STRONG ANKLES, BETTER MOVEMENT
All about ankle sprains
Ankle sprains are among the most common foot and ankle injuries. While jumping and running sports tend to have the highest rates of injury, a sprained ankle can also occur from a slip or walking on an uneven surface.
An ankle sprain occurs when an unexpected lateral or rotational force impacts the ankle and stretches the ligaments in the area. Ligaments are thick, inflexible bands of connective tissue that surround a joint. Once injured, a ligament can heal, but even healed ligaments often lack their initial tensile strength, leaving the joint feeling loose or less stable than it was before injury.
Without proper care, it is common for ankle sprains to recur. Over time, recurrent ankle sprains can result in changes to more than our ligament strength, it can also impact our lower body movement mechanics, balance and neuromuscular control.
After recurrent ankle sprains, it is common to find:
- Impaired proprioception -- or sensing where you body is in space
- A delayed stretch reflex of the peroneals -- the muscles on the outside of your ankle
- Diminished glute med activation during walking
- Greater reliance on visual input for balance
Chronic ankle instability is characterized by:
- History of repeated sprains
- Persistent ankle pain or stiffness
- Sensation of "giving way" or instability
- Unresolved swelling
- Poor balance
Many individuals with chronic ankle instability may decrease participation in sports, recreational activities or even walking for fear of another sprain. But, with proper care that addresses the whole picture, individuals with chronic ankle instability can achieve long-lasting recovery.
Components of Recovery
1. Ankle-specific care
Soft tissue work, including instrument-assisted soft tissue or dry needling, can help loosen muscles that stay tight after a sprain. Without soft tissue, these muscles often stay in spasm and can't effectively contract or react to new stressors. It is important during this time to include both ankle-focused soft tissue AND ankle-specific strengthening to get the muscles firing again after they have been loosened.
2. Static balance
Static balance involves maintaining a stable stationary position, such as standing on one leg. Training static balance, especially with your eyes closed, can be helpful for improving proprioception deficits that exist after sprains. This helps the body restore the ability to sense where the ankle is relative to the body.
3. Dynamic balance
Dynamic balance is the ability to maintain a stable trunk and core position while moving, such as walking without falling over. Proper dynamic balance relies on coordinated input from our visual, vestibular -- inner ear, and proprioceptive -- joint position, systems. Restoring dynamic balance is important for recreation and sport activities and can have a large impact on athletic agility and reaction time.
4. Lower extremity strength
It is important to strengthen the muscles that support the knee and hip while working on ankle stability. The glute med is an important lateral stabilizer in the body and firing patterns often change after ankle sprains. Restoring proper strength to the glute med and other muscles in the thigh and hip make sure you are limiting inappropriate strain on your ankle during walking or physical activity.
5. Plyometric power
After injury, plyometrics help build back joint stability and prepare the ankle for the shock absorption and propulsion required to walk, run and jump. Plyometrics use the stretch shortening cycle to load tendons and produce more force after a tendon is quickly stretched. When power is not addressed, functional deficits often linger in the ankle, impacting stability on uneven terrain and athletic agility.
A note about bracing and high top shoes:
It is common for individuals who experience repeat ankle sprains to wear braces during sports or opt for stiff, high top shoe options, such as high ankle hiking boots or cleats. There are many styles and options for bracing and taping to support the ankles, with mixed research on whether these options are effective for preventing sprains. While there is no consensus on whether braces are effective, what is universally accepted is that bracing and taping do not and should not substitute for a thorough strengthening program.
Rehab isn’t about shutting everything down or “resting until it goes away.”
It’s about teaching your body how to handle load again—so you can get back to the activities you enjoy without pain constantly creeping in. If you’ve been stuck in the cycle of temporary relief, it might be time to rethink the approach. Your ankle doesn’t just need to be supported — it needs more strength, better coordination and more power.
If ankle sprains are holding you back, our FIXXED Wakefield team will provide comprehensive evaluation and personalized treatment plan to help you move better and stay pain-free!
