Growing up as an athlete, I remember many basketball games where I landed funny and then “rolled” my ankle. Lucky for me, my ankles survived and did not turn into recurrent ankle sprains.
A sprain is defined as an injury to ligaments. Ligaments are tough yet flexible tissues that connect two adjacent bones. Ligaments are designed to support your moving parts. If the two ends of the ligament are stretched too far apart, it’s called a sprain. If the ligament is repeatedly stressed as in “rolling the ankle” all the time, then the ligaments lose their toughness and become stretched out. When this happens, ankle sprains can become recurrent.
With treatment, ligament tissue can heal. It’s important if you’ve suffered from recurrent ankle sprains that you learn how to protect against future sprains. When ligaments lose their ability to provide adequate support to the ankle, it can cause excess wear and tear in the ankle and rear foot.
Recurrent ankle sprains are a troublesome problem. This is particularly true for athletes who love to run, hike, play sports that require cutting and twisting motions like soccer and basketball, jumping, and climbing. The most common ankle sprain occurs on the outside or lateral aspect of the foot and ankle (see figure below.) Ligaments can take up to 12 weeks to heal and sometimes longer depending upon factors such as grade of sprain, overall health and activity level.
The most common way we sprain the lateral ankle is by rolling it where the sole of the foot points inward as our foot hits the ground. You may be thinking that this is a weird motion to perform and how could you possibly put your foot and ankle in this awkward position. It’s easy to do if you jump and land wrong, step off a curb awkwardly or catch your toe on something. The more you’ve rolled your ankle and suffered with recurrent ankle sprains, the easier it is for your ankle to roll again. The ligament system becomes lax. Here are a few things you can do to prevent recurrent ankle sprains.
5 Tips to Prevent Recurrent Sprained Ankles
1. Choose Your Footwear Based on Activity
If you plan to play basketball, choose a shoe that supports the ankle. When hiking, purchase hiking shoes with adequate ankle and arch support that help your ankle accommodate to the terrain. When running, be aware of the surface. Gravel, sand, trails and uneven pavement create increased stress to the ankle ligaments when your foot lands.
2. Strengthen Your Leg, Foot, Hip and Core Muscles
Believe it or not, how your foot hits the ground when you walk and run has as much to do with your hips, core and legs as it does with the surface you are landing on. Strong lateral leg and ankle muscles along with solid strength in hamstrings, quadriceps, gluteals and core muscles produce better alignment and support as you walk and run. Weakness in any of these muscle groups produces abnormal forces at the foot, ankle, knee and hip.
3. Improve Your Balance
How quickly you can respond to perturbations in balance plays a large role in preventing recurrent ankle sprains. All your moving parts have little sensors in them called proprioceptors. These sensors are constantly sending your brain messages regarding your body’s position in space. Once the brain receives the message, it sends a lightning fast message back to the muscles of your body. The message tells the muscles what to do to keep you balanced and upright. It’s a pretty slick system! Most of my clients with recurrent ankle sprains have impaired balance reactions. The good news is that proprioceptive training is very effective in restoring balance reactions and preventing recurrent ankle sprains.
4. Maintain Full Ankle Dorsiflexion
Sometimes after recurrent lateral ankle sprains, your ankle flexibility changes. Many times I see a loss of dorsiflexion (when you pull your toes towards your face) and this affects how you walk. Many of my clients come to see me years after their last ankle sprain and they have a noted loss of dorsiflexion and swelling on the front of their ankle. When I find this, I do aggressive stretching to the ankle joint and open up the Achilles and calf with exercises. This restores normal dorsiflexion and allows the ankle to sit in the middle with walking. This is essential in the prevention of ankle sprains, especially lateral ankle sprains.
5. Use the Big Toe
Another common pattern I see when treating people with recurrent ankle sprains is that they walk toward the pinky toe side of the foot. In other words, they tend to keep more weight on the outside of the foot when walking. The next time you walk, try to notice where you feel the weight on the bottom of your foot. Is it centered, or is it on the big toe or pinky toe side? When your foot is behind you, most of your weight should flow through the big toe as your foot rolls off the ground. People with recurrent ankle sprains tend to either “duck out” the feet or walk on the outside of the feet. Learn to use your whole foot and roll off the big toe side of your foot. Doing so may prevent recurrent ankle sprains.
Whether you’ve suffered from your first ankle sprain or your 12th ankle sprain, there’s always something you can do to prevent future sprains. The best first step is to seek counsel from a physical therapist. Read my blog on “How to Find a Good PT” and visit apta.org to find one in your area. If you live in the Portland metro area and are suffering from recurrent ankle sprains, please contact us at 503-295-2585 or firstname.lastname@example.org.
All the best wishes for you and your ankles with all your summer activities!