There are few things more frustrating to a runner than landing on the injured list. And while there are many popular aches and pains that go hand-in-hand with pounding the pavement, ankle sprains can be one of the most frustrating.
Maybe you rolled your ankle running or simply stepped wrong cleaning up around the house. No matter the cause, know that sprained ankles are super common and may not require total rest, says Luke Greenberg, DPT, co-founder of MOTIV in New York City. In fact, in many cases, it's important to keep the joint moving in a safe way.
"With this injury, you'll want to put as much load on it as it will tolerate without getting worse and increasing swelling or inflammation," Greenberg tells LIVESTRONG.com. "The consequences of immobilizing it are often worse than the benefit of resting it."
So, how long does a sprained ankle need to heal and how soon can you get back to running? And what exercises can you implement into your routine to potentially reduce the likelihood of another going forward? Here, the experts chime in.
What Is the Recovery Time for a Sprained Ankle?
Depending on the severity, ankle sprains can take just shy of a week to three months to heal properly. Severity can range from grade 1, featuring minor microtrauma in the ligaments without stretching them, to grade 3, a full ligament tear, according to Harvard Health Publishing.
"If you feel a nagging pain after increasing your mileage or activity levels, most likely your pain is as a result of tendonitis," Rosenblatt tells LIVESTRONG.com.
An ankle sprain doesn't always mean you'll be out of the game for three months.
"This isn't something you want to get worked up about right off the bat," Greenberg says. "[Ankle sprains] can heal relatively quickly. Maybe it's the break you didn't know you needed."
However, there are some risks to starting running again too soon. Resuming activity too early in the healing process may cause the ligament to scar in a stretched position, leading to recurring ankle sprains and chronic instability, according to an April 2015 article in Clinics in Podiatric Medicine and Surgery.
The best way to get a more accurate estimate of your projected recovery time is to touch base with a physical therapist or physician to see what type of ankle sprain you're working with. They can also help you develop an appropriate healing plan, Greenberg says.
What Is the Recovery Process for a Sprained Ankle?
Here are the five main steps in the recovery process, from ankle injury to resuming running again.
Home remedies promote healing after an 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. Apply ice for 15 to 20 minutes at a time every few hours.
Wrap your ankle with a compression bandage (Amazon.com, $9.95 for two) 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.
2. Start Gentle Movement
After a few days of rest, begin range-of-motion exercises to increase blood flow and decrease stiffness. Perform these exercises twice a 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.
3. Bear Some Weight
Practice weight shifts to get your ankle used to bearing weight in preparation for running after ankle injury.
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.
How to Do It
To practice weight shifts, stand with your feet hip-width apart. Shift your body weight side to side, then forward and back, 10 times each.
4. Work on 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.
Progress to dynamic balance exercises such as climbing stairs, jumping on two feet and hopping on one foot.
How to Do It
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.
5. Start Running
Ease back into running by jogging at a slow pace. Consider alternating intervals of jogging and 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.
3 Signs It's OK to Start Running After an Ankle Sprain
Knowing when it's safe to run again after spraining your ankle requires paying attention to how your ankle looks and feels. But these are some general signs that signals it's OK to get back out there and very slowly ramp up your mileage again.
1. There’s No More Pain
It's typically safe to put some weight on a sprained ankle — meaning it shouldn't injure you further or lead to long-term problems — as long as it doesn't hurt to do so, according to Greenberg. If it does hurt, that's a sign the sprain is more severe or not healing enough yet to return to running.
But if you can go about your day-to-day life without pain when you walk, that's a key indicator the healing process is well underway.
2. There Are No Visible Signs of Bruising or Inflammation
When looking at your sprained ankle, it can be useful to compare it to your other, non-injured one. If the swelling is still there, you're not in the clear yet.
"Swelling makes your body a bit confused," Greenberg says. "When you try to load this confused joint, it becomes unstable and tries to depend on your torn or stretched ligaments. Because of that, your muscles try to learn how to provide the stability that the ligaments were before."
The human body does a pretty good job of compensating in these new ways, but, according to Greenberg, the goal is to get back to how things were — not rely on new movement patterns. That's where a qualified expert can really help you to build back essential strength and assist in the proper rehab process.
3. Running Feels Good
One of the best ways to see if you're ready to run again is to actually start running and see how your ankle feels. Just make sure not to take on too much too soon.
"Return to run programming should be systematic, being sure to not progress distances and terrain too rapidly," Rosenblatt says. "A good rule of thumb is to pick an easily attainable distance on a flat surface and then incrementally progress both difficulty in terrain as well as distance. Try to keep distance progressions to no more than 10 percent per week."
Greenberg advises starting with smaller distances, especially for newer runners.
"Begin with smaller time increments or something like a couple miles, then work up to 5K, 10K and so on," he says.
If your ankle starts hurting again, stop running and check in with your PT or doctor.
5 Rehab Exercises for Stronger Ankles
"The number one predictor of a future ankle sprain is a past ankle sprain, and as such, even minor tweaks should be treated with a good bout of sports physical therapy," Rosenblatt says. "This should include balance training, core- and hip-strengthening and then sports-specific interventions like drills to perfect jumping and cutting."
Sports-specific drills can help strengthen your ankle in quick side-to-side or high-impact movements you may need to do.
Typically, the goal of sprained ankle rehab is to rebuild strength and stability in the ankle. In order to do this, you'll want to integrate stability-focused exercises (think: single-leg work that challenges your balance) into a regular routine. Doing this can also help prevent future ankle sprains.
The below exercises are some of the moves you'll find in a sprained ankle rehab program. Combine them into a full circuit, doing 45 to 60 seconds of each exercise.
Don't have the time to do all of them at once? Feel free to break them up throughout the day, according to Greenberg.
1. Ankle Controlled Articular Rotation (CAR)
- Start in a seated position with your legs extended. Begin by bringing your toes up.
- Rotate the bottom of your foot inward, then point your toes down and finish with rotating the bottom of your foot outward.
Your eventual goal for this exercise is to create a large circle without pain.
2. BOSU Ball Squat
- Place the BOSU ball on the ground with the flat platform facing up and the ball side facing down.
- Carefully step onto the platform one leg at a time, letting the ball sink.
- Use a hand on the ground (or a partner) for stability as needed.
- Come to standing and once you feel stable, slowly hinge at the hips and bend your knees to sit your butt back into a squat.
- Drive through your heels as you stand up.
If you're new to using a BOSU ball, place the piece of equipment platform side down to start. And, as with any movement, ensure your squat form is correct before adding in a tool to make things more challenging.
3. Single-Leg Star Tap
- Stand with your feet hip-width apart with a slight bend in your knees.
- Lift your right foot off the ground about 2 inches.
- Tap your right foot forward toward what would be 12 o’clock on a clock. Bring it back to center, keeping it hovering.
- Tap your toes out to 3 p.m. Bring them back to center.
- Tap your toes out to 6 p.m. Bring them back to center.
- Repeat on the opposite side.
4. Plyometric Hop
- Start by standing with feet hip-width apart.
- Begin hopping on both feet forward and backward.
Work up to doing this exercise on a single leg.
5. Speed Skater
- Start with your feet hip-distance apart.
- Jump to the side landing on one foot, letting your arms swing to that side.
- Quickly jump back the other direction, landing on the opposite foot.