How to Prevent an Ankle Sprain
Nearly 25,000 Americans suffer an ankle sprain every day. Ankle sprains are one of the most common sports injuries but can also occur during daily activities like going up and down stairs or walking across your lawn. Ankle sprains occur at a higher rate among basketball and soccer players due to the intensity and speed of both sports.
The ankle is a delicate complex of bone, ligaments, and tendons, which allows the ankle to move through a wide range of motion, but also makes the ankle particularly vulnerable to injury. An ankle sprain occurs when the foot twists or turns beyond its normal range of movement, causing the ankle’s ligaments to overstretch or tear. Ankle sprain recovery generally is 4 to 8 weeks; however, tissue remodeling and nerve deficits post ankle sprain can persist for up to a year after the injury.
If you do not receive timely and effective treatment and rehabilitation after your first ankle sprain, the risk of recurrent ankle sprains and chronic ankle instability is high. It’s essential to work with a physical therapist to address an ankle sprain and restore ankle joint biomechanics, strength, and balance safely before returning to sport or activity.
7 Ways to Prevent an Ankle Sprain
Improve your balance and proprioception. By engaging in balance training, the nerves in your foot and ankle learn to adjust and train the surrounding muscles in the ankle, leg, and hip to activate and control your movements. To improve balance, it’s also important to strengthen your core, your abdominals, and your hips for trunk stability.
Balance and proprioceptive exercises can include single-limb balancing on stable and unstable surfaces, coupled with throwing or kicking a ball, using a wobble board, or adding a reaching task while balancing. These exercises enhance both your static and dynamic postural control by optimizing the body’s ability to sense and correct mild deviations in joint motion. These exercises train not only the ankle joint, but proximal joint systems as well like the knee and the hip.
Engage in a preventative ankle-strengthening exercise program. Enhancing the function and strength not only of your ankle, but also of your hips, abdominals, and trunk is critical for safe movement. Specific ankle strengthening exercises can include squats, lunges, dips, heel and calf raises, and rubber band strengthening workouts. A preventative exercise program also includes stretching to improve the range of motion of the ankle muscles as well as power and agility training as the individual progresses through the strengthening program. Research has shown that an ankle-specific exercise program can reduce the chances of a repeat ankle sprain.
Use a brace or tape your ankle before activity. Using an ankle brace or taping the ankle before activity can provide added support to the ankle complex to prevent injury. Research has shown that bracing or taping the ankle can prevent an ankle sprain, especially in those who previously had an ankle sprain. Bracing and taping prevent the joint from exceeding its physiological range of motion and minimize stress on muscles that act as static stabilizers in the joint. Bracing and taping also have a neuromuscular effect, improving proprioception, peroneal muscle activity, reflexive action, reaction time, and postural stability and control.
Always warm up before activity. Prepare your ankle for movement by gently stretching and warming up your lower extremity before activity. Engage in stretching of the Achilles tendon as well as do ankle inversion, eversion, plantar flexion, and dorsiflexion exercises.
Progress your activity intensity gradually. It’s important to gradually increase the intensity and volume (time) of your exercise training. Exercising too fast for too long at a high intensity can place undue stress on your body, including your ankle, and set you up for a fatigue-related injury. Progress safely, increasing your intensity and time by 10% each week leading up to the athletic event or sports season.
Use proper footwear for your sport. Do not use worn-out footwear. Change your sports footwear every 500 miles (if running) or 6 months. Be sure to purchase supportive shoes with good traction that work for your sport. For example, do not use a cross-training shoe as your long-distance running shoe; invest in running-specific footwear to protect your ankle. If you have feet that pronate or have low arches, choose shoes that provide support at the front of the shoe and under the arch. If you have a stiffer foot or high arches, choose shoes with more cushion and a softer platform.
Be mindful of the terrain where you are exercising. Running or exercising on uneven terrain can heighten your risk of an ankle sprain considerably. Rather than running on rocky, uneven terrain, choose more even surfaces such as a synthetic track, asphalt, grass, a treadmill, or a park trail. Be careful when running on uneven terrain or up and downhill, allowing for sufficient rest following these runs as the ankle is placed under significant stress during such runs, and damage to the ankle muscles and ligaments can accumulate over time without sufficient rest.
Physical Therapy After an Ankle Sprain
Physical therapy is the first line of treatment for ankle sprains, helping individuals recover from a sprain safely and restoring function, strength, and mobility in the ankle complex to prevent recurrent ankle injury.
Physical therapy for an ankle sprain can include a variety of treatments:
Pain and swelling management using ice, heat, ultrasound, or electrical stimulation
Manual therapy soft tissue mobilizations to improve foot and ankle mobility
Balance and proprioceptive training using stable and unstable surfaces and single-leg exercises to challenge the ankle, leg, and trunk to maintain balance. The therapist may use a wobble board, obstacle course training on our Astroturf, or movement exercises on our rebounder to build balance and joint stability in the ankle complex.
Therapeutic exercise can include both range of motion exercises and strengthening exercises to improve strength, function, and mobility in the ankle complex.
Range of motion exercises target the ankle, focusing on ankle inversion, eversion, plantar flexion, and dorsi flexion as well as stretching exercises to increase the flexibility of the ankle and lower leg.
Strengthening exercises target the ankle as well as the lower leg, hips, and trunk for overall stability and powerful movement. The therapist may use resistance bands, cuff weights, and weightlifting equipment to isolate and strengthen specific muscles.
Functional and sport-specific training including agility and plyometric training to simulate sport-specific movements to prepare the athlete for a return to sport and to avoid recurrent ankle injury.
Numerous research studies have shown that targeted exercise-based rehabilitation and the use of bracing and taping are effective in preventing initial and recurrent ankle sprains. A study of boys and girls high school basketball teams showed that those who wore ankle braces had far fewer ankle sprains over the season compared to those who did not wear a brace (26 in those who wore a brace vs. 75 who did not wear a brace). A 2010 systematic review noted that ankle sprains were reduced by 70% when ankle braces were worn.
A 2015 review assessed standard training in sports teams across various ages vs. those teams who added a specific ankle sprain prevention program to their training. The prevention program significantly reduced sprains in athletes who had a previous ankle sprain; coordination and balance training have been shown to be effective in preventing recurrent ankle sprains up to 12 months after the initial sprain. Researchers found that ankle sprain prevention programs that incorporate single-limb static balancing with wobble boards and sport-specific tasks like catching, throwing, kicking, or dribbling were very effective as they require the individual to improve their proprioception and neuromuscular control.
Have you experienced an ankle sprain? Work with a physical therapist to regain function, strength, and mobility in your ankle safely!
