Stepping Towards Recovery | How Physiotherapy Facilitates The Return To Functional Activities After Ankle Instability?

 Ankle instability is a common musculoskeletal condition that can significantly impact an individual's ability to perform everyday activities. Whether it's due to a previous injury, weak ligaments, or repeated ankle sprains, this condition can lead to pain, swelling, and a decreased range of motion. However, with the help of physiotherapy, individuals with ankle instability can regain strength, stability, and confidence, ultimately returning to their normal functional activities. In this blog, we will explore how physiotherapy plays a crucial role in the rehabilitation process for ankle instability and how it empowers patients to reclaim their lives.

Ankle Instability

Ankle instability is often characterized by frequent "giving way" or feeling of instability in the ankle joint. This condition can arise from a variety of factors, including a previous ankle sprain that didn't heal properly, weakened ligaments, and poor proprioception (the body's awareness of its position in space). Consequently, individuals with ankle instability may find it challenging to walk, run, or engage in sports and other physical activities without discomfort and fear of further injury.

Role of Physiotherapy in Ankle Instability Rehabilitation

Physiotherapy is a non-invasive and effective approach to treating ankle instability. It focuses on restoring strength, flexibility, and stability to the affected ankle, thereby improving overall function and reducing the risk of re-injury. A qualified physiotherapist will create a tailored rehabilitation plan for each patient, addressing their specific needs and goals.
 

Comprehensive Assessment

The rehabilitation process begins with a comprehensive assessment by the physiotherapist. This assessment includes evaluating the patient's medical history, the nature of the ankle instability, and any underlying conditions that may contribute to the problem. Additionally, the physiotherapist will assess the patient's gait, balance, strength, and range of motion to identify specific areas that need improvement.
 

Strengthening Training

One of the primary focuses of physiotherapy for ankle instability is to strength training of the muscles around the ankle joint. A variety of exercises will be prescribed to target the calves, ankle stabilizers, and other lower leg muscles. These exercises may include calf raises, resistance band exercises, and balance training on unstable surfaces. Strengthening these muscles helps provide better support to the ankle joint and enhances its stability during movement.

Proprioception and Balance Training

Individuals with ankle instability often suffer from reduced proprioception, which affects their ability to sense the position and movement of their ankle. Physiotherapy employs specialized exercises to improve proprioception and balance. This may involve standing on one leg, using balance boards, or engaging in dynamic balance exercises. Enhancing proprioception not only reduces the risk of future injuries but also helps the patient feel more confident in weight-bearing activities.

Range of Motion Exercises

Ankle instability can lead to stiffness and a limited range of motion. Physiotherapists will incorporate specific stretching and mobility exercises to address these issues. Improving ankle flexibility allows for smoother movement and reduces strain on surrounding tissues. 

Functional Activities Rehabilitation

As the patient progresses in their rehabilitation journey, the physiotherapist will gradually introduce functional activities that mimic real-life movements. These activities may include walking on uneven surfaces, jumping, pivoting, and running drills. By practicing these activities under the guidance of the physiotherapist, patients can regain confidence in their ankle's stability and feel more comfortable engaging in day-to-day tasks. 

Taping and Bracing Techniques

In some cases, the physiotherapist may use taping or bracing techniques to provide additional support to the ankle during the early stages of rehabilitation. While these are not long-term solutions, they can be beneficial in protecting the joint and preventing further injury during the recovery process.


Ankle instability can be a frustrating and limiting condition, but it doesn't have to be a permanent hindrance. Through the guidance and expertise of a skilled physiotherapist, individuals with ankle instability can regain their strength, stability, and mobility. Physiotherapy's comprehensive approach, including strengthening exercises, proprioception training, range of motion exercises, and functional activities rehabilitation, ensures a well-rounded recovery that facilitates a safe return to functional activities. If you are experiencing ankle instability, don't hesitate to seek professional help from a physiotherapist and take the first step toward reclaiming your active and pain-free lifestyle.

 

Ankle Sprain | Physiotherapy Management and Prevention.

Have you ever lost balance and suffered a foot twist, while landing on your ankle? If yes, then this is condition of “ankle sprain”. If the ankle pain quickly disappears then you usually stop thinking about it but if the pain is severe, gives rise to swelling and starts hurting on bearing weight, then it requires necessary treatment. Several interventions have been recommended in the management of acute ankle sprains, among them, physiotherapy has been recommended with a higher level of evidence and should be incorporated in the rehabilitation process.  The physiotherapy program includes exercises ranging from simple range of motion, stretching, strengthening exercises to neuromuscular, proprioceptive, and sport-specific exercises. Through this blog, we will try to enhance your knowledge about ankle sprain and the various physiotherapy interventions which can be used as a treatment intervention for the same.

 

Ankle Sprain

Acute ankle injury is one of the most prevalent lower limb injuries occurring mostly in physically active individuals. An ankle sprain mostly occurs in females, children, and athletes taking part in indoor and outdoor sports. An ankle joint instability can occur due to the injury to the bone or muscular structures, ligaments like the lateral, medial and syndesmosis injury play a major role in ankle instability. An ankle sprain occurs when one or more ligaments of the ankle are stretched or torn. If a sprain is left untreated, it can lead to long-term ankle problems. During Injury the ankle is either rolled inward or outward. Inward twisting injury sprains are the most common type, cause pain along the outer side of the ankle. Depending on to what extent the ligaments are injured, the sprain can be classified as Grade I, II, or III.

 

Ankle Sprain Classification

• Grade 1- Mild.
• Grade 2-Medium.
• Grade 3- Severe.

 

Grade I ankle sprain

• Rest: Take rest
• Ice:  By applying ice the swelling comes down. Apply it for 10 to 20 minutes after every 1 to 2 hours during the day.
• Compression:  Compression helps to control swelling and immobilizes the part to enhance the process of healing.
• Elevation: Elevate the foot by placing it above the level of the heart.

 

Grade II ankle sprain

• Follow the R.I.C.E. program and immobilize it by using a bandage or splint.

 

Grade III ankle sprain

• There is a risk for permanent ankle instability. Rarely, surgery might be required to repair the damage or put a short leg cast for two to three weeks or a walking boot.

 

Ankle Sprain Healing Goals:

• To relieve pain.
• Regain strength.
• Regain range of motion.

Once the patient starts to stand on the ankle again, the physiotherapist gives exercises to strengthen muscles and ligaments and increase flexibility, balance, and coordination.

 

Physiotherapy Treatment:

Depending on the severity of the ankle sprain, the physiotherapist designs a treatment program to enhance the healing process and advices to return to activities and sports.

The physiotherapy interventions include the use of ice packs, heat packs, modalities like TENS, Ultrasound, Shockwave therapy, and exercises like:

 

Range-of-motion exercises:

To move the joint as far as it can be in every direction.

Ankle alphabet

• Sit in a chair, with leg extended trace the letters of the alphabet in the air with the big toe. Repeat this 2 or 3 times, moving the ankle in all directions.

Knee motion

• Sit in a chair, place the foot flat on the floor. Then slowly move the knee from side to side for 2 to 3 minutes.

 

Stretching exercises:

To keep the Achilles tendon flexible while the ankle heals.

Standing calf stretch

• Stand in front of a wall facing towards it, put the hands on the wall. Place the injured ankle one step back and the uninjured foot forward. Keep the back heel flat on the floor, slowly bend the knee of the uninjured leg until a stretch is felt in the calf of the injured side. Repeat 3 times, hold for 30 secs.

Heel raise

• Stand with the hands in front, resting against the wall, or chair back for support. Place the feet shoulder-width apart, slowly rise on the toes and come back down.  Repeat 10 times then progress to 20.

 

Strengthening exercises:

To strengthen the muscles and support the ankle.

Elastic band push

• Sit on the floor.  Extend the leg and slightly raise it to 20 degree to keep the heel off the floor. Place the elastic band around the ball of the foot and hold the two ends. Slowly push the ankle forward by pointing the toe. Then slowly bring it back. Repeat this 10 times.

Elastic band pull

• Sit on the floor, hook the upper foot and the toes into the band.  Slowly pull the foot back towards the body and return it to a vertical position. Repeat 10 times.

 

Balance and control exercises:

To help the foot and ankle respond to activities, which can help prevent reinjury. Balance and control exercises should be started when there is no pain on standing.

One leg raise

• Place hands on a wall, lift the uninjured leg behind so that the weight rests on the injured ankle. Try to hold this position for 20 to 30 secs.

Pillow balance

• Do basic balance exercises while standing on a pillow.  The foot will wobble around a lot and constantly need to be corrected to maintain balance.  Maintain this position for 30 50 secs.

 

• To protect the ankle, bracing can be done and aids like crutches can also be recommended to avoid limping. With more severe ankle injuries a boot is recommended to allow proper healing.
• Ankle sprains almost take up to 4 months to heal completely, depending on the severity.  While playing sports ankle support like an ankle brace, air stirrup, or hiking boots may be recommended to be worn during the healing time to protect the ligaments. After the ankle is healed, taping can be done or an ankle brace to support the ankle.  To prevent reinjury continue stretching exercises especially before and after physical activities to prevent reinjury.  Muscle-strengthening exercises and balance exercises should be continued to maintain ankle strength. Long-term joint pain and weakness can be seen in people with severe or repeated ankle sprain therefore all the recommended exercises should be continued even after the pain the ankle mobility and strength are retained.
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  This Blog was first posted at CB Physiotherapy