HEALTHY: Rehabbing sprained ankles so they don’t become chronic

Ankle sprains are quite common. Rolling your ankle when running and cutting or stepping on something when you come down from jumping are just two common methods. 20-40% of ankle sprains then go on to develop into chronic ankle instability results in repeated ankle sprains and having the ankle sprain even more easily. If it is severe enough people will notice their ankle is swollen after what seemed to be a normal uneventful hike. I have seen this in many adults and even young kids and teenagers.

One way to test it is to stand on one leg like a flamingo. You should be able to stand without touching down with the other foot, for 20 seconds easily and there should be very little wobbling. Many people will notice one leg being able to do this very well, and the other that they have sprained in the past being much wobblier.

This wobbliness and this chronic repeated spraining of the ankle even with lighter activities is due to damage to what is called the proprioceptive ability of the tendons in the ankle.

Proprioception is our ability to recognize where parts of our body is in space without even having to look at them. Close your eyes and bring your arm up to the square like you were swearing on a bible in a court of law…now bend the elbow to 45 degrees. Why were you able to do this without even looking? It is proprioception.

Proprioception occurs when we move a joint and the surroundings ligaments and tendons stretch. The never that runs the length of these ligaments and tendons, inside the tendon also stretch. When these proprioceptive nerves stretch, they send information to your brain telling you exactly how much they stretched and therefore how far your joint moved. This is what gives us the athletic ability to run and jump to catch a ball putting all our body parts in just the right spot at the right time to make the perfect catch.

Now imagine that when you sprained the ligaments in your ankle, not only was the ligamentous tissue damaged, but also the proprioceptive nerves. Now when you walk on something uneven, the ankle rolls too far before the nerve alerts you to compensate…and the ankle rolls a bit more than it should and the ligament and nerve are damaged even further. This is ankle instability and results in chronic ankle sprains.

Rehabbing the ankle is a bit of work but is simple and can be done at your home with very little or no equipment.

First just stand like you are a flamingo, with the sprained leg on the floor and the other one raised. Try your best not to wiggle. Over time and practice the nerves will help you not wiggle as much and give you much more fine-tuned corrections.

Second, after you can stand for at least 20 seconds with very little wiggling, you can go to doing the same activity, but this time with your eyes closed. Balance is given by three areas of your body.

1.) the circular canals in your inner ears,
2.) the proprioceptive nerves in your joints, in particular your ankles and
3.) your eyes. We can’t shut off the inputs from our inner ear, but you can shut your eyes and make the proproioceptive nerves in your ankles have to work even harder. Do this witout wobbling for 20 seconds and your may be good.

If you are an athlete however, the third and even fourth steps might be necessary. Third step is to stand like a flamingo with your eyes open but on a wobble board. The fourth step is to jump with one foot onto the wobble board and stick the landing…DON’T do this one until you are awesome at the other three. Someone out there is going to think there is a stage 5 for superheroes and jump with their eyes closed one legged onto the wobble board…DO NOT DO THAT. 😉

Often sprained ankles respond to chiropractic adjustments, ultrasound, ice and anti-inflammatory meds and herbals. If the ankle sprains are severe enough, you can brace or place Kinesio tape on the ankle which can help give your skin a “proprioceptive like” ability and help you recognize the rolling is happening.