

• Proprioception (balance) training. Improving your balance can improve your ankle stability, says Dr. Shaw. Your physical therapist can show you exercises you can do throughout the day to boost your balance. For example: standing on the affected foot with the opposite foot raised and your eyes closed.

• Agility drills. Moves such as running in small figure 8s help increase calf and ankle strength and range of motion. This can help prevent future sprains.

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit to personalize an exercise plan for you. Your PT can also help you make any adjustments to your usual exercise routine and daily activities so you can stay as active as possible.

“An ankle sprain can limit motion in the talus, the bone that makes up the lower part of the ankle joint,” says Dr. Shaw. This can make it harder to walk. That’s why it’s so important to do ankle range of motion exercises, which you can start a couple of days after your injury (or sooner if you feel up to it). 

A common exercise recommended by physical therapists involves using your foot to “write” the letters of the alphabet in the air. This uses all the muscles in your ankle, allowing you to feel it at the top of your foot and throughout your entire ankle. These are other range of motion exercises recommended by Hinge Health physical therapists.

You can begin stretching exercises around the same time that you start range-of-motion exercises. These are the stretches for sprained ankles most commonly recommended by Hinge Health physical therapists.

Strengthening the muscles that support your lower leg, foot, and ankle keeps your ankle joint strong and stable. It also helps relieve ankle pain and prevents further injury. Hinge Health physical therapists recommend these ankle strengthening exercises.

In addition to stretching, strengthening, and range of motion exercises, addressing balance is an important part of caring for your ankle and preventing future injuries. “Your proprioception, or balance, is affected when you initially sprain your ankle,” explains Dr. Shaw. “Doing rehabilitation exercises that target balance can keep your ankles healthy, especially during situations that can challenge your balance, like running on an uneven surface or stepping on or off a curb.” These are the balance exercises most highly recommended by Hinge Health physical therapists. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Show Your Ankle Some Love

"Many people just ignore an ankle sprain and, once the initial swelling and pain has gone down, they’re back to their normal routines again," says Dr. Shaw. It’s important to remember that surrounding ankle muscles and ligaments can weaken after an injury, which is why movement and rehabilitation are so important after an ankle sprain. Strengthening them and doing exercises like the ones in this article can help keep your ankles strong now and in the future. Even a minor sprain deserves some love and attention. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Kruckeberg, B. M., Beahrs, T., & Haddad, S. L. (2022, April). Sprained Ankle. OrthoInfo — American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/sprained-ankle/

2. Herzog, M. M., Kerr, Z. Y., Marshall, S. W., & Wikstrom, E. A. (2019b). Epidemiology of Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training, 54(6), 603–610. doi:10.4085/1062-6050-447-17

3. Kucera, K. L., Marshall, S. W., Wolf, S. H., Padua, D. A., Cameron, K. L., & Beutler, A. I. (2016). Association of Injury History and Incident Injury in Cadet Basic Military Training. Medicine & Science in Sports & Exercise, 48(6), 1053–1061. doi:10.1249/mss.0000000000000872

4. Wagemans, J., Bleakley, C., Taeymans, J., Schurz, A. P., Kuppens, K., Baur, H., & Vissers, D. (2022). Exercise-based rehabilitation reduces reinjury following acute lateral ankle sprain: A systematic review update with meta-analysis. PLOS ONE, 17(2), e0262023. doi:10.1371/journal.pone.0262023