Ankle sprains are the most common form of joint sprain and most people will suffer one at some point in their life. Whilst their frequency means everyone knows the signs of an ankle sprain, few people know how to actually treat one and how the treatment you apply can help you prevent it happening again!
A sprain, by definition is damage to one or more ligaments. This can be minor damage such as stretching and small tears, known as grade one, a more substantial partial rupture of a ligament – grade 2, or a complete ligament rupture – grade 3.
Although ankle sprains are common injuries, they can still be problematic and so should not be ignored. Not treating an ankle sprain thoroughly can result in future issues including re-injury and other injuries developing.
It is in everyone’s interest (not just athletes) to prevent ankle sprain injuries, whether you have had one before or not. They can result in time away from your sport or exercise and even time off work as walking and driving can be problematic.
Top US Tennis player Serena Williams is currently battling a recurring ankle sprain whilst competing in the Australian Open. She injured the same ankle last year in the run-up to the event down under, which contributed to her early exit from the 2012 championship. It now seems to have become an ongoing problem which goes to show even elite athletes suffer from recurring ankle problems!
Here are our top tips for helping to prevent an ankle sprain. It doesn’t matter if you have suffered a sprain before or not, the same things apply!
Wear Appropriate Footwear
Footwear is a big cause of ankle sprains. High heels in particular are a particular culprit as they place the ankle in an unstable position and affect our balance.
Footwear should be appropriate for the activity in which you are participating. If walking or hiking over uneven ground, wear boots as the high top will help to prevent the ankle rolling over.
Always wear shoes with good arch support and grip and make sure you tie the laces properly! Tripping over laces is another common cause of injury!
Warm-up for Sports
A lot of ankle sprains occur in sporting events be it training or competition. Whilst a lot of the time these are not preventable and just part of the game, especially with contact sports, there are things you can do to reduce your risk of injuring your ankles when playing sport.
Most importantly, make sure you warm up effectively. A warm-up should start with a pulse raiser such as jogging, followed by static stretching. The most important parts of a warm-up for preventing ankle sprains are what follows next – the dynamic stretches and the sports specific drills.
Dynamic stretches are exercises which stretch the muscles in the ways in which they will be used. They are performed in the form of drills which get the athlete mimicking movements performed in their sport, using gradually faster and bigger movements. Examples include lunges, cariocas and side-steps.
Sports specific drills and practice before a match really help with improving reaction times and co-ordination which are both required to prevent injury. Practising these skills before competition allows you to refine the movement patterns gradually and without challenge.
There are certain exercises which are shown to reduce the risk of spraining an ankle. Equipment such as wobble boards, rocker boards and wobble cushions are used to help improve the sense of proprioception at our joints.
Proprioception is the sense of positioning and movement of a joint. Whenever we move, information about the position of our body parts is sent back to the brain which can send a message back to the joint to make adjustments to our position, all within a fraction of a second. This sense is often reduced after an injury, as the sensors which relay the information to our brains are found in structures such as ligaments.
Even if you haven’t suffered an injury before, training your sense of proprioception and balance is a great idea to prevent injury. Using items such as wobble boards places the body on an unstable surface which challenges our balance and positioning. Placing your body in this situation is a great way for it to learn and become more adept at correcting itself!
Strengthening exercises for the muscles surrounding the ankle can help reduce the risk of an ankle sprain. Whilst it is important to have strong ankle muscles in general, the particular muscles which are most important in prevent ankle inversion sprains (where the ankle goes over to the outside) are the evertor and invertor muscles.
Inversion is the movement of turning the ankle over so that the sole of the foot faces inwards. Eversion is the opposite movement, turning the ankle so the sole faces outwards. The ankle allows considerably less of this movement due to its structure and ligament strength.
The evertor muscles are those that turn the sole of the foot outwards and they are known as the Peroneal muscles, located on the outer lower leg. Strengthening these will help reduce inversion at the ankle.
The invertor muscles are found on the inside of the lower leg and include Tibialis Posterior. Whilst it may seem strange advising you to strengthen the muscles which move the ankle in the direction that injury occurs, there is a reason for this. The invertor muscles should be strengthened eccentrically.
An eccentric muscle contraction occurs when the muscle contracts, but lengthens, rather than shortens. This type of contraction occurs when the body is attempting to slow or control a movement, usually against gravity or once the movement is already in full swing.
So, in the case of an inversion ankle sprain, when the ankle starts turning out, the invertor muscles contract eccentrically to try to reduce this inversion force and prevent injury.
Strengthening the invertor muscles in this way can be achieved by working with a partner. The partner forcefully moves the ankle into inversion and the patient then tries to slow and control the movement.
Supports / Taping
If you have suffered any form of ankle injury before and feel that this has left you with a weakness, then an ankle support or brace can be worn or an ankle taping technique applied.
Whilst these shouldn’t be used as a long-term solution and strengthening / balance training should be undertaken alongside, wearing a support can be helpful to reduce the risk of twisting the ankle over.
Whilst there is no guarantee of preventing an ankle sprain, following the advice given here can certainly help to reduce your risk of suffering this pesky injury! The tips above can be followed by those with no history of ankle injury and by those who have sustained an injury in the past. Just ensure that exercises / warm-ups / footwear etc are pain-free and do not aggravate any old injuries.