An ankle sprain is a common injury that can have a long lasting effect. The ankle is a complex joint stabilized mostly by ligaments, which can stretch and tear even with mild sprains. These injuries are typically addressed with the usual RICE (rest, ice, compression and elevation) to minimize acute symptoms, and more severe sprains may be immobilized to allow healing of the ligaments. However,= treatment often ends there leaving residual weakness in the ankle musculature. Ankle injuries can also result in a lack of joint position sense, which makes it difficult for an individual's ankle to control where their body is in space. This contributes greatly to the high recurrence rate of ankle sprains, and over time can cause chronic ankle pain and instability.
After any ankle sprain, it is essential to address strength and balance deficits before returning to sport or fitness activities. Simple balance training such as standing on one foot or in tandem stance (heel to toe) or balancing on uneven surfaces can be a good start. In addition, growing research supports the inclusion of core strengthening – including the gluteals – to safely return to prior activities.
When gluteal muscles are weak, the leg internally rotates with jumping, landing, and pushing off. This abnormal motion in the hip and pelvis causes the foot to also rotate, called pronation, which puts increased stress on the ankle ligaments. Overall gluteal weakness is common both in competitive and recreational athletes, and becomes more of a factor in balance and stability once the ankle experiences a loss of stability. Seemingly unrelated exercises such as single leg bridges, planking, and side stepping can help decrease the likelihood of recurring ankle injuries.
To fully recover from an ankle injury, it is important to address strength and proprioception deficits before returning to regular activity. A physical therapist or trainer can help create a personalized exercise program to address specific areas of weakness. Always consult a physician before initiating an exercise program post-injury if you are continuing to have pain and inflammation.
Brynn Weimer PT DPT