Performing Like The Pack

Ankle sprains are one of the most common injuries seen in athletics. In the future issue we will talk about the treatment of ankle sprains, but in this article we will discuss ways to prevent ankle sprains in sports. There are several factors that can predispose an athlete to twisting an ankle and spraining the joint. These factors include: a) Tight muscles, which decrease the range of motion of the ankle joint. b) Shoes that do no adequately support the activity. c) Poor proprioception or balance. Jumping athletes often develop tight Achilles tendons. The Achilles tendon connects the calf to the foot and ankle and when these structures become tight it puts the foot and ankle at a mechanical disadvantage and can lead to a sprain. When the Achilles tendon and calf tighten they put the foot in a more plantarflexed or toe down position and it is harder for the foot and ankle to get fully dorsiflexed or toe up position. The lack of dorsiflexion puts the foot in a more unstable position. In short, as you step down, the ankle joint unlocks to allow for an uneven surface. As you move forward and begin to push off, the foot and ankle lock down to allow for a stable push up. When you can't get back into that stable push back position because of a tight Achilles tendon you are more likely to roll your ankle. The proper shoe is also important. Most athletes think that a soft and mobile shoe is an advantage, particularly in jumping activities such as basketball. These shoes tend to be comfortable but tend to provide less than ideal support. It is important in a jumping sport that the mid foot and rear of the shoe are connected to provide good stability. A simple test for this is to grab the shoe by the heel and the toe and attempt to ring it like you would a dishrag. If there is excessive motion between the toe and the heel, the shoe is not a particular stable shoe. Somebody who is predisposed to ankle injuries should avoid this. A good stable shoe that is difficult to move the heel and the toes in opposite direction is a good stable shoe. Many athletes feel like these shoes are heavier and not as comfortable. While that may be true, they do provide good stability. Somebody who has had ankle sprains, the question is do you want good comfort or support to avoid weeks of injury in rehabilitation? Athletes need to know where the body is in time and space. Sometimes the body becomes confused, particularly after an ankle sprain when the athlete is returning to activity. It is important that the injured athlete regain their balance and coordination to avoid re-injury. This can be as simple as standing on the effected leg and balancing for 20-30 seconds. This is easy; you can balance with your eyes closed and balance while you raise up on your toes. When that becomes simple, you can add an unstable surface. In our athletic training room, we use curve foam rollers and many trampolines to provide uneven surfaces to redevelop that proprioception. While not all ankle sprains can be prevented, it is important for athletes predisposed to ankle injuries to maintain good range of motion in the foot and ankle, wear appropriate good foot wear to provide additional protection and maintain their balance and proprioception so that they are able to protect themselves on the uneven surface of the athletic playing field and court.