Prevention and Treatment of Acute and Recurrent Ankle Sprains
Considering the amount of force your feet and ankles are subjected to on a daily basis, especially if you are an athlete or exercise enthusiast, it is a wonder they manage to bear up under so much stress. It is particularly remarkable when you consider that your ankle joints are not supported by a strong network of muscles like many of your other joints, but they are primarily held together by a network of ligaments, strong connective tissue that connects bone to bone.
Ankle Sprains and CAI
Ankle sprains occur when the ligaments surrounding your ankle joint are stretched and torn, often in the course of a fall where your ankle rolls outward. Ankle sprains often occur during sports, or when walking or running on uneven surfaces.
An initial acute ankle sprain can lead to ongoing instability of your ankle joint, predisposing you to recurring episodes. Chronic ankle instability, or CAI, often results from single or recurring sprains. In addition to stretching and tearing of the ligaments, it is thought that chronic instability may stem in part from the brain and central nervous system.
Ligaments surrounding your ankle contain neural receptors that send information to your brain about the position and motion of your foot and ankle. A ligament sprain can cause damage to neural receptors, meaning your brain receives less information about your foot and ankle position, increasing instability and the risk of injury.
Treatment for CAI
Despite the limited number and size of muscles contributing to ankle stability, athletes or anyone with CAI can reduce the risk of ankle injury through physical therapy and exercises aimed at strengthening the structures surrounding the ankles. Therapy should address proprioception, gait training, balance, strengthening, stability, mobility and weight bearing.
Some strategies for ankle sprain prevention and risk reduction include:
- Strengthening exercises: Initially using a therapy band for resistance, and then progressing to greater load bearing exercises, the ankle should be moved against resistance in all directions within its normal range of motion. This includes pointing and flexing the foot (plantar flexion and dorsiflexion), rolling the foot from side to side, ankle circles in both directions, and turning the foot inward and outward from the ankle.
- Flexibility training: Being able to move your ankle joint through its full range of motion is important, but you may be surprised to learn that lack of flexibility in your legs, hips and trunk can also contribute to CAI, because inhibition of movement further up your kinetic chain can cause you to misplant your foot, setting you up for a sprain.
- Balance training: Your ankles make a significant contribution to balance as you stand and move. Balance training can enhance proprioception and promote strengthening of the muscles that help you establish and correct your foot and ankle position.
- Bracing and taping: In some instances, your therapist may recommend athletic taping or wearing an elastic brace during physical activity to add extra support to your ankle joints.
- Pre-sport conditioning: Overall physical conditioning helps you move more efficiently, both on and off the playing field. Off-field training is an important element of injury prevention, whether you play recreationally or professionally. Make sure you are in shape before engaging in sports, and be sure to warm up all your joints, including your ankles, before engaging in vigorous activity.
Diagnosis and Treatment of Ankle Sprains and CAI in NYC
The sports medicine team at NYDNRehab is privileged to have access to the most advanced technologies, right under the roof of our Manhattan clinic. We use real-time ultrasonography to pinpoint the exact location and nature of your ankle injury. Our computer assisted rehabilitation environment (CAREN) is one of few in the United States, and it enables us to provide full gait and motion analysis and retraining. If you suffer from chronic ankle instability and want to prevent future sprains, contact NYDNRehab today, and let our foot and ankle specialists provide you with the very best physical therapy in NYC.
