Resisted dorsiflexion: Using a stretchable tube placed around the leg of a table or heavy chair, pull your foot toward your body while keeping your knee straight, stretching the tubing.

Resisted plantar flexion: Gently press the ball of your foot down and point your toes, stretching the tubing.

Resisted inversion: Turn your injured foot inward and upward, stretching the tubing.

Resisted eversion: Turn your injured foot up and out, stretching the tubing.

Static and dynamic balance exercises: Stand on injured leg for 30 seconds with different surfaces (floor, pillow) and close your eyes.

w w w . m a r s h f i e l d c l i n i c . o r g

Ankle Injury Care

Instructions for recognition, treatment and rehabilitation of the common ankle injury

Return to ActionYour return to sports should be decided in consultation with a sports medicine specialist, based on your symptoms and function.

Treatment/exercise recommendations

l Compression wrap/horseshoe

l Ice

l Exercises/rehabilitation

l Follow-up

l Other

Special instructions _____________________

__________________________________________

__________________________________________

__________________________________________

Provider ________________________________

Phone __________________________________

If symptoms worsen or do not improve, consult your healthcare provider promptly.

098-011 (04/09) © 2009 Marshfield Clinic

What is an Ankle InjuryAnkle injuries typically consist of a stretch or tear of the ligaments in the ankle joint, straining of the muscles, or trauma to the bones. Symptoms include aching/pain, swelling, discoloration, inability to bear weight, and decreased range of motion and strength.

Common Ankle Ligament Anatomy •Posteriortalofibularligament

•Anteriortalofibularligament

•Calcaneofibularligament

Additional possible related injuries include fractures, muscle strains, foot sprains or nerve injuries.

TreatmentRest

Limit activity until pain decreases and weight-bearing is tolerable. You may need crutches.

Motion

Maintain pain-free dorsiflexion, or range of motion bringing toes up toward the shin.

Ice/cold therapy

•Icebagfor20minuteseveryhour

•Iceslushbath,lessthan15minutes

•Icemassagefor10–12minutes (rub ice in cup over area)

•Useiceforaminimumofthreedays

Compression

•UseanAcebandagewrapandhorseshoe felt pad

•Startwrapattoesanduniformlywrap around foot and past ankle

•Noskinshouldbeexposedandtoesshould be normal color

Elevation

• Keepyourankleatalevelabovetheheart

• Tosleep,usepillowsorasleepingbagunder the ankle

Rehabilitation

Your progression to rehabilitation will depend on strength, range of motion, and pain. Rehabilitation exercises focus on improving range of motion and increasing strength.

Perform these exercises two times per day:

Stretches hold for ____ seconds _______ reps

Strengthening _______ sets _______ reps

Ankle Injury ExercisesTowel stretch: Loop a towel around the ball of your foot and pull the towel toward your body, keeping your knee straight.

Ankle range of motion: Sitting or lying down with your legs straight, move your ankle up and down, in and out, and in circles. (ABCs)

Standing calf stretch: Turn your injured foot slightly inward and push heel into floor. Slowly lean into the wall until you feel a stretch in the back of your calf.

Standing soleus stretch: Stand facing a wall with your hands at about chest level. With both knees slightly bent and the injured foot back, gently lean into the wall until you feel a stretch in your lower calf.

Heel raises: Standing or sitting, raise up onto your toes and hold it for fiveseconds,then slowly lower down.

Posteriortalofibular ligament

Calcaneofibular ligament

Anteriortalofibular ligament