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Never Sprain Your Ankle Again!

Date: December 1, 2016      Publication: Bottom Line Health      Source:  Luke T. Donovan, PhD, ATC, The University of North Carolina      Print:

This all-too-common injury can lead to arthritis and other chronic problems…

If you haven’t sprained an ankle yet, it may be just a matter of time. About 25,000 Americans suffer from these painful injuries every day—that’s a total of 9 million such injuries each year.

But an ankle sprain is not that serious, right? We’ve all seen athletes limping off the field, only to return to the game soon after. You’ve probably done the same thing yourself. You take a wrong step…your foot turns…you hobble for a while…and you forget about it.

What you may not realize: An ankle sprain can cause a lifetime of problems, including persistent ankle weakness, difficulty walking and even arthritis of the ankle. What you need to know to protect yourself…

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LINGERING DAMAGE

An ankle sprain occurs when a ligament (the band of tissue that connects bone to bone) stretches beyond its normal limits. The more a ligament stretches—or even tears—the more severe the sprain.

Most people who sprain an ankle never see a doctor. They assume that a little rest—along with an over-the-counter pain reliever and perhaps some ice packs—will take care of things. It’s true that the immediate symptoms usually clear up quickly…within a matter of days or weeks. But what happens after that?

Studies have shown that more than 30% of people who sprain an ankle go on to develop chronic ankle instability. The joint feels as though it might “give” at any time. As a result, their health may suffer—they tend to exercise less…gain weight…and have more limitations in their daily movements. People who have sprained an ankle are also twice as likely to reinjure it.

To be clear, an ankle sprain does not cause high blood pressure or diabetes, for example, but it often does interfere with the types of activities that help prevent these and other serious chronic conditions. Ankle sprains have also been linked to a 13% to 16% increased risk for arthritic ankles.

SPRAIN-PROOF YOUR ANKLES

The ankles are uniquely prone to injuries due to the mobility and wide range of motion of the ankle joint…and the fact that the ankles support the weight of your entire body.

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For these reasons, it’s wise for all adults—and especially those who have suffered previous ankle injuries (even if they were years ago)—to do a simple daily regimen of stretching, strengthening and balancing exercises.

Try to do all of the exercises below a few times a day—together, they take only about 10 minutes…

Stand on one foot. This balancing exercise helps prevent ankle sprains by improving ankle muscle reflexes and proprioception, the body’s ability to orient itself in space. I tell people to do the exercise when they’re standing in line…talking on the phone…or even brushing their teeth.

What to do: Simply stand on one foot near a chair or any other stationary object that you can grab on to if you lose your balance. Stand on one foot for about 30 seconds, then switch sides. Work up to a minute or two on each side. When it starts to feel easy: Close your eyes while you balance. Taking away the visual feedback forces the muscles and nerves to work harder.

Soft-surface stands. To further improve ankle muscle function and your sense of balance, do one-legged stands (as described above) on a pillow, a foam pad or a balance disc (they’re also called balance trainer balls and are available at sporting-goods stores and online).

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The unstable surface forces your body to adapt to changes in balance and weight distribution. It makes your muscles more reactive, which can help you adjust to sudden changes in walking surfaces, posture, foot movements, etc.

Calf stretches. The calf muscles connect to the Achilles tendon in the ankle. Stretching and strengthening the calves improves stability and range of motion.

What to do: While facing a wall, stand back about one foot with your palms on the wall for support. Take one step back with your right foot and slightly bend your left leg. You’ll feel the stretch in your right calf/ankle. Hold the position for about 10 seconds, then repeat on the other side. Perform the stretch three times on each side and work up to holding it for 30 seconds.

Ankle/calf raises. As mentioned above, stronger calves and Achilles tendons improve ankle stability. This exercise strengthens both.

What to do: While still facing a wall, with your palms on the wall for support, rise up on your toes as far as you can. Hold the stretch for a few seconds, then lower your heels to the floor. Repeat eight to 10 times. It’s harder than it sounds! As your muscles get stronger, you can increase the difficulty by taking one foot off the floor when rising/lowering with the other foot.

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Resistance exercises. With an elastic resistance band, you can strengthen the ankle by moving it in its complete range of motion.

What to do: While sitting in a chair, wrap an elastic resistance band under the ball of your foot. While holding the band tightly, move the foot/ankle up, down, left and right. Repeat a few times in each direction. Then perform on the other foot.

WHEN TO GET HELP

What if you think that you’ve actually sprained an ankle? First, see a doctor. You’ll need an X-ray to determine whether you have a bone fracture, which typically requires the foot/ankle to be immobilized by a hard cast or boot.

If you have a sprain, don’t try to simply “walk it off.” The best thing you can do is keep weight off the ankle as much as possible until the pain and swelling are completely gone. An elastic bandage (such as ACE) can help minimize swelling.

During this time, you may also want to immobilize the joint with a brace (such as AirCast) for four to six weeks. Such braces are available online and at most drugstores for about $20 and up.

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Also helpful: To reduce pain and swelling, apply a cold pack (or ice wrapped in a towel) to the ankle for 20 minutes, once every hour for up to eight hours a day. Continue with this frequency for at least the first day after the sprain. After that, let pain be your guide—apply cold as long as the pain is severe and cut back as it eases.

To help prevent long-term problems: I advise getting some form of rehabilitation—from a physical therapist or an athletic trainer—after the injury heals.

Source: Luke T. Donovan, PhD, ATC, an assistant professor in the department of kinesiology at The University of North Carolina at Charlotte, and past program director of the Post-Professional Athletic Training Program at The University of Toledo. His research interests include chronic ankle instability.