Written by Zak Roser
Ankle sprain rehabilitation is key and often missed after low-grade incidents.
Below is a quote on this issue from Jonathan Pierce of Kinetik Performance Co. Much of the information below was adapted from his teachings.
“So what I see commonly with even low-to-moderate grade ankle sprains is that you may incur a bunch of soft tissue damage and swelling, causing pain in the short-term but once that’s been rested and iced those things recede. Typically once the pain levels go down, individuals are returned to sport. But that doesn’t mean the ligamentous and nervous systems have been reacclimated to manage that stress. So the big takeaway is to make sure you have retrained and treated the ligaments, not just the soft tissues. The ligaments usually lag behind and thus, that’s the system that enables proprioception to happen.”
So what can you do to rehabilitate?
There is a large correlation between ligament proprioception in the foot/ankle and control with the hip. If this connection is inhibited after the injury and not re-trained you are likely to reinjure in the future.
Short Foot Drill
Focus: Stable Base of Support
The key to this to consider three points of contact of the foot – the heel, head of the 5th metatarsal (lateral side) and the base of the great toe. All three points must be active in order to “lift the arch.” To do this correctly, all toes must be driven straight into the ground (not curled). This places the foot in an active position and it is ready to perform any task. This can be practiced while any time you are standing.
Focus: Hip Control of the Ankle
This is ideally performed on an AirX pad or wobble board for best results. Place all weight on the working leg, the leg on the bench is simply for balance. Make sure your ankle, hip and shoulder are in one line. Next, find the short foot position with the working foot then begin to roll the ankle into inversion/pronation followed by eversion/supination. The point is to feel your hip, in the capsule – controlling what the ankle is doing. If it is hard to feel at first – I suggest closing your eyes and flexing your glute.
To start, try three sets of 60-90 seconds four to five times a week.
Hip Rotation Sliders
Focus: Hip Strength with Foot/Ankle Stabilization
This is a great way to build the intrinsic strength of the hip and ankle. It is done in five different directions. Again, almost all your weight is on the planted leg, the leg on the slider is simply for balance. One of the biggest mistakes I see during this exercise is individuals load their quads to much, meaning their knee goes out over the toes, as opposed to staying relatively stacked over the ankle. This subtle change allows the hip to be loaded effectively. Before and after each repetition make sure to stand tall by squeezing your quad and glute of the working leg.
Try two sets of five repetitions in each direction (25 per side) four to five times a week. For added difficulty try standing on an AirX with the working leg. Also, if you don’t have access to a slider, a paper plate or sock on a wood floor works great.
Focus: Blood Flow, Foot Mechanics
Using Voodoo floss on the foot and ankle can help rebuild the bodies ability to control where the foot is in space by bringing new blood to the ligaments that have been damaged. There are four different protocols, which allow for self-manipulation of the foot in order to reestablish a stable base of support.
Stay tuned for those drills and more so that you can save yourself from reinjury of the ankle post-sprain and new injuries and dysfunctions of the hip and knee.