Tedd Girouard,
MS, ATC
Head Athletic Trainer FC Las Vegas
Brent Mangus, EdD, ATC
Associate Professor University of Nevada Las Vegas
So the doctor or Certified Athletic Trainer (ATC) has
told you that have a sprained ankle, he or she may have
also mentioned that this is one of the most common injuries
occurring to athletes today. Your doctor or ATC possibly
explained to you that sprains are the result of trauma
and damage to the ligaments in that location. Ligaments
attach from one bone to an adjoining bone and ankle sprains
are usually "graded" as either 1st, 2nd, or 3rd degree
sprains. You may not know what this grading system means,
or what effects it has on your participating in soccer.
The first thing you want to know is "how bad is my
sprain, which grade is it?" Well your doctor should be
able to let you know the extent or grade of injury you
have experienced. In the sports medicine community, sprains
are graded as to the amount of damage done to the ligaments
around a specific joint. A "grade one" sprain is characterized
by damage to one ligament in your ankle, the ligament
is "stretched" with some damage to the integrity of the
ligament itself. It is almost like pulling taffy a just
little. The ligament may look close to the original ligament,
but it has a different length. A "grade two" sprain is
characterized by substantial damage to at least 2 ligaments
around the ankle joint. In a grade two ankle sprain there
is not a complete tear of any ligament(s). A grade three
sprain is the most damaging of all ankle sprains and
is characterized as a complete disruption of at least
one ligament and substantial damage to some of the other
supporting ligaments. Grade 1 ankle sprains may be rehabilitated
at home using the following outline. If you have a more
substantial injury, please consult a local athletic trainer
or physical therapist for more advanced rehabilitation
specifics.
Rehabilitation for a Grade 1 (minor) Ankle Sprain
Phase 1a: 0 - 24 hours
- Keep your ankle elevated above your heart
and use an elastic wrap to maintain compression
on the ankle unless it is being iced or exercised.
- Ice your ankle with either an ice bag for 30
minutes or an bucket for 20 minutes every 2 hours.
- Keep off your ankle (rest)
Phase 1b: 24 - 72 hours (Cryokinetics)
- Cool your ankle by submerging the entire foot
in a five gallon plastic bucket filled half full
with ice and water for 20 minutes.
- After icing your foot, walk as normal as possible
in a figure eight pattern for 5 minutes
- Return your ankle to the bucket for 5 minutes
- Next, try to balance on your injured ankle
in short time periods for 5 minutes or more.
You may want to try to bend your knee during
this exercise. (See Photo
Right) If this is too easy fold a towel
in fourths and balance on the towel, this will
make it a little more difficult to maintain your
balance
- Return your ankle to the bucket for 5 minutes.
Next, using your toes, write the alphabet with
your ankle from A - Z multiple times.
- Strech the calf of your injured side 3 times
for 30 seconds.
- Re-wrap your ankle with the elastic wrap and
repeat the above steps every 2 hours if possible
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Phase 2: Days 4 - 6
See your Certified Athletic Trainer Before Moving
on to Phase 2:
- While in the elastic wrap try and jog in straight
lines for 5 to 10 minutes, if this is too painful
then walk for 10 - 15 minutes.
- Spend 5 minutes stretching your calf muscles
by standing about one from a wall foot, keep
your heels on the floor and lean forward until
your chin touches the wall. Keep your heels on
the ground and move your feet farther from the
wall as you get better at this exercise.
- Perform balance exercises similar to Phase
1 for 5 minutes but try and find a place to throw
a ball against a wall to yourself while balancing.
This will increase the difficulty of balancing
and help to exercise the ankle as needed
- Try to do calf raises for 2 - 3 minutes
- Perform ankle exercises against someone holding
your foot. Try to push out, in, up, and down.
Do this for 2 minutes, take a short rest, then
do again for 2 more minutes
- Have someone throw a ball at your feet and
volley the ball back for 3 - 4 minutes (See Photo
Right)
- Following your exercise use the ice bucket
for 15 minutes or apply an ice bag directly to
your ankle for 30 minutes.
- Repeat the above steps 3 times per day if
possible.
If pain or swelling increases with activitiy Ice
the ankle after each time you perform these exercises.
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Phase 3: Days 7 - 10
Perform these exercises with appropriately applied
tape or a commercially available ankle brace.
- Warm up by jogging for 15 - 20 minutes
- Stretch your calf for 2 - 3 minutes
- Find a jump rope and skip for 3 - 5 minutes
- Do some sprinting exercise working from straight
sprinting to cutting movements (use pain as an indicator
of how hard to try)
- Try some jumping exercises like hopping from side
to side.
- Ice after your exercise session
- Repeat the above steps 3 times per day.
Once you are able to complete these exercises completely
pain free you should be ready to start practice one again.
We suggest checking with your ATC to perform a functional
test before returning to your team.
When you return to practice take it slow, try some short
runs, and some light passing working up to some longer
runs and passing some long balls. The last thing you
should work up to is shooting, in particular shooting
with the outside of your foot as this will place the
most stress on the damaged ligaments. When you are able
to do these things without pain, you should be able to
return to full speed play.
Use an ankle brace or properly applied tape for the
next month, as the ligaments may still not be back to
100% for some time.
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