This article was shared with DC Aligned by WebExercises and Dr. Dave Cruz. Download the Web Exercises Ankle Rehabilitation and Strengthening Guide to share with patients and reinforce the techniques learned in Dr. Silverman’s article.
Ankle injuries involving the ligaments—sprains—are some the most common injuries in sports. They occur most commonly in soccer, volleyball, basketball, and all sports that involve jumping, side-stepping, running, and rapid changes of direction. Ankle sprains account for 10 to 30 percent of all sports injuries.
Ankle inversion sprains are the most common sports trauma. They typically occur as the foot flexes downward (plantar flexion) and rolls in (inversion/supination). These sprains damage the outside (lateral) ankle ligamentous complex.
Ankle sprains have the highest recurrence rate of all sports injuries, and also have a high rate of subsequent chronic symptoms. The reported recurrence rate for lateral ankle sprains is 80 percent.
Causes and Risk Factors
One of the most common causes of ankle sprains is lack of conditioning. If the muscles, tendons, and ligaments around the ankle joint have not been trained or conditioned, this can lead to a weakness that may result in ankle sprains. A simple conditioning program that helps to even out any imbalances at the ankle will help considerably. The most common risk factor for an ankle sprain is a previous history of sprains that haven’t been treated with a program of conditioning and proprioception exercises to strengthen the joint.
Additional common causes of ankle sprains include:
- Lack of proper warm-up. Dynamic warm-up is always the best choice before an athletic event.
- Inappropriate footwear.
- Training on uneven ground.
Preventive Exercise Programming: Balance and Proprioception
Balance and proprioception are essential to athletes. Proprioception is the ability to determine where the body is in space. This helps the brain know if the body is off balance. Proprioception is especially important to athletes who have had ankle injuries. Training in proprioception can help these people avoid recurrent ankle injuries. This was shown in a 2004 study by Evert Verhagen in the American Journal of Sports Medicine, which showed that proprioceptive balance board training is effective for the prevention of recurrent ankle sprains.
Balance and proprioception can be improved by standing on one or two legs on a wobble board.
Well-conditioned muscles, tendons, and ligaments are crucial for preventing ankle sprains. In particular, many studies have found a correlation between a weak gluteus maximus and the occurrence of ankle inversion sprains. The protocol below addresses these areas and helps reduce the risk of ankle sprains by strengthening the entire structure of the ankle.
Sit in chair with feet flat on the floor, knees at a 90-degree angle. Place resistance band around forefoot, anchoring the opposite end to a firm structure. Place both hands between the knees to help maintain alignment between kneecap and second toe.
Ankle Eversion with Band: Movement
Lift forefoot off the floor and move outward in a scooping motion against the resistance band. Keep the hands between the knees to maintain proper knee/ankle alignment. Slowly return to start position. Repeat without placing foot on floor for recommended sets and reps.
Sit in chair with feet flat on the floor, knees at a 90-degree angle. Place resistance band around forefoot, anchoring opposite end to firm structure. Keep the hands between the knees to maintain proper knee/ankle alignment. Maintain alignment between kneecap and second toe.
Ankle Inversion with Band: Movement
Lift forefoot off the floor and invert ankle in a scooping motion against the resistance band. Slowly return to start position. Maintain knee/ankle alignment throughout the exercise. Repeat without placing foot on floor for recommended sets and reps.
Lie on floor, face up. Extend arms to sides. Bend knees with feet firmly on floor. Lift one foot off floor by straightening one leg from the knee.
Activate core muscles. Lift hips off floor to attain a bridge position with knees, hips, and shoulders in alignment. Slowly return to start position. Repeat for prescribed repetitions and sets. Initially, some cramping in the back of the thigh may occur. A simple hamstring stretch, before and after, may prevent this.
Download the Web Exercises Ankle Rehabilitation and Strengthening Guide to share with patients and reinforce the techniques learned in Dr. Silverman’s article.
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