Ankle sprains are among the most common of diagnoses seen by physical therapists. Most of us have regrettably experienced this painful injury through playing sports that require jumping, quick movements, and frequent changes in direction. Soccer, football, ultimate frisbee, basketball, and volleyball are all good examples of popular sports that often result in sprains.
What most people do not realize is that ankle sprains can have nagging consequences that can be seen years after the initial injury. Today we will address two effects that are worth your attention.
The first problem resulting from the ankle sprain involves the ligaments that are “stretched out” from the sudden and often violent turning of the ankle past its normal range of motion. Once they are stretched out, they will never return to their original shapes. We are left with an ankle that is less stable, especially in the direction that the sprain occurred.
To add fuel to the fire, the sprained ligaments lose the ability to efficiently communicate with your brain. The result is decreased coordination of the ankle. Watch someone who recently sprained his or her ankle attempt to balance on his or her leg: you will see a general lack of balance and coordination that is reflective of this phenomenon.
A second clinical problem seen long after the initial ankle sprain is chronic stiffness. Months, and even years after the injury, it is common to see a loss of ankle dorsiflexion. This loss of range in the ankle has a domino effect: normal walking becomes compromised, and muscles higher in the leg and pelvis lose efficiency and strength. This can lead to other problems such as lower back pain and hip bursitis.
Rehabbing an ankle sprain
Every ankle sprain patient that we see is given at minimum two exercises to perform in order to combat the above mentioned problems. The first is single leg balance training with the shoes off. The muscles supporting the ankle and foot need to be retrained in order to provide the maximum amount of stability. We typically will ask the patient to attempt to balance on the affected leg with the knee slightly unlocked until the ankle is fatigued.
Secondly we have patients learn to perform a calf-style stretch to regain any lost dorsiflexion. The patient faces the wall with the sprained ankle placed about two to three feet from the wall. The toes are pointed toward the wall, the knees are slightly bent, and the hands are placed on the wall. The patient is asked to lean forwards until a gentle stretch is felt in the top portion of the ankle. Ten to fifteen seconds of gentle stretch is advised. This stretch may be familiar to runners.
Take a minute to look at how well your ankle moves. Does one ankle have less range and coordination than the other? Did you ever sprain that ankle? If so, it is in your best interest to do something about it.