Ankle Sprain Injury Prevention
THE SINGLE GREATEST
EXERCISE FEW PEOPLE KNOW
Rob Woodside
MPT, CSCS
Ankle sprains
plague not only athletes (statistically it is the most common injury
sustained by athletes), but also people simply engaging in everyday
activities. Fortunately, research in the past 10 to 15 years has
shed enormous light on how to prevent ankle sprains.
First and foremost,
we understand now that ankle sprains reoccur not merely because
of failures in ankle flexibility or strength, but moreso due to
the loss of balance and control (1-6) in the entire leg.
Normally, as
you get close to "rolling" your ankle, little receptors in the ligaments
of the ankle sense this and send a message upstairs to the central
nervous system (CNS). The CNS then reacts by contracting the correct
muscles in an effort to prevent a sprain. In the chronically
sprained ankle however, that system of protection is disrupted,
and the time it takes for those muscles to react and protect is
diminished. Therefore, the ligaments get stressed and re-tear
(or sprain) again and again.
Secondly, we
now understand that by retraining balance in someone who suffers
from chronic ankle sprains, we can speed that protective mechanism
back up, and subsequently decrease the chances of re-injury (2-7).
Third, we now
understand that by specialized balance training, we can also improve
the internal protective response to an ankle sprain in uninjured
people as well (4,5).
So how do we
most effectively train balance? Often, ankle rehab begins with relearning
to balance just on one leg. For people with a history of ankle sprains
or with a recent ankle injury, this can actually be very challenging.
For those beyond
that point, the following exercise offers a way for even high-level
athletes to condition the ankle to resist spraining.
Stand on one foot.
Now reach with the opposite leg outward in all directions, forward,
sideways, backwards, diagonally, etc. Reach out as far as possible
and hold for three to five seconds.
Each direction offers a different challenge to your balance and
trains the receptors of the ankle, knee, and hip. The farther you
reach the harder the balance leg is working. Start small and work
your way up. You can also reach with your arms, as this challenges
your balance differently.
Your body's protective response to an ankle sprain
involves adjustments at not only the ankle but also at the knee,
hip and spine. Research has shown that people with a history of
an ankle sprain have a delayed response in the muscles surrounding
the hip as well as the ankle (8-10). The above exercise involves
not only the ankle balance receptors, but also the hips, making
it extraordinarily effective.
The best time to do this is while watching television
for 15-30 minutes (because this isn't the most exciting exercise
in the world). To increase the difficulty level, try the exercises
standing on a pillow, or with your eyes closed. The more creative
you are the better chance of simulating all activities that will
challenge your body.
REFERENCES:
1.
Garrick JG, Requa RK: The epidemiology of foot and ankle injuries
in sports. Clin Sports Med 1988;7(1):29-36.
2. Richie DH Jr: Functional instability of the ankle and the role
of neuromuscular control: a comprehensive review. J Foot Ankle Surg
2001 Jul-Aug;40(4):240-51.
3. Osborne MD, Chou LS, Laskowski ER, et al: The effect of ankle disk
training on muscle reaction time in subjects with a history of ankle
sprain. Am J Sports Med 2001 Sep-Oct;29(5):627-32.
4. Sheth P, Yu B, Laskowski ER, An KN: Ankle disk training influences
reaction times of selected muscles in a simulated ankle sprain. Am
J Sports Med 1997 Jul-Aug;25(4):538-43.
5. Aydin T, Yildiz Y, Yildiz C, et al: Proprioception of the ankle:
a comparison between female teenaged gymnasts and controls. Foot Ankle
Int 2002 Feb;23(2):123-9.
6. Junge A, et al: Prevention of soccer injuries: A prospective intervention
study in youth amateur players. Am J Sports Med 2002; 30(5): 652-9.
7. Tropp H, et al: Prevention of ankle sprains. Am J Sports Med 1985
(13): 259-62.
8. Bullock-Saxton JE, Janda V, Bullock MI: The influence of ankle
sprain injury on muscle activation during hip extension. Int J Sports
Med 1994 Aug;15(6):330-4.
9. Bullock-Saxton JE: Local sensation changes and altered hip muscle
function following severe ankle sprain. Phys Ther 1994 Jan;74(1):17-28;
discussion 28-31.
10. Beckman SM, Buchanan TS: Ankle inversion injury and hypermobility:
effect on hip and ankle muscle electromyography onset latency. Arch
Phys Med Rehabil 1995 Dec;76(12):1138-43. |
DISCLAIMER:
The
information presented on DaiseyPT.com is provided for educational
purposes only and is not intended to be a substitute for professional
medical or physical therapy advice. You should not use the information
on this web site for diagnosing or treating a medical or health
condition. If you have or suspect you have a medical problem, promptly
contact your professional healthcare provider.
The exercises
presented in these articles pose risks if performed incorrectly
or if performed by persons who may be inappropriate for them. They
are provided for informational purposes only and to provide education
and insight into a particular interest. Daisey Physical Therapy
& Sports Medicine Inc. does not recommend performing them without
a complete history and examination as well as professional instruction.
Daisey Physical Therapy & Sports Medicine assumes no liability
for any injury that may occur by attempting the exercises presented
here.
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