Rehabilitation of Ankle Injuries Plus Maintaining Cardiovascular Fitness Through Injury

Injuries frustrate athletes. The mental effects can outweigh the functional limitations and pain. What can we expect after an ankle injury?

First, I reposted an old piece I wrote about ankle injury prevention. "An ounce of prevention is worth a pound of cure." 

Next, recovery depends on the extent of injury but also on us. 

From Medscape.com

The disclaimer is to always consult your healthcare provider. 

You progress through range of motion exercises, stretching, strengthening, and balance and control exercises. 

When should you start rehab? Michigan Medicine recommends, 

"Start rehab with range-of-motion exercises in the first 72 hours after your injury. Continue with further rehab, including stretching, strength training, and balance exercises, over the next several weeks to months."

Sensory input is altered (nerve damage) early after ankle injury. Braces help correct that. Here is a comprehensive review of the benefits of ankle rehab including bracing. "The use of ankle taping and bracing has proprioceptive, mechanical, and injury-protection benefits and causes minimal to no performance decrements." I've shared previously that bracing (e.g. laced braces) is superior to taping. 

How do you start? Increase range of motion, "Trace the alphabet with your toe, which encourages ankle movement in all directions. Trace the alphabet 1 to 3 times."

Add towel curls. "While sitting, place your foot on a towel on the floor and scrunch the towel toward you with your toes. Then, also using your toes, push the towel away from you."

Progress to stretching and strengthening exercises outlined in the above article. 

Some therapists recommend using marbles to work both muscles and ankle motion. 

The 64 dollar question. When can I return to play? "It depends." It's not simple because it involves not only the ankle, but conditioning, timing, and skills maintenance. 

"Achilles tendon stretching should be instituted within 48 to 72 hours of injury, regardless of weight-bearing capacity, in light of the tissue's tendency to contract after trauma."

This article addresses the injury, treatment, rehab, conditioning and integration. There's no one size fits all. It depends on the injury, which we could rename rolled, wronged, and ruptured. Many will have grade 2 injuries which may take four to five weeks to heal. 

Lagniappe. Staying in shape while injured. Maintaining cardiovascular fitness while injured is a challenge. Considerations include (with therapist approval): 

- Circuit weight training (without using the injured ankle)

- One-legged cycling (stationary bicycle)

- Swimming 

- Situps/"V - ups"

- Rope slams

Seated cardio workout.

Chair shooting (need a partner)