18 Jun I keep spraining my ankle, it must be weak
This isn’t an uncommon thing to hear from anyone unfortunate enough to suffer regular ankle injuries. The likely hood that you have weak ankles is very low even if you are spraining one or both of them regularly. The cause of the problem is more likely one of poor communication between the brain and the muscles surrounding your ankle which results in a loss of what we call proprioception.
The body is very robust and it’s pretty hard to take it to it’s limits. Now this doesn’t mean that you can’t do it just that it is unlikely to be happening regularly. As I mentioned, after the initial injury it is likely there has been a loss of proprioception, proprioception is the communication between the brain and your body that lets you know where you are in space. Whilst there will have been some ligament and muscle damage in the initial injury this doesn’t mean that you now have a loose, unstable ankle unless you had quite a severe injury that needed surgical repair which you didn’t get. Much more likely is that you are sensitive in the affected ankle and react strongly to any perceived damage to it.
An incomplete recovery from the initial injury can leave you weaker than you were previously but not so weak that you should have issues controlling the movement of the joint.
Where we have an acute injury such as a sprained ankle the brain receives information from the area telling it of the possibility of damage to the ankle ligaments. We process this information and then decide on how to act on it. In most circumstances this means we receive information from the injured area, process it and realise that we’ve hurt ourselves and feel the pain in our ankle and alter how we move to protect the it. Gradually as you heal the movement and strength returns and everything is fine from then on.
If it has been a minor sprain you may bnot need to do anything but have a little bit of rest and all will be good, though I would always recommend getting this type of injury checked out. If it has been a more serious injury and you don’t go through a full rehab process then it is possible that you loose the ability to differentiate between what is an injury, that is actual tissue damage, and what is an over reaction to a potential problem.
In cases where everything is working well what should happen when there are very minor strains and sprains is something along the lines of what Paul Ingraham of the Pain Science blog describes here;
|NERVES||Got problems here! Bad problems! Red alert!|
|BRAIN||Yeah? Hmm. Okay, so noted. But you know what? I have access to information — sorry, it’s classified, you’ll just have to take my word for it — that suggests that we don’t have to worry about this much.|
|NERVES||I’m telling you, this is serious!|
|BRAIN||Nope, I don’t buy it.|
|NERVES||Look, I may not have access to this “information” you’re always talking about, but I know tissue damage, and I am not kidding around, this is a credible threat, and I am going to keep telling you about it.|
|BRAIN||Actually, you’re having trouble remembering what the problem is. You’re going to send me fewer messages for a while. Also, these aren’t the droids you’re looking for.|
|NERVES||Uh, right. What was I saying? Gosh, it seems like just a second ago I had something important to say, and it’s just gone. I’ll get back to you later I guess …|
Now if there hasn’t been a full recovery where you have gone through a proper rehab program this can get a bit messed up and the brain starts receiving regular “updates” that there is a problem and starts believing them. When this happens you can turn your ankle in a way that when healthy you would ignore but because you didn’t heal fully in terms of restoring what we like to call thoughtless, fearless movement every time you have an incident like this you start to think you’ve badly hurt yourself.
This is where the rehab process has take into account both rebuilding the strength of the muscles and quality of the movement.
When you are running you are spending ALL your time on one leg so it is very important to good balance and coordination. This is often lost to a degree when you are injured and is a very important portion of the rehab process to regain it.
At the start of any rehab program it will be all about restoring the basic function of the ankle through the ranges of movement that occur there and generally regaining the confidence to walk without limping. But as we move through the process we definitely want to begin challenging your ability to work on one leg.
We begin the process with drills that help re-groove accepting weight onto the injured leg and using static balance exercises like single leg RDL’s and hip aeroplanes. We then look to progress through more challenging exercises such as hopping from one foot to the other in different planes, to hopping in a straight line on one foot, hoping and sticking the landing and so on. All the time looking to make the drill more challenging so that you really have to work to not topple over.
All of this is a gradual process that constantly challenges you but not at such a level that you can’t adapt with end result being that there is a good chance you will have better balance and coordination than you did prior to your injury.