Are you one of those people who seem to sprain your ankle all the time?
To some extent, ankle sprains are part and parcel of physical activity.
But if it happens again and again, here’s what can happen and how you can reduce your risk of a recurring ankle sprain.
One sprain can lead to another… and another
A large review of ankle sprain studies in the journal Sports medicine found that most people who actively play sports or train can expect to have a fairly low incidence of ankle sprain per 1,000 hours of training.
But he also said: “Women were at higher risk of ankle sprain than men and children than teenagers and adults, with indoor and field sports being the highest risk activity. .”
The most common type of ankle sprain occurs if the ligaments on the outside of the ankle are stretched or torn when the joint moves beyond the normal range of motion. This is called an inversion or lateral ankle sprain.
Strong evidence from studies suggests that once people sprain their ankle, they are more likely to sprain it again.
As one review of the evidence put it: “A history of lateral ankle sprain is known to disrupt the structural integrity of ligaments and sensorimotor function, likely impairing an individual’s ability to avoid harmful situations.”
Some ankle sprains may seem very minor, with almost no swelling or mobility issues. But some people can end up with what’s called chronic ankle instability, where they tend to sprain their ankle over and over again.
Another review looking at factors contributing to chronic ankle instability found that “feelings of unsteadiness and recurrent ankle sprains (called chronic ankle instability or CAI) have been reported in up to 70% of patients. Further development of CAI has adverse health consequences, including reduced quality of life and early osteoarthritis.”
Once an ankle fracture is ruled out, busy hospital emergency departments often send patients home with instructions to ice the ankle and not use it for a day or two. There is often no advice to follow up with a physical therapist for rehabilitation.
This is unfortunate, as evidence suggests that people with a history of ankle sprains are likely to:
Even the other ankle may be at risk
Research suggests that people who sprain their ankle are more likely to have injuries to other joints in the same leg, or even the opposite leg. A review in the International Journal of Sports Physiotherapy noted “an ankle sprain is related to both reinjury and subsequent injury to the contralateral side”.
Why? It may have something to do with the brain’s tremendous ability to constantly adapt.
Just as prolonged bed rest or prolonged exposure to microgravity in astronauts can cause changes in the brain and how it relates to movement, perhaps our brains subconsciously compensate after an ankle injury.
This could be, for example, limping or slightly changing the way you walk; maybe you don’t want to subconsciously challenge the ankle for fear of spraining it again. This can put other joints or the opposite limb at increased risk.
This neuroplasticity adds new challenges to assessing or rehabilitating an ankle injury and predicting who may be at increased risk for subsequent injury.
What can you do to reduce the risk of ankle re-sprain?
If you suffer from recurrent ankle sprains, see a physiotherapist. They can teach you how to reduce risk.
Currently, the best evidence for reducing the risk of ankle re-sprain comes down to two main things:
1) Protect the joint with an ankle brace in case of activity
This could mean using a professionally fitted external support splint (not an elastic sleeve). This is a relatively inexpensive and effective means of risk reduction.
2) Use balance exercises and ‘proprioceptive training’
Here are examples of proprioceptive training:
- balancing on each leg, one at a time, while throwing and catching a ball against a wall
- balancing on an ankle disc or a swing board for three to five minutes a day.
These exercises can help strengthen the muscles and ligaments in your ankle.
As one review of the literature put it: “Proprioceptive training is a cost-effective and time-effective intervention that may benefit patients who have previously experienced an ankle sprain during physical activity and may subsequently reduce the risk of further complications”.
Gordon Waddington, AIS Professor of Sports Medicine Research, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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