The importance of Ankle Rehabilitation after a Sprain

Ankle sprain is a common medical condition where one or more of the ligaments of the ankle is torn or partially torn, usually through turning the foot under and causing excessive stress on the ligaments of the ankle. This can be caused by excessive external rotation, inversion or rarely aversion of the foot. When the foot is moved past its normal range of motion, the excess stress puts a strain on the ligaments. If the strain is great enough to the ligaments, then the ligament becomes damaged, or sprained.

 

The proprioceptive system is a part of the nervous system sending information to the brain about the position of your body, joints and muscles in space and in relation to the floor etc. It is made up of receptor nerves that are positioned in the muscles, joints and ligaments around joints. The receptors can sense tension and stretch and pass this information to the brain where it is processed. The brain then responds by signaling to muscles to contract or relax in order to produce the desired movement or to maintain posture.

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During and after injury to joints and ligaments the nerve receptors in the muscles joints and ligaments are also damaged, which means the information that is usually sent to the brain is disordered. As a consequence the joint feels odd or just doesn’t feel right. Once the ankle joint has been damaged, or a ligament has been torn or partially torn, there will be a deficit in the proprioceptive ability of the individual, leaving the person prone to re-injury, or a decrease in their coordination during any activity that uses ankle movement, such as walking, running etc.

Proprioceptive ability can be retrained through specific exercises given by our physical therapist team. The consequent improvement can compensate for the loss of nerve input caused by the injury and it makes a huge difference in decreasing the chances of re-injury. Proprioception also helps speed a patient’s confident return to his activities of daily living and training. Following an ankle sprain, strengthening exercises should be performed once you can bear weight comfortably and your range of motion is almost complete.

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There are several types of strengthening exercises. The easiest to begin with are isometric exercises that you do by pushing against a fixed object with your ankle. Once this has been mastered, you can progress to isotonic exercises, which involve using your ankle’s range of motion against some form of resistance. Once you have regained the motion and strength in your ankle, you are ready for sporting activities such as gentle jogging and biking. Proprioceptive exercises for balance, coordination and agility using a biomechanical ankle platform system, standing with your affected leg on a pillow should be initiated. After this a balance board may be suggested. After you feel your ankle strength is approximately 80% as strong as your other ankle, then you can begin cutting or twisting sports.

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In our clinic, once the ankle has been rehabilitated we would scan the feet to ensure that good foot bio-mechanics has been restored and perhaps prescribe custom made orthotics to help avoid re-injury.