Ankle Sprain? Start Here.

This video describes how we start treating ankle sprains at NorCal Physio. Even though this is a seemingly simple step, this step builds a foundation of muscle control and stability. If you skip this step, it is likely that you will continue to have recurring ankle sprains. So don't underestimate the power of these exercises for ankle sprains.

Ankle sprains. We all have had at least one. 

I remember my ankle sprain. The cause of the ankle sprain: jumping off a flight of stairs. When I went to the orthopaedic doctor, they said the X-ray showed no significant injury and was probably just a simple sprain.  I was told to use a boot for a couple weeks and it would be fine. It definitely was not fine in a couple weeks. I had significant swelling, pain, and weakness.

So what did I do? I spent the next 6 months training for the San Francisco Marathon. They told me nothing was broken or torn, so I thought it was a good idea! My training was primarily trail running in mountains. So my ankle was constantly swollen. Not just swollen, but actual pitting edema - I would push my finger into my ankle and the fingerprint stayed there for at least a minute. Not great.

But they said it was just a sprain so I kept training. And kept spraining. And kept swelling. So I kept icing, which would help with the pain and would hide the swelling a bit. 

Eventually, I went to a different orthopaedic doctor who looked at the x-rays from the injury day, said "this is bad", and referred me to an ankle specialist. Apparently a couple weeks in a boot was not sufficient.

This is an extreme case, but the underlying thought process is the same as any ankle sprain. If you sprain your ankle, the risk of more ankle sprains increases.

The cause of chronic ankle sprains

Here's why one sprain often leads to another:

Ankle sprains are painful and cause swelling. When either swelling or pain are present, the muscles act differently because they are inhibited. Pain inhibition and swelling inhibition cause the muscles to be more cautious when they are firing. If there is more caution, the ankle is less supported. When the ankle is less supported, the risk of injury increases. 

So your multiple ankle sprains that keep happening are actually building off of the previous ankle sprains.

No, you don't have "bad ankles".

It could be that the ligament has not completely healed. Or maybe the ligament has healed, but the ankle is still unstable because the muscles have not been retrained. Or maybe your other ankle is taking more force because you are avoiding your previously injured ankle.

Ankle sprain recovery at NorCal Physio

At NorCal Physio, the goal is not only to make sure you recover from the ankle sprain, but that you also decrease the risk of future injury.

"But doesn't rest, ice, and compression heal ankle sprains?" If that is all you do, then definitely not. If it were that simple, I would never work with ankle sprains.

So before you give up and say you have "bad ankles", try our way first. The NorCal Physio process for ankle sprains is as follows:

1. Evaluate the condition and create a plan. What happened, what is damaged, how do we progress from here. This happens at the Physio Eval.
2. Alleviate the pain. Pain will change how muscles work and how joints move. In this step, we are also reducing swelling. Actually reducing, not just using ice to hide the swelling.
3. Fix the underlying cause. Maybe you were at peak performance before the injury, but ankle sprains can cause havoc in your muscles and joints. We need to find where you are unstable and fix that. That means improving foot stability, ankle control, and hip strength. It means starting with unweighted exercises, progressing to stabilization exercises, and finishing off with dynamic and loaded exercises.
4. Plan for the future. One ankle sprain sets you up for another. So what is the game plan for the future? We will answer that question.

Ankle sprains - annoying, recurring, and often debilitating. However, attack the problem correctly and you could not only fix this sprain but also decrease the risk of future sprains.

The video above is how we start treating ankle sprains. Even though this is a seemingly simple step, this step builds a foundation of muscle control and stability. If you skip this step, it is likely that you will continue to have recurring ankle sprains. So don't underestimate the power of these exercises for ankle sprains.

So let me finish that story I started above. After the SF marathon, I had surgery on my ankle. I completed intense rehab, worked on my ankle and hip stability, and started running again. My training plan consisted of rehab style exercises for my ankle, hip stabilization exercises, and lots of running. Six months after surgery, I completed an ultra marathon without swelling, without pain, and without injury.

Telling you that is not to brag or sound amazing, but to compare my training through a chronic ankle sprain and my training after recovering from an ankle sprain. Playing through an injury, especially an ankle sprain, will not only cause pain but will also decrease your performance.

So if you think that you are just being tough and working through the pain, understand that you are mistaken. You are limiting your performance potential.

Want help creating a recovery and performance plan? We are here for you! Schedule a Physio Eval or fill out a Contact Us form.