ankle sprains: the most under-rehabbed injury
Ankle sprains are like uninvited guests at a party – they show up unexpectedly and can be quite a nuisance. Whether you're an athlete or just someone who enjoys an occasional stroll, chances are you've experienced the discomfort of an ankle sprain at some point in your life. But what exactly is an ankle sprain, and why do they often linger longer than expected?
Anatomy of an Ankle Sprain
When we talk about ankle sprains, we're usually referring to injuries involving the ligaments on the outer side of the ankle. These ligaments, such as the anterior talofibular ligament (ATFL) and the fibulocalcaneal ligament, are crucial for stabilizing the ankle joint. Ankle sprains typically occur when the foot rolls inward, stretching or tearing these ligaments in the process.
Ankle sprains are graded based on severity, ranging from grade one (mild stretching) to grade three (complete ligament tear). Even in milder cases, the loss of proprioception – the body's ability to sense joint position – can significantly impact recovery and increase the risk of future sprains.
Why Your Ankle Sprain Lingers
If you've found yourself still bothered by an ankle sprain long after the initial injury, you're not alone. Here are three common reasons why ankle sprains can be persistent:
1. Inadequate Rehabilitation
One of the biggest mistakes people make is discontinuing rehabilitation once the pain subsides. While pain relief is important, true recovery requires comprehensive rehabilitation that goes beyond symptom management. Building strength, improving balance, and restoring proprioception are essential for long-term ankle health.
2. Ineffective Rehab Strategies
Traditional rehabilitation methods often focus on unstable surfaces like wobble boards and foam pads. While these tools have their place, they may not adequately prepare the ankle for real-world challenges. Functional exercises that mimic daily activities or sports-specific movements are more beneficial for restoring stability and preventing re-injury.
3. Lack of Activity-Specific Training
If your goal is to return to running, hiking, or any other physical activity, it's crucial to incorporate that activity into your rehabilitation plan. Merely strengthening the ankle in isolation may not translate to improved performance or reduced injury risk in your chosen activity.
Choosing the Right Footwear
Another aspect often overlooked in ankle sprain recovery is footwear selection. Contrary to popular belief, bulky, cushioned shoes may not be the best choice post-injury. Minimalist footwear with a low stack height (the distance between your foot and the ground) can promote better ankle stability by minimizing the lever arm during foot inversion.
While minimalist shoes are ideal for everyday use, exceptions exist for activities requiring additional support, such as backpacking or heavy lifting. In such cases, footwear with increased ankle support may be warranted to mitigate the risk of re-injury.
The Road to Recovery
Rehabilitating an ankle sprain isn't just about reducing pain; it's about restoring function and preventing future injuries. A comprehensive approach that addresses strength, balance, proprioception, and activity-specific training is key to achieving optimal outcomes.
If you've recently sprained your ankle or are still grappling with lingering symptoms, don't hesitate to seek professional guidance. By investing time and effort into your rehabilitation, you can overcome the limitations of your ankle sprain and get back to doing what you love – pain-free and with confidence.
Rehab Exercises:
Week 1: GOAL is to improve range of motion, reduce swelling, and reduce pain. VIDEO
Week 1-2: Restore Range of Motion and load in pain-free range. VIDEO
Week 2+: Increased ankle loading and ligament loading. VIDEO
Week 4+: Improve strength, endurance, and tolerance to inversion stress
Week 6-8+: Increase power, speed, resilience, and stability, preparing for sport-specific demands
Do NOT STOP your rehab plan when your pain is gone. KEEP GOING until you have returned to FULL FUNCTION!
Your plan should be at least 8 weeks. Yes, even for a Grade 1 ankle sprain.
Healing takes time, especially when you want to get back to meaningful activities.
Need help? Book a free consult with us!
Dr Mark Murdoch is a runner, chiropractor, and rehab specialist in Vernon, BC.
Every week he works with runners, mountain bikers, and adventure athletes who want to get back to their sport better than ever.
Request a free consult with him here: CONTACT
