Physiotherapy for Ankle Ligament Tear - Strengthening, Stretching, and Balancing Exercises

What Is an Ankle Ligament Tear?

An ankle ligament tear is also known as a sprained ankle. It occurs when one or more ligaments get damaged at the ankle. Ligaments are the parts that connect one bone to another. The ankle is made of several ligaments. When the ankle ligaments get damaged or torn it causes pain and difficulty in walking. A sprained ankle is categorized based on its severity as:

• Grade 1 Sprain - There will be mild tenderness, swelling around the ankle, bruising, slight stretching, and a small number of ligaments that get damaged. There will be no pain with weight bearing.

• Grade 2 Sprain - There will be moderate tenderness, swelling, and bruising. There will be mild pain with weight bearing and a large number of ligaments get damaged.

• Grade 3 Sprain - There will be a complete tear of the ankle ligament. There will be bruising, significant swelling and tenderness, and severe pain with weight bearing.

What Causes Ankle Ligament Tears?

Ankle ligament tears are usually caused by trauma or injury to the ankle. The ligaments get stretched too much and thus the tear happens. The tear can happen in two ways:

• Ankle twisted inwards (inversion injury).

• Ankle twisted outwards (eversion injury).

Tears in the ankle ligaments may occur suddenly during activities like:

• Exercising on an uneven surface.

• Walking on an uneven surface.

• Tripping.

• Falling down.

• Involving in sports that require jumping and cutting such as basketball, tennis, soccer, football, and trail running.

What Are the Symptoms of an Ankle Ligament Tear?

Usually, the symptoms appear suddenly at the time of the trauma. The symptoms include:

• Pain.

• Swelling.

• Pain with weight bearing.

• Stiffness.

• Pain with inhibited movements.

• Bruising.

• Difficulty in walking.

• Weakness.

• Tenderness on touch.

• In severe ligament tears, the person can hear or feel a popping sound.

How Is an Ankle Ligament Tear Treated Through Physiotherapy?

Physical therapists recommend various types of exercises for an ankle ligament tear which include:

1. Range of motion exercises.

2. Stretching exercises.

3. Strengthening exercises.

4. Balance and control exercises.

Ankle Range of Motion Exercises -

These exercises help to maintain and improve the range of motion and flexibility of the ankle.

Ankle Alphabet -

• The person should start by sitting on a comfortable chair or a couch by extending their legs outward.

• Then the person should trace the alphabet letters using a big toe in the air.

• This exercise can be repeated two or three times if there is no pain felt in the ankle. It helps to move the ankles in all directions.

Towel Scrunches -

• The person should sit on a chair and place a small towel in the front. Then the person should gently grab the towel with the toes and scrunch their legs up 5 times

• Then the towel should be released and the exercises should be repeated 8 to 10 times.

Knee Motion -

• The person should sit on the chair by placing their foot flat on the floor. Then the person should slowly move their knees from side to side two or three times. This exercise stretches and relaxes the ligaments of the ankle.

Ankle Stretching Exercises -

The ankle stretching exercises target the Achilles tendon to stretch.

Towel Stretch -

• The person should sit on the floor with their back with extended legs in front. Then a towel should be warped around the foot.

• Then the person should pull the towel so that the toes move towards their body.

• The position should be held for 30 seconds and repeated on the other side.

One Leg Balance -

• The person should stand by placing their hands on the wall and lift their unaffected leg behind them. This makes the injured leg bear weight.

• The position should be held for 20 to 30 seconds.

Heel Raise -

• The person should stand against the wall by resting their hands on it. Then the person slowly raises their toes with their feet shoulder-width apart.

• Then the leg should come back down.

• This exercise should be done 10 to 20 times and repeat on the other side.

Standing Calf Stretch -

• The person should stand against the wall by placing their hands on it. Then the injured leg should be placed one step back behind the unaffected leg.

• Then by keeping the heel flat on the floor, the person should slowly bend the knees of the unaffected leg until they feel stretched on the calf of the injured leg.

• The position should be held for 30 seconds and repeated 3 times.

Ankle Strengthening Exercises -

Once the ankle gets a good range of motion with stretching and range of motion exercises, then the physical therapist recommends ankle strengthening exercises.

Elastic Band Push -

• The person should sit on the floor and prop their ankle with a rolled towel to prevent the heel from touching the floor.

• Then the person should wrap an elastic band around the foot and hold the ends of the band.

• Now the person slowly pushes the toes toward their body.

• This exercise should be repeated 10 times.

Ankle In -

• A resistance band should be tied around the heavy object. Then the person should hook their foot inside the band.

• Then the person should slowly move their foot inward against the resistance band.

• This exercise should be repeated 10 times.

Ankle Out -

• A resistance band should be tied around the heavy object. Then The person should hook their foot inside the band.

• Then the person should slowly move their foot outward against the resistance band.

• This exercise should be repeated 10 times.

Elastic Band Pull -

• The person should hook their foot into the resistance band which is tied to a heavy object.

• Then the person should slowly move their foot backward and return it to the vertical position.

• This exercise should be repeated 10 times.

Ankle Balance and Control Exercises -

These exercises help in improving control and balance while standing.

Basic Balance -

• The person should stand on the injured leg and place the unaffected leg behind the injured leg without touching the floor and balance the body.

• This position should be held for 30 seconds.

• If the person feels unsteady they can get support from a table or chair.

Balance With Eyes Closed -

• The person should stand on the injured leg with their eyes closed and balance the body.

• The position should be held for 30 seconds.

Pillow Balance -

• The person should stand on a pillow with the injured leg and balance the body.

• The position should be held for one minute.

Pillow Balance With Eye Closed -

• The person should stand on a pillow with an injured leg and both eyes should be closed. Then their body should be balanced.

• The position should be held for a few seconds.

Conclusion

Ankle ligament tears are very common. The severity of the condition varies greatly. Even the minor sprain in the ankle requires treatment. Very light exercises can be started within three days of the injury. Reaching out to the physical therapist may be beneficial.