Are you one of those people who constantly sprain your ankle?
To a certain extent, ankle sprains are part of being active.
But if it keeps happening, here’s what might be going on — and how you can reduce the risk of a recurring ankle sprain.
One sprain can lead to another…and then another
A large review of ankle sprain studies in the journal sports medicine found that most people who actively exercise or exercise can expect a relatively low incidence of ankle sprains per 1,000 hours of exercise time.
But it also said, “Women had a higher risk of suffering an ankle sprain than men and children compared to adolescents and adults, with indoor and court sports presenting the highest risk.”
The most common type of ankle sprain occurs when the ligaments on the outside of the ankle become stretched or torn when the joint moves beyond its normal range of motion. This is called an inversion or lateral ankle sprain.
Strong evidence from studies suggests that people who sprain their ankle 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 ligament structural integrity and sensorimotor function, which is likely to impair a person’s ability to avoid injurious situations.”
Some ankle sprains appear to be very minor, with almost no swelling or mobility issues. But some people can end up with what is known as 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 instability and recurrent ankle sprains (referred to as chronic ankle instability, or CAI) have been reported in up to 70 percent of patients, along with a decreased quality of life and early-onset osteoarthritis.”
Once an ankle fracture has been ruled out, busy hospital emergency rooms often send patients home with instructions to ice the ankle and keep it off for a day or two. There is often no advice to see a physical therapist for rehabilitation.
This is unfortunate as evidence suggests that people with a history of ankle sprains are likely to:
The other ankle can also be at risk
Research suggests that people who sprain their ankle are more likely to have injuries to other joints on the same leg or even the opposite leg. A review in International Journal of Sports Physiotherapy noted that “an ankle sprain is associated with both re-injury and subsequent injury to the contralateral side”.
Why? It could have something to do with the brain’s tremendous ability to constantly adapt.
Just as prolonged bed rest or prolonged exposure to microgravity can cause changes in astronauts’ brains and the way it relates to movement, our brains may unconsciously compensate after an ankle injury.
This can happen, for example, by limping or by changing your gait slightly; Perhaps you subconsciously don’t want to challenge the ankle for fear of spraining it again. This may put other joints or the opposite limb at increased risk.
This neuroplasticity poses new challenges in assessing or rehabilitating ankle injuries and predicting who is likely to be at increased risk for subsequent injuries.
What can you do to reduce the risk of spraining your ankle again?
If you get repeated ankle sprains, see a physical therapist. They can teach you how to reduce the risk.
Currently, the best evidence of reducing the likelihood of re-spraining your ankle comes down to two main things:
1) Protection of the joint with an ankle brace during activity
This could mean using a professionally fitted external support brace (not an elastic cuff). This is a relatively inexpensive and effective means of risk reduction.
2) Use of balance exercises and “proprioceptive training”
Examples of proprioceptive training are:
- balancing on each leg, one at a time, while throwing and catching a ball against a wall
- Balance on an ankle disk or wobble board for three to five minutes daily.
These exercises can help strengthen the muscles and ligaments in your ankle.
As stated in a review of the literature, “Proprioceptive training is a cost- and time-effective intervention that can benefit patients who have previously sustained an ankle sprain from physical activity and reduce the risk of further complications.”
Gordon Waddington, AIS Professor of Sports Medicine Research, University of Canberra
This article was republished by The Conversation under a Creative Commons license. Read the original article.
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