Rest is recommended to limit any movement that causes pain. This may include non-weight bearing in a brace with crutches.
Cryotherapy or ice therapy is a simple and effective modality used to reduce pain and swelling. Ice is applied for 20-30 minutes.
Compression bandaging is recommended to support the injured soft tissue and reduce excessive inflammation.
The affected leg is kept in elevation above the heart to assist gravity to reduce excessive swelling around the ankle.
An ankle brace can be used to protect the damaged ligament, it provides protection and stability.
Kinesio taping helps to provide mechanical support for an unstable ankle joint.
Transcutaneous Electrical Stimulation:
Transcutaneous Electrical Stimulation is found to be effective to decrease swelling, spasms, and pain.
Therapeutic ultrasound decreases pain, and inflammation improves function, and helps to enhance the healing process.
Manual therapy includes soft tissue massage, lymphatic drainage, talocrural distraction in the neutral position, and anterior to posterior talocrural glides. Manual therapy helps in pain reduction, reduces stiffness, and increases functionality.
Range of Motion exercises:
Range of motion exercises are done to increase joint movement and functionality. Simple range of motion exercises can be done to improve joint movement. Passive range of motion exercises for dorsiflexion can be performed in both weight-bearing and non-weight-bearing positions.
Muscle Strengthening exercises:
Calf, ankle, and foot muscles require strengthening after a high ankle sprain. Strengthening exercises provide normal dynamic ankle control and function. Strength and power should be gradually progressed from non-weight bearing to partial and then full weight-bearing and resistance-loaded exercises.
Stretching exercises like standing stretch, seated dorsiflexion, stretch with theraband, double heel raise progressing to single heel raise, and dorsiflexion stretching on a step stool can be used to increase the flexibility of the muscles.
Proprioception and Agility exercises:
Balance and proprioception are adversely affected by a high ankle sprain. To prevent the re-injury, the patient should return to sport, the physiotherapist guides the patient through the exercises to improve the performance. Depending on the type of sport or lifestyle, speed, agility, proprioception, and power program are customized to prepare the patient for light sport-specific training. Ankle proprioception, postural reflexes, and balance reeducation are also done.
Exercise training is progressed to jogging, cycling, agility, jumping, and sport-specific drills involving high-intensity exercises.