Ankle Sprains are SNEAKY but they are one of the most common injuries we see in athletes. Unless you stepped in a hole, or collided with someone, non-contact sprains can be avoided! We are here to give you the knowledge to help prevent them or get the help you need.
The most common type of ankle sprain is an inversion sprain. This is what we call "rolling your ankle." The foot is pointed in and downward stress is put on the outside of the ankle your weight distribute over it. This stress can injure several of the joints, muscles, and ligament in the foot but the most common ligament to be injured in an ankle sprain is the ATFL (Anterior Talo-Fibular Ligament). This ligament connects the lower leg bone to the top of your foot. In severe cases the ankle bones can also fracture with the sprain.
So why does this happen?!? Let's break it down:
A Weak Foot: A strong foot and ankle are way less likely to roll. The ability to push off of a strong stable ankle or keeping those toes up and clearing the ground are both key to prevention. This requires full strength of all the 4 major groups of ankle muscles as well as foot intrinsic musculature.
Lack of Flexibility: When your muscles are tight and lack the proper length the body will try to figure out the body will find a way to get to the destination. For example, if your calf muscles are too tight to allow you to move forward your body will get there by going around the side. This is in the exact direction of rolling your ankle. The two biggest players predisposing us to an ankle sprain are lack of Ankle Dorsiflexion and lack of Hip Extension.
Poor Awareness: Our joints have an ability to sense or be aware of where our bodies are in space. This is called proprioception. We have proprioceptors in our joints that give our muscles the timing to coordinate for change of direction, start/stop, and most importantly to regain a neutral position on an unstable surface. These receptors lie in our ligaments and are damaged when we sprain our ankles. We often sprain our ankle because we have poor proprioception in them. AND WHEN WE SPRAIN OUR ANKLE, the joints proprioception must be retrained. This is one reason ankle rehabilitation post an ankle sprain is so important and why people who do not properly rehabilitation their ankle post sprain often become repeat ankle sprainers.
Posture: Your foot posture always has a role in any joint or muscle dysfunction. When in the car or sitting comfortably how do you position your feet? Are they flat on the floor? Are tucked or hanging out to the side? When you stand or walk do you turn your toes in or out? Your daily foot postures can put strain on your ligaments and also condition your foot positions poorly putting you at risk for an ankle sprain. Slow down and check in that your everyday practices are serving your body to work to its full potential.
Your Arch Alignment: Is your foot flat or do you have a high arch? Know your body. If your foot is flat you need to make sure you are incorporating arch strength in your programming. If you arch is high arch then you need to make sure that your foot is also flexible. We are all genetically designed differently, but having an active and strong arch and a flexible foot will always lead to less ankle sprains.
Footwear: Do your shoes allow your toes adequate room or are they squished in your shoes. You should be able to open your feet as wide as possible in you daily footwear.
Taping: Somewhere along the line hard ankle taping became a thing in athletes of all types. Volleyball players use to see their athletic trainers prior to their games and all of them would get both ankles types to improve ankle stability and "reduce" ankle sprains. We have learned so much about the ankle and feet the past several years and one of them is that hard taping the ankles makes them weak and more susceptible to sprains. The only way to reduce your risk of spraining your ankle is to keep your ankle strong, stable and flexible.
So now that you know these things what next?
First, if your are a chronic ankle sprain'er or you have recently sprained your ankle and it is not getting better then you need to take a hard look at the list above and figure out what category/s you might be falling in. Second, if you have not had any formal physical therapy for your ankle we recommend you get some. Physical therapy is the one way you can learn ways to improve your, strength, flexible, proprioception, foot posture and be educated on proper footwear.
We hope this helped you!
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Yours in strength,
Dr. Brown & Dr. Bay