Ankle Injuries: Get Back on Your Feet with Effective Rehab

Ankle Injuries: Get Back on Your Feet with Effective Rehab

Ankle injuries are a pain (literally) for many athletes. Up to 45% of all sports injuries involve the ankle, and research shows that a whopping 83% of these involve the lateral ligament [1, 2]. Current research shows excellent long term outcomes for non operative management in cases not involving a complete rupture in terms of cost, intra and post op complications and prolonged absense associated with surgical interventions

The good news? Most ankle sprains can be effectively treated without surgery. Here’s what you need to know about ankle sprain rehab and how to get back on your feet safely and quickly.

Understanding an ankle sprain

There are different types of ankle sprains, depending on which ligaments are affected:

• Lateral ankle sprain: This is the most common type, caused by rolling your ankle inwards (plantar flexion and inversion).
• Deltoid ligament sprain: This occurs when your ankle rolls outwards (eversion and pronation).
• High ankle sprain (Syndesmosis): This less frequent sprain involves the ligaments connecting the shin bones (contact with twisting and rotation with dorsal fleksion).

Risk Factors and Prevention

Previous ankle injuries significantly increase your risk of another sprain. Additionally, limited ankle mobility (dorsiflexion) and weak hip muscles can contribute to ankle instability [3, 4, 5].

Here are some tips to prevent future sprains:

• Maintain good ankle and hip strength (3.4% strength of bodyweight) (5) and flexibility with more than 34 degree ankle dorsi flexion range (4).

The Road to Recovery: Ankle Rehabilitation

Ankle rehab typically follows a staged approach:

• Early Stage (Focus: Pain Management and biological healing): This stage involves reducing pain and swelling, promoting healing, and regaining range of motion. Techniques like POLICE (Protect, optimal loading, Ice, Compression, Elevation) and gentle joint mobilizations can be helpful (6).
• Mid Stage (Focus: Strength and Balance): As pain subsides, strengthening exercises and balance training become crucial. This helps regain stability and proprioception (your body’s awareness of joint position). Focus on normalizing gait patterns and minimizing any compensatory movements in your hips or knees.
• Late Stage (Focus: Return to Activity): Here, you’ll gradually progress to sport-specific drills and plyometric exercises to prepare for your chosen activity.
• Maintenance: Don’t forget ongoing maintenance! Regularly incorporating strengthening and balance exercises into your routine can significantly reduce your risk of future sprains. Prevention.

Exercise selection (basic examples)
– ankle pump without or with resistance of a theraband
– isometric calf raises, eccentric calf raises, concentric-eccentric calf raises
– balance exercises like static single leg hold and tandem stance.
– balance line walk on ustable surface progessing with pertubation.
– balance weight shift tempo.
– Working on dorsal flexion.
– top toe walking
– Eccentric SL RDL
– banded double leg and single leg pogos
– Starting lateral mini jump
– change of direction jump
– staggered step off
– Drop jump
– bulgarian split squat jump
– step up and hop
– forward step off and hop
– lateral step off

bracing and taping

bracing and taping reduces risk of recurrent and first time ankle sprains (7). Lace up ankle brace is the most commonly recommend functional support (8). Rigid tape usage based upon cost athlete preference and compliance. Be aware of DVT, skin reactions and blood flow constrictions

Orthotics and shoes

Talk to your podiatrist.

Sum up
By understanding your injury, following a proper rehabilitation program, and incorporating preventative measures, you can get your ankles back to feeling strong and confident! With proper guidance and dedication to rehab, you can overcome your ankle sprain and get back to enjoying your activities! It’s important to consult a healthcare professional for a personalized rehabilitation plan based on the severity of your injury. Feel free to contact me if any questions.

references

1. Tee, E., Melbourne, J., Sattler, L., & Hing, W. (2021). Evidence for Rehabilitation Interventions After Acute Lateral Ankle Sprains in Athletes: A Scoping Review. Journal of Sport Rehabilitation https://doi.org/10.1123/jsr.2021-0244
2. Fong DT, Hong Y, Chan LK, Yung PS, Chan KM. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007. doi: 10.2165/00007256-
   200737010-00006. PMID: 17190537
3. Herzog, M. M., Kerr, Z. Y., Marshall, S. W., & Wikstrom, E. A. (2019). Epidemiology of Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training, https://doi.org/10.4085/1062-6050-447-17
4. Noronha M, Refshauge KM, Herbert RD, et al. Do voluntary strength, proprioception, range of motion, or postural sway predict occurrence of lateral ankle sprain?. Br J Sports Med 2006;40:824–8
5. Powers, C. M., Ghoddosi, N., Straub, R. K., & Khayambashi, K. (2017). Hip Strength as a Predictor of Ankle Sprains in Male Soccer Players: A Prospective Study. Journal of Athletic Training https://doi.org/10.4085/1062-6050-52.11.18
6. Weerasekara, I., Osmotherly, P., Snodgrass, S., Marquez, J., de Zoete, R., & Rivett, D. A. (2018). Clinical Benefits of Joint Mobilization on Ankle Sprains: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation https://doi.org/10.1016/j.apmr.2017.07.019
7. Vuurberg, G., Hoorntje, A., Wink, L. M., van der Doelen, B. F. W., van den Bekerom, M. P., Dekker, R., van Dijk, C. N., Krips, R., Loogman, M. C. M., Ridderikhof, M. L., Smithuis, F. F., Stufkens, S. A. S., Verhagen, E. A. L. M., de Bie, R. A., & Kerkhoffs, G. M. M. J. (2018). Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. British Journal of Sports Medicine, 52(15), 956–956. https://doi.org/10.1136/bjsports-2017-098106
8. Denton, J. M., Waldhelm, A., Hacke, J. D., & Gross, M. T. (2015). Clinician Recommendations and Perceptions of Factors Associated With Ankle Brace Use. Sports Health: A Multidisciplinary Approach, 7(3), 267–269. https://doi.org/10.1177/1941738115572984