How can I prevent repeat ankle sprain injury?

Unfortunately ankle sprains are very common, up to 25,000 a day in the United States of America. More people are having such severe ankle sprains that they might end up going to the emergency room for them. You can look at strengthening the muscles around the ankle for sure, but we do want to take the bigger picture into mind and many times after there is an ankle sprain the muscles around the front of the hip and calve get very tight. Specifically, the hip flexor and the IT band get very tight and then the glutes get weak, so you probably need some flexibility techniques there and around the ankle and the calves. Whether that is self-massage or stretching, you will also need to do some core stability work for the abdominals and glutes. Single-leg balance can be quite helpful as well to stimulate the receptors around the foot and the ankle can work right to help hold the ankle and foot in good alignment. It is not just about strengthening the ankle, although there is some point in strengthening the muscles around the ankle, but it is getting the receptors in the foot to work with the muscles, to align the bones, so the entire body can work in a coordinated fashion. Ankle sprains can be tricky, they can have cascading effects up throughout the rest of the body and if they are not treated correctly, can lead to other injuries later on.
Dr. Mike Clark, DPT

While it is common to think that to prevent ankle sprains you should focus solely on strengthening the muscles around your ankles, in fact – and maybe more importantly – you must also concentrate your efforts on improving the strength of the muscles around your hips. Research demonstrates that when you sprain an ankle, not only do the connective tissues that support it become loose and less responsive but it also shuts down the butt muscles – decreasing the ability to maintain balance and proper lower body alignment. As a result, the lack of ligament support and decreased balance increases the risk of reinjuring your ankle. Without proper reconditioning, over time the hip muscles become less and less active and do not help protect the ankle, making you more susceptible to further ankle sprains and other injuries.

The most effective way to recondition your ankles and prevent future sprains is by doing exercises that wake-up and strengthen key muscles around the hips – i.e. butt muscles – as well as those that challenge your ability to balance on one leg and maintain proper alignment.

Incorporate the following exercises into the beginning of your exercise routine as part of your warm-up, performing 3 sets of 10-15 repetitions for each:

  • Ball Bridge

[media id="DEV__4c7e461d338df5_68981546" title="Ball Bridge"] 

  • Tube Walking Side to Side

[media id="DEV__4c8243e12c37a2_66045881" title="Tube Walking Side to Side"]

  • Single Leg Balance with Reach (progress from standing on the floor, to standing on a towel, to standing on a pillow cushion to enhance difficulty and challenge to the muscles around the ankle and hip)

The first question is how do you keep spraining them? Is the activity you are completing hazardous to your health? Do you have supportive shoes? And do you rest enough following the injury?

A great way to help strength your ankles will be through calf raise. When you complete a calf raise, you will be flexing through your ankle and this will help build proper strength. Beyond this, take the appropriate time to rest and be sure to answer those questions above. From there, we can figure out a more direct plan of action to assist you.

When someone sprains their ankle, they damage the ligaments that surround the joint. The ankle joint is not as stable as it used to be, so it will be more susceptible to reinjury. Once the pain and swelling have decreased and you have full motion at the ankle, you should begin strengthening exercises. To help prevent reinjury, you can strengthen the muscles that are around the ankle joint. To strengthen the ankle, you can perform exercises with surgical tubing or exercise bands. The exercises are plantar flexion, dorsiflexion, eversion and inversion. These exercises correspond to moving the foot upward, downward, inward and outward.

To perform dorsiflexion, the band will be placed around the top of the foot and another person will hold the end of the band. Then pull your foot upward and slowly let it return downward. To perform plantar flexion exercise, the band needs to be placed around the bottom of the foot. Then hold the end of the band and push the foot down against the band as if pushing on a gas pedal. To perform the eversion strengthening exercise, the band needs to be placed on the lateral (outside) part of the foot, while holding the other end of the band at the other side. To perform the inversion exercise, place the band around the medial (inside) part of the foot and have someone hold the other end of the band at the other side. The person holding the end of the band needs to hold tight enough so that it applies resistance without too much tension. If the resistance becomes too easy, then you are ready to progress to the next resistance band strength level.

In addition, it is important to work on balancing on the injured ankle as well. Stand on your injured leg, with the knee slightly bent. Then balance on one leg for 30 seconds. Once you are able to balance easily on level ground for 30 seconds, have someone throw a ball for you to catch while balancing or close your eyes while balancing.

Should any of these exercises cause pain, seek medical attention from a physician. The physician may also refer you to an appropriate healthcare provider, such as an athletic trainer, to assist you with a progressive rehabilitation program.

(This answer provided for NATA by the King College Athletic Training Education Program.)

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.