After an injury, it can be frustrating to sit around, waiting for an ankle sprain to heal — especially if you are a runner. Depending on how bad your injury was, you might be out of the running game for only a couple of weeks or up to several months. However, there are other exercises you can do to improve your mobility and strength during the healing process to prepare you for running after an ankle injury.
The length of time it takes to return to running after an ankle sprain will depend on the extent of your injury. You might get back on the road after a mild injury within two weeks, but more severe injuries can take up to several months.
Running on a Sprained Ankle
Although your ankle might begin to feel better within a week or so, it is imperative that you allow your ankle to fully heal before resuming activity. Running on a sprained ankle can cause permanent problems. According to a 2015 article published by Clinics in Podiatric Medicine and Surgery, resuming activity too early in the healing process can cause the ligament to scar in a stretched position, leading to recurring ankle sprains and chronic instability.
Soft tissue injuries, such as a sprained ankle, heal in three phases — the acute or inflammatory phase, the subacute or proliferative phase, and the maturation or remodeling phase. The acute phase typically only lasts for three days after injury. The subacute phase begins at day 4 and lasts for about three weeks.
During the maturation phase, scar tissue forms to rebuild the damaged ligament. Running may be resumed during this phase of healing.
Understand Your Injury
Ankle sprains are a common trauma injury, particularly among athletes. According to Physiopedia, 85 percent of ankle sprains occur from rolling the ankle inward, damaging ligaments on the outside of your ankle.
Ankle sprains vary in severity and are graded based on the extent of injury. Grade 1 sprains cause microtrauma in the ligaments without stretching them, with little impact on your function. Running after a grade 1 ankle sprain could resume as early as two weeks after injury. Grade 2 sprains involve stretching of the ligaments, but they stay intact. Running can often resume within three to four weeks after these injuries.
Grade 3 ankle sprains are the most severe, causing a full ligament tear. These injuries can lead to ankle instability if left untreated and often require surgery to reconstruct the damaged ligament. Although specific guidelines vary by surgeon, you will likely have to wait 14 to 16 weeks after surgery to resume running.
When to Rest
Home remedies promote healing after ankle sprain to help you return to running on schedule. During the acute phase, use the R.I.C.E. principle — rest, ice, compression and elevation. Rest typically includes reducing the amount of weight you put on your ankle, and you might need to use crutches. Ice can be applied for 15 to 20 minutes at a time, every few hours.
Wrap your ankle with a compression bandage for support and to reduce swelling. Make sure you can fit one finger between the bandage and your skin to keep from wrapping it too tightly. Elevate the foot above the level of your heart while resting to help reduce swelling.
See a Doctor
If your symptoms worsen, or do not begin to improve after the acute phase of healing, see a doctor. Ankle sprains can occur with additional injuries such as a bone fracture.
Time to Move
After a few days of rest, begin range-of-motion exercises to increase blood flow and decrease stiffness. Perform these exercises twice each day and only move within a pain-free range.
HOW TO DO IT: Draw the alphabet in the air, leading with your big toe. Perform ankle circles 10 times in each direction.
Bear Some Weight
Practice weight shifts to get your ankle used to bearing weight in preparation for running after ankle injury.
HOW TO DO IT: Stand with your feet hip-width apart. Shift your body weight side to side, then forward and back, 10 times each.
Progress from two crutches to one, using it on the opposite side from your injury. Once you can walk without limping, stop using the crutch.
Walking in water can help improve your gait with less stress on your healing ankle. You can also progress to aqua running after an ankle injury.
Improve Your Balance
Ankle sprains can damage proprioceptors in your ankle that help you maintain your balance. These receptors can be retrained with balance activities. Begin these activities once you can bear full weight on your ankle without pain.
Practice standing on uneven surfaces, such as a pillow, and standing with your eyes closed. Begin on both feet and progress to standing only on your injured ankle. Continue these exercises until the time that you can balance on one foot is equal on both sides.
Progress to dynamic balance exercises such as climbing stairs, jumping on two feet and hopping on one foot.
Get Ready to Run
Ease back into running by jogging at a slow pace. Consider low-intensity interval training, such as jogging for 30 seconds, followed by one minute of walking. Start with short sessions, such as 15 minutes, adding a few minutes to each subsequent workout.
Once you can continuously jog without walking breaks, increase your speed to a run. Alternate jogging and running at set intervals. Stick to flat surfaces while you are easing back into running — hills can increase your risk of falls and overwork your muscles.
If your injury is severe, or recurring, you might need to wear a brace during sports activities.
Return to Sports
The final phase of returning to running after an ankle injury includes sports-specific training. These activities can include agility drills, plyometrics, ball skills and sprints.
Consider consulting an athletic trainer or physical therapist for specific return-to-sport guidelines — particularly if you are an athlete — to help prevent reinjury.
- Clinics in Podiatric Medicine and Surgery: Return to Play After an Ankle Sprain
- Sanford Orthopedics Sports Medicine: High Ankle Sprain Rehabilitation Guide
- American Academy of Orthopaedic Surgeons: Foot and Ankle Conditioning Program
- Physiopedia: Ankle Sprain
- Mayo Clinic: Sprained Ankle
- UW Health Sports Rehabilitation: Rehabilitation Guidelines for Lateral Ankle Reconstruction