1. Why Is Ankle Rehabilitation Important?

During spring, outdoor running increases, leading to a higher risk of ankle sprains and ligament injuries. After initial management (immobilization and rest), a stepwise rehabilitation program is essential to restore ankle mobility, strength, balance, and proprioception, and to prevent re-injury.
This guide provides detailed instructions, sensations, and precautions for each exercise.

2. Step-by-Step Rehabilitation Exercises with Accurate Descriptions

■ Acute Phase (1–2 weeks after injury)

• Reduce pain and swelling, and maintain basic ankle movement.

1. Ankle Pump
   Position: Lie flat on your back on a mat or bed, legs straight.
   Movement:
   1. Slowly pull your toes up toward your face, so the top of your foot moves closer to your shin.
   2. Hold for 1–2 seconds when you feel a gentle stretch in your calf.
   3. Slowly point your toes away from you (downward), as if pressing a car pedal.
   4. Hold for 1–2 seconds when you feel a stretch in the front of your ankle.
   5. Repeat this up-and-down motion 10–20 times.
   Tip: Move slowly, use your full range of motion, and focus on a gentle stretch and relaxation.
   Caution: Stop if you feel sharp pain; do not force the movement.
2. Ankle Circles
   Position: Same as above.
   Movement:
   1. Lift one foot slightly off the floor (just enough so it doesn't touch).
   2. Draw a circle with your toes, rotating your ankle clockwise 10 times, then counterclockwise 10 times.
   3. Repeat with the other foot.
   Tip: Keep the movement smooth and controlled; do not let your knee or hip move.

■ Subacute/Recovery Phase (2–6 weeks)

• Restore ankle muscle strength, balance, and proprioception.

1. Resistance Band Exercises
   Position: Sit on the floor with your legs straight. Loop a resistance band around your foot and hold the ends in your hands.
   Movements:
   • Dorsiflexion (toes up): Pull your toes up toward your face against the band's resistance, hold for 2 seconds, then slowly return.
   • Plantarflexion (toes down): Point your toes away from you against the band's resistance, hold for 2 seconds, then return.
   • Inversion/Eversion: Anchor the band to the inside or outside of your foot, then slowly turn your foot inward (inversion) or outward (eversion) against resistance.
   Repetitions: 10–15 times per direction, 2–3 sets.
   Tip: Move slowly and focus on muscle contraction.
2. Towel Scrunches
   Position: Sit in a chair with a towel spread on the floor in front of you.
   Movement:
   1. Use your toes to scrunch and pull the towel toward you.
   2. Once you can do this easily, add a small weight (like a book or water bottle) on the towel.
   Repetitions: 10–15 times, 2–3 sets.
   Tip: Focus on feeling your arch and foot muscles contract.
3. Calf Raise
   Position: Stand holding onto a wall or railing for balance.
   Movement:
   1. With feet shoulder-width apart, slowly lift your heels to stand on your toes.
   2. Hold for 2 seconds as you feel your calf muscles contract.
   3. Slowly lower your heels back down.
   4. As you progress, try on one leg at a time.
   Repetitions: 10–15 times, 2–3 sets.

■ Advanced/Strengthening Phase (after 6 weeks)

• Return to sports and regain functional strength and agility.

1. Single Leg Balance (on balance board or cushion)
   Position: Stand on one leg on a balance board or thick cushion.
   Movement:
   1. Hold your balance for 10–30 seconds, gradually increasing up to 1 minute.
   2. For more challenge, close your eyes or raise your arms overhead.
   Tip: Distribute weight evenly, especially on your big toe and inner arch.
2. Lunges, Squats, and Hops
   Positions:
   • Lunge: Step forward and bend both knees to 90 degrees.
   • Squat: Stand with feet shoulder-width apart, bend knees and hips to 90 degrees as if sitting back.
   • Hop: Gently jump and land on one or both feet.
   Movement:
   1. Repeat lunges, squats, and hops to strengthen the entire lower body and improve coordination.
   2. Practice single-leg hops, direction changes, and jump landings to simulate real sports situations.
   Repetitions: 10–15 times each, 2–3 sets.

3. Practical Tips & Precautions

• Always perform exercises within a pain-free range.
• Focus on muscle use: Be mindful of your calf, foot, and toe muscles during movement.
• Increase difficulty gradually: Start with support (wall, railing) and progress to independent exercises.
• Frequency: 1–2 times daily, 10–15 reps per exercise, 2–3 sets; increase as tolerated.
• If pain persists or recovery is slow, consult a medical professional or physical therapist.

4. Exercise Summary Table

5. References

1. Runner’s World. Everything You Need to Know About Ankle Injuries.
   https://www.runnersworld.com/health-injuries/a20865304/ankle-injuries/
2. Acute Ankle Sprain Management: An Umbrella Review of Systematic Reviews.
   Journal of Orthopaedic & Sports Physical Therapy, 2021
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273319/
3. Healthline: 15 Exercises for Your Sprained Ankle
   https://www.healthline.com/health/fitness-exercise/sprained-ankle-exercises
4. Physitrack, “How to perform the Ankle Pumps”
   https://www.physitrack.com/exercise-library/how-to-perform-the-ankle-pumps-exercise
5. PLOS ONE: Exercise-based rehabilitation reduces reinjury following acute ankle sprain
   https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193417

This information is for general reference only. Always consult a healthcare professional or physical therapist for a diagnosis and personalized guidance.