Ankle sprains are the most common injuries in many popular sports and very identifiable when they occur. You roll your ankle, feel a click or pop, followed by pain, swelling and sometimes bruising. After it happens once it is likely for it happen again and result in a chronic performance hindering injury.
A multi-sport study looking at ankle sprains showed that “as much as 73% of all athletes had recurrent ankle sprain and 59% of these athletes had significant disability and residual symptoms which led to impairment of their athletic performance [1].”
So how do you prevent recurring ankle sprains and impairment in athletic performance?
The common “first aid” protocol for ankle sprain is known as PRICE (protect, rest, ice, compress and elevate). It addresses the acute pain and inflammatory processes of the injury. This is a start but how do you really get a sprained ankle back to normal? There is more to this injury than just pain and swelling. After dealing with the swelling the biggest issue is the sprained ligaments and strained muscles. Injuries to the ankle joint cause some degree of instability and loss of position sense (the ability to sense balance).
The greater the injury to the ligamentous structures surrounding the ankle, the greater the loss of joint position sense. This is known as deafferentation where signals from ankle muscles and tendons to the brain and vice versa are disrupted due to damaged receptors in those structures. Deafferentation may be permanent and may result in impaired reflex stabilization of leg muscles during sudden passive displacement of the ankle. [2] This is the reason for high rates of re-injury, residual symptoms and impaired athletic performance.
To prevent chronic ankle instability after a sprain, a proper evaluation and treatment plan is necessary. In out clinic we throw PRICE out the window. Sprained ankles are stiff, so we need to restore full range of motion with active and passive mobility protocols and decrease scar tissue formation and promote tissue healing with myofascial release techniques. We address inflammation with decompression taping like Rock Tape. And, to help you get back in the game, we will progress you though specific balance and agility exercises to restore stability, position sense and improve overall function.
[1] An epidemiological survey on ankle sprain M. S. Yeung MPhil, Kai-Ming Chan MCh(Orth) FRCS*, C. H. So MPhilt and W. Y. Yuan MSc
[2] Kinesthetic Awareness in Subjects with Multiple Ankle Sprains. PHYS THER. 1988; 68:1667-1671.Stanley N Garn and Roberta A Newton
