by Megan Gallagher, SPT
Causes & Treatments For Recurring Ankle Sprains
A common injury amongst athletes in particular are ankle sprains, which are typically rehabbed using the PRICE method: Protection, Rest, Ice, Compression, Elevation. Some athletes, however, may require treatment for chronic ankle instability. Ankle sprains can happen to anyone and are easily managed, however complications arise when one ankle sprain turns into two, and then four, then eight, and so on and so forth. Those who have a high rate of recurrence for ankle sprains likely have what is called “Chronic Ankle Instability” or CAI.
What causes CAI?
Often times, CAI develops after an initial ankle sprain was not completely healed and something happens where a second sprain occurs. When an ankle sprain happens, connective tissues (such as ligaments) in the ankle are stretched or torn. Each time the ankle is sprained, more stretching and tearing of the ligamentous soft tissue ensues. The more damage done to the ankle structures without proper healing time, the more instability develops at the ankle. This instability is heightened when walking on uneven surfaces, or making quick position changes in say a sports game. This then leads to more ankle sprains, more instability, and the cycle continues.
Clinical Impairments Of Chronic Ankle Instability:
There are two main impairments noted in patients with CAI: Proprioception and Muscle Weakness.
1. Proprioception:
Proprioception is a type of sensory input that is defined as the ability to know where the body is moved and positioned. These proprioceptive receptors are located in joint capsules, ligaments, muscles, and tendons. If these structures get damaged with continuous ankle sprains, proprioceptive and balance problems may arise which can further contribute to the cycle of chronic ankle sprains and CAI.
2. Muscle Weakness:
To help keep the foot and ankle in a neutral position, muscles must fire equally on the outside and inside parts of the ankle. If a muscle is weak, it may prevent the ankle from being stabilized during movement, and ankle sprains occur, again adding to the cycle of CAI.
What can a Physical Therapist do?
If someone has chronic ankle instability, a physical therapist will work to strengthen the muscles around the ankle, as well as improve the proprioceptive input to help with postural control and stabilize the foot and ankle. A PT will work on balance exercises with you, this could include standing on one leg, standing on soft surfaces, or adding gentle pushes to try and knock you off balance. Muscle strengthening is also incorporated with the use of bands, weights, or even bodyweight movements to assist in strengthening the surrounding muscles. The stronger the muscles are around the foot and ankle, the better stabilized the joints will be.
The best way to prevent CAI is to make sure that you take the time to fully recover from the initial ankle sprain, as well as strengthening the musculature around the ankle to prevent more sprains from occurring.
The physical therapy team at Capital Area Physical Therapy can provide evaluation and treatment for chronic ankle instability. Call (518) 289-5242 for more information on a number of strategies and techniques surrounding how to address recurring ankle sprains and other related issues.
