Let's Not Twist Again, Like We Did Last Summer

Ankle sprain injuries are terribly common. If you are a basketball or soccer player then you know this fact all too well. In fact, nearly half of all reported sports injuries involve the ankle, according to the National Athletic Trainer’s Association. Fortunately, boxing and her sister disciplines are not considered to be among the sports with high incidences of ankle injuries. Still, you’re going to be moving your feet in quick succession and not always in basic linear motion. That means a fighter is at much more risk than your average sprinter or swimmer.

Additionally, when your muscles are depleted from strenuous activity, like fighting, it inevitably places more stress on your ligaments, which increases the danger. Plus, when you’re feeling fatigued it throws off your entire system of balance, which can put you at an even greater risk of injuring an ankle. 

 sprained ankle

It doesn’t take any particularly significant action and you don’t necessarily need to be doing something athletic to suffer a sprain. Whether or not you’re a klutz, it’s not difficult to twist your ankle by simply walking on uneven ground or perhaps missing that last step.

As an athletic person though, you may be at both an advantage, due to better muscular development, and also a disadvantage, due to the riskier situations you put yourself into. You’ll be in the thick of your training, taking care of business, when suddenly, just for the briefest moment, your foot is facing an angle that does not make sense with what the rest of you is doing. POP! You’ve sprained your ankle.

The average woman has more flexibility than the average man and in a lot of ways that’s a good thing. But there’s a definite downside. Part of the reason for the extra flexibility may be due to a greater laxity, or looseness, of the ligaments. The tradeoff is that, for all the range of motion advantages, there is an equally increased risk of injuries, such as sprains. Couple that with the fact that the average woman has substantially thinner cartilage and smaller ankle bones than the average man, and you can understand why women can be especially susceptible to ankle injuries (it should be noted that the difference in susceptibility to ankle sprains between men and women begins largely when the age is over, say, 30. Perhaps the wearing of high heels also contributes to the rate of injury increasing?)

Like most injuries, ankle sprains come in different varieties and of different severities. The garden variety can best be called lateral ankle sprains and occur when the ankle joint twists inward. These cover about 80% or more of sprained ankle cases. A typically more severe type is the dreaded high ankle sprain, and this happens when the foot and leg twists outwardly, causing an injury above the ankle.

When you get a pretty bad ankle sprain, it is always best to visit your doctor or at least consult someone who knows what they're doing to make certain you’ve not done any more damage than a simple sprain. In the beginning you’ll want to keep most or all of your weight off the affected ankle, especially up until you’ve determined whether the ankle is stable or not. However don’t think about taking weeks off from activity, including walking. While you don’t want to return to training full speed too soon, it is highly beneficial to include at least some light activity to help promote healing, even if that means doing it on one foot and crutches!

Use common sense. If you’re recovering from a twisted ankle, any recuperative activities should emphasize linear and stable movement. Stay off the rocky paths, and avoid activity that requires a lot of turning. Riding a stationary bike can be useful to regain strength and range of motion. Of course, progress slowly. And if you want to ride an actual bike to help healing, just be sure to stay on pretty level surfaces so you’re not required to exert too much pressure on your poor ankle.

We recommend against extensive use of ice on your ankle, and instead let your natural healing processes do their thing, but you should follow your doctor or physical therapist’s prescription on this, or at least seek out more information and make your own decision. Keep in mind that as you first begin putting weight back onto the injured appendage it is important to limit the amount of flex and rotation that happens around the hinge until things have well healed and range of motion has largely returned.

If you want to talk about ankle sprain prevention, many athletes, including many pros, swear by using braces or by taping the joints, but there seems to be only weak evidence that this is strong prevention. In fact, there is research that suggests ankle bracing could even increase the risk of injury to a foot or knee, as these structures will inevitably need to compensate for the lessened mobility of the braced ankle. Not good. 

Based on our research, we generally are not proponents of any kind of static stretching before exercise. We won’t go into that now, but definitely know that stretching your ligaments, especially any injured ligaments, is not a good idea. If you’re looking to “loosen up” stiff joints pre-workout, it’s better to simply warm up the area with some light activity like walking or other low impact exercise.

It may be that the only truly effective method of prevention is through strength development. Now, we’re not suggesting you start doing a myriad of ankle specific lifts in the weight room. What we’re looking for are some exercises and activities that will promote both the mobility and the stability of the ankle joint. And it’s not just about that one little area. For good protection, you want to develop a solid posterior chain - from your feet all the way to your lower back.

Walking on uneven and sloped surfaces is a simple, effective method of making your ankles more unbreakable! Of course, hiking on rough terrain is also a good way to cause the injury you’re trying to prevent, so take care and see where you’re stepping.

Running is pretty hard on all of your joints, from toes to your lower back, but running on sand, grass, or other soft surface in your bare feet is a very good way to strengthen the muscles that help stabilize your ankles. 

Riding a bike is another good way to strengthen the ankle area. And since you’d be pedaling in a circular, yet linear pattern you’re gaining some mobility without exposing the ankle to any twisting.

Jumping rope is another superb way to condition your ankle stabilizing muscles and can also be done barefoot. In fact, it’s a good idea to do any warm up activities barefoot whenever possible. This will go a long way towards building a strong mental awareness of your feet and ankles.

Based on research, but not experience, we wouldn’t recommend using Bosu balance balls. They could be useful for ankle strengthening, but from what we read, the balance balls can wreak havoc on the knees.

You can also perform some simple ankle movements to boost your ankle mobility. This may seem counterintuitive, but mobility of the ankle joint provides additional stability. 

Besides conditioning, it’s a good idea to get your feet and legs right. You can grab a tennis ball and roll it under the arches of each foot for a minute or so everyday to help loosen up the wires that run between your feet and ankles. And some massage or foam rolling of the calves and quadriceps areas may help to ensure that there’s no excessive tightness that could cause instability of your ankles.

If you’ve suffered an ankle sprain at some point you’re more at risk to sprain that ankle again. In fact, due to many factors, including the psychological, it’s not very hard to become susceptible to chronic ankle spraining. So be smart. Get everything healthy down there before returning to 100% intensity in your training. Progress slowly too, because you also need to restore your confidence in your ankles.

Posted on August 18, 2015 .