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An extremely common and annoying injury is the ankle sprain. Unfortunately, this is also an injury that is under-managed and often doesn’t receive the attention and rehab it deserves. This then leads to future recurrent injuries, a vicious cycle develops, and your ankles become weaker and more prone to the dreaded sprain!

Firstly, lets clarify the difference between ligaments and tendons.

A ligament connects a bone to another bone and provide proprioception which is extremely important for balance!

A tendon connects a muscle to bone, which also need to be strong around joints to provide strength and stability.

Types of ankle sprain

INVERSION sprain: When your foot rolls inward (onto the outside of your foot), the ligaments most likely to be affected are the ATFL or CFL that on the outside/top of your ankle.

EVERSION: On the flip side (literally!) If you roll your foot outwards, there are a group of three ligaments that can be damaged called the Deltoid ligaments. Eversion injuries are far less common than inversion.

How does this happen?

Ligaments are damaged when the joint is taken beyond your normal, anatomical range of motion. Depending on the severity, the damage can range from a small tear to a complete rupture.

Running on uneven surfaces, rapid change of direction, or landing from a jump awkwardly are often situations that can lead to a sprained ankle. Poor muscle strength around the ankle e.g. calves, and poor balance are other likely contributing factors!

Management

If you suspect you’ve sprained your ankle, sit with your foot elevated and gently try to move your ankle up and down within your pain limits. Pain is a blessing, it will tell you what you should and shouldn’t be doing especially in the early stages! Book an appointment with your physio as soon as possible for an assessment and seek guidance for proper steps to manage your injury. 

Some early stage exercises may include:

  • Ankle pumps and alphabets – moving your ankle through gentle ranges of movement as tolerated
  • Double leg calf raises
  • Avoid stretching of the ankle

NO PAIN ≠ FIXED

Once the pain goes away, don’t be fooled, your ankle isn’t instantly recovered! When your pain subsides, this is the time to assess your balance and pay attention to the areas that may have contributed to your injury in the first place. It is a good idea to test your calf strength, balance, and ankle mobility.

A trusty test we do in the clinic with a lot of lower limb injuries is a single leg calf raise!

How many can you do on each leg without stopping?

If you cant get to 25 on each leg there may be some room for improvement!

How’s your balance?

Can you stand on one leg with your eyes closed?

Can you walk heel to toe on an imaginary tightrope with your eyes open? What about closed?

Here are some simple balance exercises you can implement in your routine

  • Standing on one leg with your eyes closed for 30 seconds try 3 x 30 sec on each leg. If this is too easy – stand on a pillow!
  • Hopping on one leg – try 3 x 30 seconds on each side
  • Single leg calf raises from a step – try 3 x 12 reps on each leg as high as possible

It is also important to consider strength in your glutes and abdominals to provide stability for the whole lower limb!

Please remember – it’s not ‘just an ankle sprain’ make sure you give these injuries some TLC and attention to strengthening and balance, and stop the vicious cycle!

Teri Schubert

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