Lateral Ankle Sprain Advanced Exercises & Techniques

This article will cover lateral ankle sprain advanced exercises & techniques. We have written a previous ankle [P]Rehab article on how to [P]Rehab your ankles and initially manage a lateral ankle sprain. However, how do you get the ankle back to 100%? What exercises should you include in the athlete’s training sessions to best prepare them for returning to play? What can clinicians do hands-on to rehab and help support a lateral ankle sprain? Read more to find out!

 

Take Your Ankle Exercises To The Next Level! Y-Balance

The Y-Balance exercise comes from the Star Excursion Balance Test (SEBT), which is a common functional test to examine dynamic ankle stability. Functional tests themselves can become interventions and exercises, thus you have the Y-Balance exercise! Functional tests are important to perform because they provide a format to communicate an individual’s current functional capacity. Functional tests also help to determine a starting point and track progress towards return to sport participation. You can click here to learn more about the SEBT.

One of my favorite sayings is – you cannot track progress without measuring change

The Y-Balance exercise is a dynamic single leg exercise that works on balance, proprioception, and strength. Depending on the direction you reach, the ankle joint will have to move through varying positions of ankle dorsiflexion, pronation, and supination. Deceleration of joint motions is so important to train when recovering from an injury to mitigate the risk of re-injury or secondary injury. As much as this exercise can be a starting point for individuals recovering from a lateral ankle sprain, there are ways to ramp it up to add it to the list of lateral ankle sprain advanced exercises & techniques.

[P]Rehab Your Ankle Sprain! ankle sprain prehab lateral ankle sprain advanced exercises

Lateral ankle sprains are the most common lower body injury to occur in sports and recreational physical activities. Ankle sprains can be challenging and frustrating due to also having the highest reinjury rate amongst any lower body injury. This high reinjury rate is likely because the ankle sprain wasn’t properly managed in the first place. It’s time to change the narrative with [P]Rehab! This program will help you recover from an ankle sprain and protect your ankle as you get back to your normal life. Learn more HERE!

 

Lateral Ankle Sprain Advanced Exercises

Here is an article that suggests poor performance on the SEBT can predict lower extremity injury risk.

Adding an unstable surface to the Y-Balance is one simple way to make this exercise more challenging. Unstable surface training has received a lot of criticism about whether it actually improves performance, and whether or not it is a waste of time including this training for individuals. There is also mixed evidence when examining the benefits of unstable surface training with results in-favor and against this type of training. HOWEVER, with that being said unstable surface training has its place to help an individual improve their balance and proprioception. When programmed APPROPRIATELY in an individuals rehab and strengthening and conditioning program, it can help an individual get back to doing the things they love to do!

If you don’t like unstable surfaces, you can add other components to the Y-Balance to add it to the list of lateral ankle sprain advanced exercises & techniques including…

  • Eyes closed

 

  • Increase/decrease speed of movement

 

  • Add external load (weight in either hand)

 

  • manual perturbations

READ: THE BEST SOCCER EXERCISES FOR INJURY PREVENTION

soccer injury prevention exercises the prehab guys

 

Lateral Ankle Sprain Advanced Exercises: Calf Strengthening

Here is one of my favorite squat variations to target the calves and dynamic ankle stability. I typically add this once an individual feels comfortable with heel raises standing and heel raises in a squatted position. I also like to program this with side steps on toes. Definitely add this to the list of lateral ankle sprain advanced exercises & techniques!

Bulletproof Your Foot and Ankle With [P]Rehabfoot ankle program the prehab guys lateral ankle sprain advanced exercises

The Foot & Ankle [P]Rehab Program is a physical therapist developed, step-by-step program that teaches you how to optimize your foot & ankle health. This 3-phase program will expose you to various foot & ankle strengthening and stabilization exercises supported by science. This program will bulletproof this region for anything life throws at you! Learn more HERE! 

 

Single Leg Balance With Ankle Inversion

“You didn’t get hurt on the table, you’re likely not going to get better on the table” -IKN

This is one of my go-to lateral ankle sprain advanced exercises & techniques. Training positions of vulnerability is important for a few reasons…

  • It is important to be able to tolerate and CONTROL these positions

 

  • It is important to regain CONFIDENCE in these positions

 

  • It is important to practice multi-tasking (sport specific movements) in these positions

 

Often there is a lot of time spent avoiding and minimizing these vulnerable positions. However, it is imperative that an individual has the ability to decelerate and control positions of vulnerability. This principle can be applied to other injuries such as an ACL – decelerating dynamic knee valgus should be a major focus in ACL prehab and rehab!

LISTEN: ACL INJURIES WITH DR. NIMA MEHRAN

acl injuries nima mehran the prehab guys

 

Forward & Lateral Bosu Lunges With Single Leg Balance

This is on the list of lateral ankle sprain advanced exercises & techniques for a few reasons…

  • Promotes dynamic ankle and lower body stability

 

  • Promotes learning deceleration

 

  • Promotes speed and muscular power by practicing a powerful dynamic push-off

 

  • Promotes confidence in the sprained ankle

 

Should you and can you do this on both sides?! Absolutely!

 

Lateral Hop & Stick

Lets breakdown what is the most important movement an individual needs to CONTROL after a lateral ankle sprain… lateral movements! When you move laterally (if it is your right ankle -> moving to your right) the ankle has to decelerate an external inversion force to maintain contact with the ground. If you were to hop to your right and loss your balance to the right, your big toe, as well as the medial side of your foot, would come off the ground positioning your ankle into inversion. When the time is right, I have every individual that has experienced a lateral ankle sprain perform this exercise.

You can make this exercise easier or harder! It doesn’t have to look like this…

Remove the bosu, decrease the distance covered, provide upper body support, you decide! Yes these are advanced lateral ankle sprain exercises, however, you can modify and regress everything shown thus far to challenge the sprained ankle appropriately! The beauty of all these lateral ankle sprain advanced exercises & techniques is that you can alter them however you’d like!

 

Soccer [P]Rehab Program

Soccer Prehab Program The Prehab Guys

Soccer to some, futbol to others, but to us it’s what got Arash & Craig into physical therapy in the first place! Just like any sport, soccer has physical requirements and demands a lot from your body. Prepare for the sport you love and protect your body from the most common soccer injuries with our program! You will train hard and expose your body to soccer-specific injury prevention (what we like to call risk-reduction) exercises so that you’ll be as ready as you can be to play! This program is rooted in scientific evidence, our clinical expertise as physical therapists, and of course our experience as soccer players! Find out more HERE.

 

Lateral Ankle Sprains: Hands-on Techniques

Below are some interventions that you can add in to your treatment plan as a physical therapist when working with patients who have lateral ankle sprains!

Ankle Rhythmic Stabilization

Working ankle stability is key following a lateral ankle sprain. With repeated lateral ankle sprain cases, the concern for Chronic Ankle Instability (CAI) increases. There are great partner exercises for soccer players that target the hamstrings (Nordic Hamstring Curl) and adductors (Copenhagen Adduction), what about the ankle?!

Here is a PNF Rhythmic Stabilization exercise designed for the ankle that I use with athletes. Notice I have the patient close his eyes here to really focus on stabilizing his ankle. I think as PTs and other clinicians we do a great job utilizing hands-on Proprioceptive Neuromuscular Facilitation (PNF) techniques for regions like the shoulder, but why not use them for other regions like the ankle?! This is a must add for lateral ankle sprain advanced exercises & techniques.

I think this is a great exercise teammates could add to their strengthening and conditioning programs. I like to program it with 3 to 4 sets of 15-30 seconds matching the individual’s resistance. It is important to not overpower the individual’s ankle and make it move too much! Also, don’t feel limited to this position, however, I like this position because it allows you to stabilize the person’s leg and not let them cheat.

 

Lateral Ankle Stability Tape Technique

Why tape? Tape can help with pain mitigation and neurosensory input.

After an injury such as an ankle sprain, people tend to deal with a lot of pain. Pain can interfere with the mind-body connection leading to abnormal movement patterns. Tape can help with the connection and perception of movement between our brain and our body, which can help with pain and ultimately help people move better! Demonstrated in this video is a lateral ankle stability tape technique using Cover-Roll and Leukotape.

 

Is the tape keeping the ankle in place and limiting motion? – NO

Be sure to watch and listen to the entire video as I talk about what the tape job does/does not do and why I choose the angles and anchors that I did. In short – the tape is giving the individual FEEDBACK as to what position his ankle is moving into. The skin is one of the largest, if not the largest, organ in our body. Sensory fibers are the fastest fibers in the body – tapping into this system can potentially improve that mind-body connection we spoke of earlier, which can tell the individual exactly where their ankle is in relation to space EARLIER than it would without tape. As we know, ankle sprains can lead to proprioception deficits up to a YEAR, why wouldn’t you want to consider giving the ankle more input and feedback?

Could it simply be placebo? Yes, however we know in sports there are a lot of things that are placebo (simply a person doing the same exact warm-up routine a certain way) that the athlete swears it improves their performance. In this case, the athlete felt less pain and more confident with his ankle and his ability to play soccer after I tapped it. Will I continue to tape it long-term? No, but for short-term if it helps to get my athlete back on the field sooner I will do it!

 

Closing Thoughts

Lateral ankle sprains are not only one of the most common injuries that people sustain, but it also has one of the highest reoccurrence rates. Therefore, even when the ankle is having no pain at all, and you feel back to your 100%, do not forget about exercises that train the foot and ankle! If you continue to keep your ankle strong, mobile, and stable, it will help you prevent injuries in the future!

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

8 Comments
  • Julia
    Posted at 15:23h, 01 April Reply

    Thank you for these! I am a dancer who has struggled with repeated ankle sprains. I’ve noticed that typical stability rehab exercises aren’t challeneging enough to meet the needs of dancers. I think a huge part of that is recruitment and proprioception as well as training stability in extremely dynamic situations.

    In addition, I will try these exercises on both sides, since I recent learned that injury can reduce stability both the injured and uninjured leg due to changes postural patterns – Wikstrom EA, Naik S, Lodha N, Cauraugh JH. Balance capabilities after lateral ankle trauma and intervention: a meta-analysis. Med Sci Sports Exerc. 2009;41:1287–1295.

    • Michael Lau
      Posted at 12:19h, 21 April Reply

      We have huge proponents of working both sides for the reasons you laid out! Hope these exercises have continued to help!

  • Vibrators
    Posted at 00:20h, 17 May Reply

    Wester J U, Jespersen S M, Nielsen K D, Neumann L. Wobble board training after partial sprains of the lateral ligaments of the ankle: a prospective randomized study.

  • Allen H.
    Posted at 14:49h, 29 November Reply

    Any ideas for chronic Peroneal Tendonopathy ? Tried everything ( strengthening, soft tissue work ) keeps coming back. One thing that seems to provide the most relief although temporary is ankle manipulation.

    • Michael Lau
      Posted at 19:33h, 13 January Reply

      Got to load it! Can be tricky but tons and tons of heavy loading will do any tendinopathy wonders!

  • Akima
    Posted at 22:54h, 28 March Reply

    Hi guys
    Had achilles strain and had leg in cast for about 20 days plantar flexed !
    Now cant dorsiflex because of pinching pain in front of my leg. Doing all kinda of stretches with band in front of ankle Etc… And cant go to doctor because this corona virus thing. Any ideas? Should i rest it or continue with stretching

    • Michael Lau
      Posted at 11:47h, 06 April Reply

      Hey Akima,

      As long as the pinching is in front, you should be good. You don’t want to overly stretch the calf the first few weeks.

      We also have a complete ankle prehab program that you can check out here. Think of this as your PT! https://theprehabguys.com/foot-ankle-prehab-program/. In our programs, we have a discussion board where we would be able to answer all your questions as you are going through it!

  • Akima
    Posted at 08:32h, 30 March Reply

    Any ideas how to fix anterior ankle impingement? Im doing banded mobilizations an stretches but nothing helps, had my leg Immobilized in a plantarflexed position for about 10 days and cant dorsiflex now, feel pinching pain near talus bone.

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