How to know if you have full Ankle Injury Recovery?: 5 Quick physio tests to check

sprained ankle treatment stretching against lamp post

Ensuring Complete Ankle Injury Recovery: 5 Physio Tests for Confirmation

Ankle injuries, particularly ankle sprains, are common occurrences often associated with a risk of recurrence. Inadequate recovery may lead to prolonged discomfort and restrict participation in physical activities. A critical aspect of full ankle injury recovery involves regaining the ankle’s complete function, encompassing its movement, strength, and control. For instance, research highlights that insufficient recovery of dorsiflexion, a specific ankle movement, increases the likelihood of subsequent sprains. An unstable ankle poses a risk for new injuries. This article presents quick self-tests to assess the extent of ankle recovery and readiness to resume activities post-injury. Consult a physiotherapist for precise guidance in performing these tests accurately. Our specialised sessions for sprained ankle treatment focus on restoring range of motion and ensuring optimal readiness for sports and physical activities.

Close-up of woman hands holding and touching her ankle, suffering from ankle pain. Ankle pain may be caused by an injury, like a sprain, or by a medical condition, such as arthritis.
An injury, such as a sprain, or a medical condition, like arthritis, may be the cause of ankle pain.


Understanding Ankle Sprain Recovery:

Welcome to the Comprehensive Guide for Ankle Sprain Recovery! This guide is tailored to assist you in effectively managing and accelerating the healing process of a sprained ankle. Ankle sprains are common injuries that can impede mobility and cause discomfort. Following these expert-recommended strategies and exercises can expedite recovery and restore normal dorsiflexion range of motion (ROM) in just two days.

Key Factors in Fast Healing:

Immediate Care:

  • R.I.C.E. Method (Rest, Ice, Compression, Elevation): Apply these principles immediately after the injury to reduce pain and inflammation.
  • Immobilisation: Use a brace or wrap to stabilise the ankle and prevent further damage.
  • Avoid Weight-Bearing: Minimise putting weight on the affected ankle to prevent aggravation.

Early Rehabilitation:

  • Gentle Range of Motion Exercises: Perform controlled movements to maintain flexibility and prevent stiffness.
  • Strengthening Exercises: Engage in exercises targeting the ankle’s stability and strength to aid recovery.

Optimal Nutrition and Hydration:

  • Ensure adequate nutrients like vitamins C and E and protein intake to support tissue repair.
  • Stay hydrated to promote healing and reduce inflammation.

Strategies for Fast Healing:

  • Ankle Sprain Recovery Exercises:
    • Alphabet Writing: Rotate your ankle to trace the alphabet in the air, facilitating mobility and circulation.
    • Towel Scrunches: Use your toes to scrunch up a towel placed on the floor, enhancing foot and ankle strength.
    • Calf Raises: Perform calf raises to strengthen the muscles supporting the ankle joint.
    • Ankle Circles: Gently rotate the ankle clockwise and counterclockwise to improve flexibility.

Effective Pain Management Techniques:

  • NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Take over-the-counter medications like ibuprofen to alleviate pain and reduce swelling.
  • Topical Analgesics: Use creams or gels containing menthol or lidocaine to soothe the affected area.

Proper Rest and Elevation:

  • Elevate the injured ankle above heart level to reduce swelling and promote blood circulation.
  • Ensure adequate rest to allow the body to focus on healing.

Normal Dorsiflexion Range of Motion:

(Normal dorsiflexion ROM in the ankle is essential for proper gait and movement. To measure dorsiflexion ROM, the foot is flexed upward towards the shin. The average dorsiflexion ROM is around 20 degrees, allowing for smooth walking and running motions without discomfort.)

Recovery Timeline and Expectations:

(While a complete recovery from a sprained ankle within two days might be challenging, diligent adherence to the strategies above can significantly accelerate healing. Moderate sprains typically recover within 1-3 weeks, whereas severe sprains may take several months for full recovery.)

5 Physio Tests for Confirmation of Ankle Recovery:

1. Evaluating Ankle Recovery through Full Active Range of Motion in All Directions:

The ankle has four degrees of movement: dorsiflexion, plantarflexion, inversion, and eversion (refer to the picture below for the movements and expected range). The numbers provided for the expected full range of motion are arbitrary. What is usually more accurate is the comparison with your non-injured foot. You should not feel any pain in any of these movements, especially towards the end point of the movement.

Do this ankle range test for ankle dorsiflexion movement.

Try this simple clinical test to see if your ankle has fully recovered.

(1) Position your injured foot on a stool and inch your knee forward towards the wall as shown. Your heel must remain in contact with the stool.

(2) Measure the number of fingers from your big toe to wall,considering any limitations due to pain or stiffness.

(3) Compare this distance to your uninjured side. If you feel pain or if the distance is shorter on the injured side, complete recovery from the initial injury has not been achieved.

2.Single Leg Balance: Stability Test with Eyes Closed for 30 Seconds on the Injured Foot

Balance is important as part of our daily function, and it is contributed by our visual and joint proprioception (joint position sense). Every step we take tests our dynamic balance. While balancing on one leg with our eyes open should be a piece of cake, the real test of our proprioception happens when the task is performed eyes closed and sustained for 30s with minimal sway. Less than 30 seconds hold means your ankle needs plenty of balancing training. It is a step towards Ankle Injury Recovery.

3. Single Leg Heel Raises: Assessing Ankle Strength with 40 Repetitions

This test evaluates ankle strength by performing heel raises. Follow these steps:

Place your hands on a wall for stability during the test.

Step 1: Lift both heels off the floor to determine your maximum lift while maintaining straight knees and aligned shin bones. Repeat this task 40 times.

Step 2: Perform the same task while standing on one leg, aiming to achieve the same lift as when using both legs. Lower with control.

Difficulty completing 40 repetitions indicates a need for further strength training.

4.     Single Leg Hop (Height and Distance): Functional Test for Ankle Performance

Perform a single leg hop, aiming for maximum height with the non-injured leg, then repeat the task with the injured ankle. Achieve similar heights without pain during takeoff or landing. Additionally, balance on one leg and hop forward, maintaining balance without swaying. Compare distances between sides; they should be similar, signifying balanced recovery.

5.   Pain-Free Running: Assessing Dynamic Functionality

A woman running to Ankle Injury Recovery
Once you’ve succeeded in the previous tests and attained 95% symmetry with the single leg hop for distance, progress to dynamic activities like jogging and sprinting. Any ankle pain during these activities may compromise body mechanics, increasing the risk of re-injury or injury to other body areas.

If you score 5 out of 5 for the above tests, you are ready to conquer the world. If not, be kind do your ankle and consult our Singapore Physio clinic to learn more about specific training you need to do to ace the tests!

Dr Sharon Wang
Principal Physiotherapist

Dr Sharon Wang, writes from her heart and her personality shines through during her physiotherapy session with her patients. This exercise enthusiast loves a good workout, and you can catch her doing her Yoga to dance routine any day.
Questions and Answers on all things physio

Frequently Asked Questions

  1. Ankle Sprain Recovery:
    • Exercises for Ankle Sprain Recovery: Physiotherapists recommend various exercises focusing on mobility, strength, and stability. These exercises may include ankle circles, calf raises, and balance exercises.
    • Recovery Duration: The recovery time for an ankle sprain varies based on its severity. Mild sprains may take a few weeks, while severe sprains might require several months to recover. Gentle exercises and movements are generally recommended.
    • Ice or heat: Initially, ice is preferred to reduce inflammation. Heat therapy can be introduced in the later stages to aid in blood circulation and relaxation.
    • Starting Exercise Post-Injury: Gentle exercises and movements are generally initiated early to prevent stiffness. However, the timeline may vary for each individual based on their injury.
    • Role of Physical Therapy: Physiotherapy is crucial in ankle sprain recovery, offering tailored exercises, manual therapy, and guidance to expedite healing and prevent re-injury. Orthopaedic surgeons often endorse physiotherapy as integral to rehabilitation after ankle surgery.
    • Insurance Coverage: Insurance plans commonly cover physiotherapy as a recognised and essential treatment for ankle sprains.
  1. Sprained Ankle Recovery:
    • Home Remedies: Physiotherapists may recommend R.I.C.E. (rest, ice, compression, and elevation) along with specific exercises and modalities for home care.
    • Speeding Up Healing: While full recovery within 2 days is unlikely, physiotherapy interventions like therapeutic exercises, manual therapy, and modalities can help expedite healing significantly.
    • Weight-bearing: The physiotherapist gradually introduces weight-bearing based on the patient’s healing progress.
    • Signs of Healing: Reduced pain, improved range of motion, and regaining strength are indicators that a sprained ankle is healing.
    • Rest Duration: The duration of rest varies depending on the severity of the sprain and individual healing rates.
  1. How to Recover from a Sprained Ankle Fast in Two Days:
    • Feasibility of 2-Day Recovery: Complete recovery within two days is unrealistic for most ankle sprains. However, immediate application of R.I.C.E., gentle exercises, and professional physiotherapy interventions can aid in faster recovery.
    • Quick Remedies: Physiotherapists may suggest early intervention strategies like gentle exercises, appropriate rest, and ice application to alleviate immediate discomfort and initiate healing.
    • First 48 Hours: During the initial 48 hours, R.I.C.E., minimal weight-bearing, and protected movements are usually recommended.
    • Exercises for Rapid Recovery: Specific exercises prescribed by a physiotherapist can support healing within the first few days after the injury.
  1. How to Heal a Sprained Ankle Fast:
    • Expedited Healing Approaches: Physiotherapy interventions like tailored exercises, electrotherapy modalities, manual therapy, and ergonomic advice can expedite healing.
    • Medications or Supplements: Physiotherapists do not prescribe medications but might suggest over-the-counter pain relievers or supplements known to support tissue repair.
    • Use of ankle braces or wraps: A physiotherapist may advise using these aids to provide stability and support during the recovery phase.
    • Role of Nutrition: Nutrition rich in vitamins and protein supports the body’s healing processes and complements physiotherapy.
  1. Normal Dorsiflexion R.O.M.:
    • Normal R.O.M.: Ankle dorsiflexion R.O.M. of around 20 degrees is typical for fluid walking and running motions without discomfort.
    • Measuring Dorsiflexion R.O.M.: Physiotherapists use clinical measurements and tests to assess and monitor ankle dorsiflexion R.O.M.
    • Effects of Limited R.O.M.: Restricted dorsiflexion R.O.M. might impact gait and movement efficiency, potentially leading to compensatory patterns that can predispose to other injuries.
    • Exercises for Improvement: Physiotherapists devise personalised exercises and stretch targeting ankle dorsiflexion to enhance R.O.M. and functional mobility.

Conclusion and Additional Notes: Physiotherapy, often recommended and endorsed by orthopaedic surgeons, serves as a definitive and integral treatment modality for ankle sprains. Many insurance plans recognise and cover physiotherapy sessions as part of rehabilitation, underscoring their importance in facilitating effective recovery and preventing future injuries. Always consult a physiotherapist or healthcare professional for personalised guidance and treatment strategies tailored to your condition and recovery goals.

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