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The Ankle Part 1: The Common Sprain

1 Jun 2015
Andrew Wynd
Ankle sprains are extremely common and are almost seen as “routine” in sport, especially those involving changes of direction. Unfortunately, these injuries are often not rehabilitated completely and can lead to all sorts of ongoing issues.

Most commonly injured are the ligaments on the outside of the ankle, namely the specific band called the anterior talo-fibular ligament, or ATFL for short. This band of fibrous tissue limits plantarflexion (pointing the foot down) and inversion (turning the foot inwards). Luckily, should it be damaged through an ankle sprain, it has a good capacity to heal and for scar tissue and there are other ligaments which still provide good stability.

Beware however of just resting and waiting for a simple ankle sprain. Countless studies have shown that high level balance and proprioception (ability to sense and react to various positions) do NOT come back on their own (Hiller et al., 2011). This leaves the athlete with a potentially unstable platform and the consequences can vary, including:

  • Recurrent sprains, leading to chronic instability
  • Compensation further up the “chain” ie: knee or hip problems
  • Altered movements patterns
  • Increased risk of acute knee injury, such as an ACL rupture

To avoid recurrence and reduce the risk of the above, a well-designed rehabilitation program is critical (Postle, Pak and Smith, 2012). Restoring full movement and strength is a given, but close attention should be given to proprioceptive training.

My favourite three high level balance drills are included below. Please note, these should only be done when pain and swelling have subsided and please consult an expert for further guidance.

  1. BOSU ball drills
    1. Standing on the injured side and balancing on the flat side
    2. Hopping and rotating on the ball side
  2. Hopping and landing challenges
    1. Create challenges such as jumping over a stick and landing on a mark
    2. Jumping and landing between two objects
  3. Shuttle runs
    1. Make sure you turn through both directions, with increasing speed

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