1. Immediate Care (First 48–72 Hours) – R.I.C.E. Reduce pain, swelling, and inflammation. Avoid putting weight on the injured ankle. Use crutches if necessary. Apply ice packs for 15–20 minutes every 2–3 hours. Use an elastic bandage or ankle wrap to minimize swelling. Keep the ankle raised above heart level to reduce fluid buildup.
2. Early Rehabilitation (3–7 Days Post-Injury) - Restore mobility and reduce stiffness. Begin gentle range-of-motion (ROM) exercises, such as: Ankle circles, Alphabet writing with the toes, Continue light compression and elevation. Avoid movements that cause pain or stress the ligaments.
3. Intermediate Phase (1–3 Weeks Post-Injury) - Start isometric strengthening (pressing the foot against a wall without moving it). Progress to resistance band exercises: Inversion, eversion, dorsiflexion, and plantar flexion. Perform calf stretches and gentle weight-bearing exercises as tolerated.
4. Advanced Strengthening and Balance (3–6 Weeks Post-Injury) - Add single-leg balance exercises on flat and uneven surfaces. Continue progressive strengthening (heel raises, squats, step-ups). Introduce proprioception training (e.g., using a wobble board).
5. Functional Training (6–12 Weeks Post-Injury) - Begin sport-specific or activity-specific drills: Side shuffles, hopping, jogging, or agility ladder drills. Incorporate dynamic balance and plyometric training. Consider ankle bracing or taping for additional support during activity.
6. Full Recovery and Maintenance (3 Months and Beyond) - Continue strength and balance exercises 2–3 times a week. Maintain flexibility with stretching routines. Warm up properly before physical activity. Wear appropriate footwear that provides support.
Severe ligament tears (Grade II or III) may require immobilization or surgery before rehabilitation begins. Always follow guidance from a sports doctor or physiotherapist to tailor exercises to your injury severity and recovery rate. Rushing recovery can increase the risk of chronic ankle instability.
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