Often I hear patients say, “I have sprained this ankle so many times. I do the rehabilitative work and strengthen my ankle, but it just keeps happening.” This is a common, and preventable, problem.
When an ankle sprain occurs, ligament tissue stretches and tears. Of course it is important to apply acute care- think “RICE” (rest, ice, compression and elevation), and to do strengthening exercises once the acute inflammatory period is over (usually 48-72 hours). There is, however, one commonly overlooked solution to keeping these ankle sprains from recurring: proprioceptive rehabilitation.
I know, it sounds like a big word and it must be complicated, but it’s not. Proprioception is our ability to know where we are in space without having to use our eyes. Think about where your foot is right now, or your pinky, or your elbow. You don’t have to look- you know where it is by the grace of your functioning nervous system. The millions of nerve endings in your muscles, ligaments and joint receptors are telling your brain for you so you can keep your eyes glued to this blog! It is this system, your proprioceptive system, that is damaged when you tear the ligaments of your ankle.
When you tear ligaments, you tear nerve endings. Effectively, you lose some of the feedback that your ankle is constantly providing your brain when you are standing on your feet. So even if you have done the proper acute care and subsequent strengthening, if you don’t re-establish the neurologic connection between your ankle joint and your brain you are unable to adapt to changes beneath your feet, such as a crack in the sidewalk or a slippery banana peel. You need those nerves in the ankle to tell your brain what is going on down there!
A recent study in the American Journal of Sports Medicine followed soccer players with a history of ankle sprains and subjected them to various forms of prevention: orthotics, strength training, proprioceptive rehab and a control group. Relative to the control group, proprioceptive training reduced the risk of ankle sprains by 87%. This is an aspect of ankle sprains that cannot be ignored!
The exercises are simple and easy to implement, and can be done anywhere, but they do require some instruction. So come on by Parkside Clinic or call and ask for a special proprioceptive evaluation. Dr. Suppnick and I will show you some simple exercises to get you back out there with healthy joints, ready to stay that way.
Aaron Armbruster, DC