I can just see it. Your athlete is running. Almost in slow motion you see them land awkwardly on their foot. Their Ankle starts to roll inwards and you just think to yourself… “damn”. They hit the ground and, shaking your head, you walk over to assess how bad it is.

So many times this has happened to me. It’s so frustrating. Ok, time to figure out the plan. What have they done? How bad is it? How long will it take to get better? What exercises should they be doing?

Let me run you through an example of an athlete I recently rehabilitated through an ankle sprain. Hopefully this will give you an idea of the process and what you can do to help moving forwards.

Firstly I need to preface this article by saying any injury should be initially assessed by a healthcare professional. They should also be in charge of the overall rehabilitation plan and it’s very important not to step outside your scope of practice or you can land yourself in a bit of trouble.

Ok, so Ethan is a 14 year old football (soccer) player. He plays for an elite development program and needs to get back to sport ASAP.

Ethan rolled his ankle in a game and was able to limp off the field. Upon examination I determined he hadn’t fractured his ankle but had fully ruptured one of the 3 ligaments on the outside of his ankle (the ATFL).

One of the first things I get an athlete doing if they sprain their ankle is to walk properly on it, in a safe environment and not for too long. This plays a massive role in their initial recovery and healing. It articulates the ankle joint to ease up any stiffness, it re-connects the muscles around the ankle to the brain (neuromuscular connection) and improves circulation through the ankle and leg. The leg relies on the muscles to pump fluid through so if the athlete spends too much time sedentary, the ankle can get congested which will slow healing. Please note: this is only if I’ve cleared the athlete from having a fracture.

Phase 1 (2 weeks):

• Walking
• Single leg balance
  • Straight leg X 1 min
  • Bent leg X 1 min
• Alphabet with ankle
• Calf stretch (straight leg) X 45 secs

This is an example of my phase 1 for Ethan. We are aiming to restore normal ankle range of motion (ROM), reduce swelling, normalise muscular tone and start to rehabilitate proprioception (the body’s sense of balance). I would also combine this with manual therapy.

Phase 2A (2 weeks):

• Star excursion 3 X 1 full circle
• Ankle eversions with theraband 3 X 10
• Calf stretch
  • Straight leg X 45 secs
  • Bent leg X 45 secs

My second phase involves more significant stability and proprioception retraining. I also like to isolate and target the peroneal muscles in this phase as they’ve often been damaged as a result of the injury. I try to keep this phase broken up into 2 parts. This is because I want to introduce plyometrics (jumping/hopping) as soon as possible but for the first 2 weeks I want to safely progress stability first.

Phase 2B (2 weeks):

• Star excursion 3 X 1 full circle
• Ankle eversions with theraband 3 X 10
• Calf stretch
  • Straight leg X 45 secs
  • Bent leg X 45 secs
• Broad jump (landing focus) 3 X 5
• Hopping on spot 3 X 5
• Hopping (up and back):
  • Forward X 5
  • Side (each) X 5
  • Diagonal (forward & backward) X 5

Phew that’s a fair chunk of information. Take your time chewing on that and go over it again if necessary.

Stay tuned for Part 2

Cheers,

Charlie

Dr. Charles Shipley (Osteopath)
Osteopath, Coach, Presenter, Assessor
Director of Protect Performance

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