Ankle Sprain

An ankle sprain happens when an ankle ligament—which is the fibrous tissue that connects one bone to another—gets stretched or torn.

Causes

There are a number of reasons why an ankle sprain may occur. Some common ones include:

• Landing awkwardly while playing sports
• Walking or running on an uneven surface
• Improper sport technique from working out when fatigued or over training

Symptoms

Common symptoms related to an ankle sprain are:

• Outside of ankle pain, tenderness, swelling or bruising
• Painful weight bearing
• Stiffness or inability to fully move ankle

Diagnosis

To determine if your child has an ankle sprain our specialists will perform a physical exam that includes flexibility tests, stress tests, muscle tests and gait analysis. These additional tests will help our specialized team better understand your child’s condition, assess range of motion and identify abnormalities that might occur in bone alignment or muscle function.

After a physical exam, our specialists may also order imaging tests such as an X-ray, MRI, ultrasound or computed tomography to confirm your child has a sprained ankle and not a fracture.

Treatment

Possible non-surgical treatments your doctor may offer or recommend to treat your child’s ankle sprain include:

• Over the counter nonsteroidal anti-inflammatory drug (NSAIDs)
• Physical therapy or home exercise program
• Wrapping an elastic bandage around the ankle to reduce swelling
• Wearing a lace-up brace or ankle stirrup
• Using crutches until your child can walk without pain

Return to Sport

After your child has had a musculoskeletal injury like an ankle sprain, it’s normal to want to know how long the injury will take to heal and what you can expect.

Every child is unique, every injury is different. Your doctor will be able to give you guidelines as to when your child may be able to return to play. In general the healing time for an ankle sprain is several weeks and will depend on the severity of the injury.

The best thing you can do for your child is to make sure you consistently follow your doctor’s instructions, including doing at-home exercises regularly. When it is okay to do so, our doctors and staff will let you know when your child can return to play at a controlled level.

Prevention

• Perform proper warm up exercises
• Engage in ankle strengthening exercises
• Wear proper, well-fitting shoes when exercising
• Stretch gently and adequately before and after athletic or recreational activities
• Ensure proper technique is being used when playing sports and avoid playing fatigued
• If you’ve had previous ankle sprains consider ankle tape or a lace up ankle brace

Recovery

At-Home Care

Common at-home treatment options for ankle sprains include:

• Icing the Area: Put ice packs wrapped in a towel or thin cloth on your child’s affected area for 20–30 minutes every 3-4 hours for the first 2-3 days. If pain does not go away, contact your healthcare provider.
• Elevating the Injured Limb: If your child has a broken leg, elevate it by placing it on a pillow when your child is lying down. Elevating it above the heart level can help reduce swelling and pain.
• Taking Non-Prescription Medication: Take a non-steroidal, anti-inflammatory drug (NSAID), such as ibuprofen as recommended by your healthcare provider.
• Exercising: Your doctor may recommend doing exercises at home. These are designed to stretch the affected joint, maintain range of motion in the joint and strengthen your child’s joint.

Below are common exercises a doctor may recommend to help your child recover after an ankle sprain. Always check with your doctor to find out which exercises are right for your child.

As soon as your child can tolerate pressure on the ball of their foot, they can begin stretching their ankle using the towel stretch. When this stretch is too easy, try the standing calf stretch and the soleus stretch. They can do exercises 4 and 5 when their ankle swelling has stopped increasing. They may do exercises 6 through 10 when they can stand on their injured ankle without pain.

Stretching

Towel Stretch

• Sit on a hard surface with injured leg stretched out in front.
• Loop a towel around the ball of the foot.
• Pull the towel toward the body keeping knee straight.
• Hold for 30 seconds. Repeat 3 times.

Standing Calf Stretch

• Facing a wall, put hands against the wall at about eye level.
• Keep the uninjured leg forward and the injured leg back about 12-18 inches.
• Keep the injured leg straight and the heel on the floor.
• Keep toes pointed towards the wall.
• Next, do a slight lunge by bending the knee of the forward leg. Tell your child to lean into the wall until they feel a stretch in the calf muscle.
• Hold for 30-60 seconds. Repeat 3 times.

Standing Soleus Stretch

• Facing a wall, put hands against the wall at about eye level.
• Keep the uninjured leg forward and the injured leg back about 4-6 inches behind the uninjured leg.
• Tell your child to keep both heels on the ground and gently bend their knees until they feel a stretch in the calf muscle.
• Hold for 30-60 seconds. Repeat 3 times.

Range of Motion

Ankle Range of Motion

• Tell your child to pretend they are writing each of the letters of the alphabet with their foot.
• Move ankle in all directions.
• Do this exercise sitting or lying down.
• Ask child to draw pictures of animals, like a cat or a giraffe, if they don’t yet know the alphabet.
• Do twice

Strengthening

Latex Band Resistance Exercises

Resisted Dorsiflexion

• Sit with leg out straight and foot near a door.
• Wrap the band around the ball of the foot.
• Anchor the other end of the band to the door by tying a knot in the band, slipping it between the door and the frame, and closing the door.
• Pull toes toward face and return slowly to the starting position.
• Repeat 10 times. Do 3 sets of 10.

Resisted Eversion

• Sit with both legs outstretched.
• Loop the band around both feet.
• Turn injured foot upward and outward slowly.
• Hold for 5 seconds.
• Repeat 10 times. Do 3 sets of 10.

Resisted Inversion

• Sit with legs outstretched and cross uninjured leg over injured ankle.
• Wrap the band around the ball of injured foot and then loop it around uninjured foot so that the band is anchored at one end.
• Hold the other end of the band in hand.
• Turn injured foot inward and upward so band stretches.
• Return to the starting position.
• Repeat 10 times. Do 3 sets of 10.

Resisted Plantar Flexion

• Sit with leg outstretched.
• Loop the middle section of the band around the ball of the foot.
• Hold the ends of the band in both hands.
• Press the ball of foot down gently, and point toes.
• Stretch the band, then return to the starting position.
• Repeat 10 times. Do 3 sets of 10.

Single Heel Raises

• Hold onto a table and balance on injured side.
• Lift heel off the ground.
• Repeat 10 times, twice a day.
• Perform without holding onto anything for a greater challenge.

Toe Raises

• Stand in a normal weight-bearing position.
• Rock back on heels so that toes come off the ground.
• Hold for 5 seconds.
• Repeat 10 times. Do 3 sets of 10

Single Leg Balance

• Stand without any support, and attempt to balance on injured leg.
• Begin with eyes open, and then try with eyes closed.
• Hold the single leg position for 30 seconds.
• Repeat 3 times.

Jumping Rope

• Land on both legs for 5 minutes.
• Land on only the injured leg for 5 minutes.