Rolling an ankle is a common experience for many people. Whether you are a runner, pick-up basketball player, surfer, or just kinda stepped outside of your house wrong (its okay I have done that exact thing) rolling an ankle can put you off your game.
Anatomy Time!
The ankle is a complex part of the body with 3-6ish bones that make up the structure depending on how you look at it. The top of the ankle includes the tibia and fibula, which are the two bones that make up the lower leg or shin. Below the tibia-fibula structure sits the talus, and below the talus is the calcaneus or heel bone. In front of the calcaneus lie the navicular and cuboid bones. When pointing the foot down (such as pushing on a gas pedal in a car), the talus moves slightly forward while the calcaneus rotates up. When pointing the foot up, the talus moves slightly backwards and the calcaneus rotates downwards. Simultaneously, the tibia and fibula have to move apart from each other to allow room for the talus. Confused yet? Don’t worry, understanding the mechanics of how the bones and joints interact is the job of bio mechanists. Let’s move on to why this anatomy is important.
Common Ankle sprains
The most common way to roll an ankle is from catching the outside of the foot, making the whole foot move inward. This movement is called inversion, which puts stress on the ligaments outside of the ankle that attach the fibula to the talus and the calcaneus. Increased stress on these ligaments can produce stretching and in some cases tearing of those ligaments, and can be put into broad categories ranging from grade 1, with stretching but no tearing occurs, to grade 3 where there is a full tear or rupture(Peterson et al). The severity of the tear can usually be determined by a combination of symptoms and with imaging, including MRI
For many weekend warriors (myself included) fall into the grade 1-1.5 ankle sprain. Yes, I made up a 1.5 grade because the conventional grading systems aren’t as specific as I would like them to be. A 1-1.5 sprain means that no significant or long lasting injury is likely past 1-4 weeks. I will add the caveat that without proper rehabilitation and specific exercise/ stretching these issues can continue past this time frame and can put the individual at a higher risk for injury later in life. For this reason, as always, I recommend discussing your specific injury with a physical therapist for the most accurate and effective treatment, however below are some exercises and treatment options that may help if you have suffered a common ankle sprain.
Ankle Eversion - Place the right foot on a towel so the heel is off the floor. Loop an exercise band around the right foot and wrap it around the left foot holding the other end with your hands. Keep the left foot steady and move the right foot out against the resistance. Make the movement slow and steady, trying not to shake. Maintain the right knee still and try not to rotate the leg while moving the right foot. Reverse the band for work on the left foot as needed. Complete 3 sets of 15.
Ankle Inversion - Place the R foot in a loop of an exercise band. Cross the left foot over the right and wrap the band around it holding the end of the band with your hands. Move the foot inward against the resistance. Again, try to maintain a slow and steady movement back and forth. Maintain the right leg still without rotating. Reverse the band for work on the left foot as needed.Complete 3 sets of 15
Calf Stretch - Stand with both feet facing forward with the one foot behind the other. Use a wall or chair for support. Bend one knee while keeping the heel of the other on the ground. You should feel a stretch in the back of the calf. If you do not, move the back foot further away and start the stretch over. Hold a stretch for 30 seconds and repeat 3 times.
Calf Stretch - Stand with both feet facing forward with the one foot behind the other. Use a wall or chair for support. Bend both knees while leaning forward. You should feel a stretch in the back of the calf, slightly lower than the calf stretch. If you do not, push the back heel down further. Maintain both feet facing forward. Hold a stretch for 30 seconds and repeat 3 times.
Check out how calf strength can improve ankle rehab here!
Research:
Petersen, W., Rembitzki, I. V., Koppenburg, A. G., Ellermann, A., Liebau, C., Brüggemann, G. P., & Best, R. (2013). Treatment of acute ankle ligament injuries: a systematic review.Archives of orthopaedic and trauma surgery,133(8), 1129-1141.
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