Ankle sprains are common amongst athletes young and old and is one of the top reasons athletes miss playing time. The most common type of ankle is sprain is an ankle inversion sprain, or where your foot rolls and stretches the ligaments on the outside of the ankle. The best way to recover from an ankle is to prevent it from occurring in the first place as even mild-to-moderate sprains can turn into chronic ankle instability. As high as 61% of soccer player sustained recurrent ankle sprain after a mild ankle and 38% of those resulted in mechanical instability or actual structural damage (1). Let’s look at the top 4 strategies to prevent ankle sprains used in the Physical Therapy clinic.

#1- Strengthen the Ankle

The first way to prevent ankle sprains is also the most obvious, to strengthen the ankle. By strengthening the muscles around the ankle it will decrease your risk for injury and you will more likely be able to stop the ankle from “rolling.”  To do this start with your legs straight in front of you and tie a band around both ankles. Move one foot all directions, side-to-side, up and down,  away from the other foot. This targets the muscles of the lower leg.

#2 - Strengthen the Hip

This may not seem as obvious but there is a lot of good research over the past decade demonstrate that weakness in the hip causes an increased risk in sustaining a sprained ankle. In a study performed in 2016 Roel et al found that the backside of the hip and the outside muscles of the hip were most important. This is because our two most important joints that control our lateral movements? Our hips and our ankles.

To strengthen the hip, try two modifications of the same exercise. Lie on your side and lift your top leg towards the ceiling. This will strengthen the outside of the hip. Next lie on your stomach and keeping your knee straight, lift your leg towards the ceiling again. This strengthens the backside of the hip.

#3 - Practice Dynamic Balance

One of the best ways to protect your ankles is to practice dynamic balance and proprioception, or the ankles awareness of its position in space. The better the ankle is at communicating with the brain the less likely it is to become injured. This allows for quicker joint correction and recovery. When the ankle begins to “roll” into a sprain, it will more quickly react pull itself back without injuring itself due to the quicker communication.

One of the best ways to practice this is through a single leg balance exercise. Start on a flat surface, standing on one leg and slightly bend your hip and knee. Try to maintain for more than 30 seconds. If that is too easy try to do the same thing but with your eyes closed. Finally, as you master that try to stand on a soft cushion or pillow, with your eyes closed, and holding for more than 30 seconds at a time.

#4 - Prevent it from Occurring Again

One of the single best predictors of sustaining an ankle sprain is……… already having had a sprain. As high as 70% of people will suffer multiple lateral ankle sprains after the initial injury within the next 6 - 12 months (3). That’s an amazingly high percentage! One of the best ways to prevent a second ankle sprain is through bracing.

By wearing a lightweight lace up brace during physical activity for the next year after the first injury, this allows for the ligaments to fully heal and tighten up again. It will help the muscles calm down, prevent further injury, and allow you feel comfortable returning to activities. It may help offset some of the symptoms of chronic ankle instability before it starts.

Ankle sprains used to be thought of as a minor injury but with the progress of recent research we now know they can have serious long term deficits.

Works Cited

  1. Attenborough AS, Hiller CE, Smith RM, Stuelcken M, Greene A, Sinclair PJ. Chronic ankle instability in sporting populations. Sports Med. 2014 Nov;44(11):1545-56. doi: 10.1007/s40279-014-0218-2. Review. PubMed PMID: 24981244.
  2. Roel De Ridder, PT, PhD, Erik Witvrouw, PT, PhD, Mieke Dolphens, PT, PhD, Philip Roosen, PT, PhD, and Ans Van Ginckel, PT, PhD. Hip Strength as an Intrinsic Risk Factor for Lateral Ankle Sprains in Youth Soccer Players: A 3-Season Prospective Study. The American Journal of Sports Medicine Vol 45, Issue 2, pp. 410 - 416. November 16, 2016. https://doi.org/10.1177/0363546516672650
  3. McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med. 2001;35:103–108. [PMC free article] [PubMed]
  4. Braun BL. Effects of ankle sprain in a general clinic population 6 to 18 months after medical evaluation. Arch Fam Med. 1999;8(2):143-148.

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