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Lateral Ankle Sprain

Lateral Ankle Sprain Protocol-Brigham and Women's Hospital

Acute Phase: Days 1-3

Goals: Decrease pain and swelling, protect from further injury

  • Pain and swelling management (RICE)
  • Protection of injured ligaments (taping, splints, casting, walking boot etc.)
  • Gait-WBAT

Sub-Acute Phase: 2-4 days to 2 weeks

Goals: Decrease/eliminate pain, increase ROM, decrease swelling, increase strength

  • Continue pain and swelling management
  • Subtalar and talocrurcal joint mobilizations
  • ROM with pain-free range: DF/PF/EV/IV AROM, calf stretching
  • Increase weight bearing of affected extremity during gait
  • Isometric strengthening

Rehabilitative Phase: 2-6 weeks

Goals: Regain ROM and strength, increase endurance and proprioception

  • Continue joint mobilizations and stretching
  • Progress to pain-free concentric and eccentric strengthening exercises (both open chain and closed chain)
  • Proprioception exercises (balance board, BAPS board, single leg stance etc.)
  • Gait training-promote equal weight beraing and weaning of assistive devices
  • Endurance activities (stationary biking, swimming, walking, etc.)

Functional Phase: 6 weeks

Goals: Return to full activity and function

  • Continue strengthening exercises
  • Coordination and agility training-depends on patient's prior level of function, recreational activities, and goals 


Standard of Care: Ankle Sprain. Brigham and Women's Hospital Web site.