Here are Exercises for Ward Off Sprained Ankles

When Chris Peterson sprained his ankle playing football in high school, he brushed it off as a minor injury. His ankle hurt for a couple of days, but no one suggested he see a doctor, and soon enough, he felt better. “I got back to playing as soon as I could,” said Dr. Peterson, now a physical therapist at Washington University in St. Louis Louis. However, although his ankle didn’t hurt, it just wasn’t the same afterward.

“I ‘m wrong, and my ankle was just not there,” which often led to falls, he said.

Sprained ankles are among the most common musculoskeletal injuries. Official estimates are that two million people in the US sprain their ankle every year, but the real number is much higher, as many people never seek care for their injury.

Although an ankle sprain may seem like a minor injury, suffering leads to a much higher chance of doing it again. In one study of military cadets, those with a history of sprained ankles were 3.4 times more likely to sprain their course during the course of their ankle, compared with those with no history of sprained ankles. For an estimated 40 percent of people, a sprained ankle can lead to chronic ankle instability, characterized by repeated rolling of the ankle, a general feeling of wobbliness and instability, and occasional pain, tenderness or swelling.

If you’ve sprained your ankle in the past, that doesn’t mean that you’re destined to go through life with an achy, wobbly joint, fearing the moment when it will give way. Experts recommend a number of exercises to strengthen the ankles, which in turn reduce the chances of sustaining a sprain, whether for the first time or the 10th.

“The biggest reason people have recurrent ankle sprains is that they never do rehabilitation,” said Dr. Michael Fredericson, a sports physician at Stanford University.

The ankle is a complex patchwork of bones and ligaments stitched together, connecting the tibia and fibula to the leg of the delicate bones. It does a lot of work, bearing the full weight of the body while also bending and flexing in many directions. It’s this versatility, along with a constant workload, that makes recovering from an ankle injury so difficult and critical, since it’s very easy to reinjure an ankle. “There is not a lot of room for error, especially if you do sports,” Dr. Fredericson said.

The key is exercise. In a recent meta-analysis of 14 randomized controlled trials, exercise-based interventions were more effective at reducing the risk of recurring sprains than usual care, which often consisted of rest, ice, compression and elevation.

“We do know that exercise therapy works,” said Jente Wagemans, a graduate student at the University of Antwerp and lead author of the study. “We know it’s effective for preventing a secondary injury.”

Even in the first few days after a sprain, it can help move the ankle. Dr. Alysia Robichau, a sports physician at Houston Methodist Hospital, often recommends very light, non-weight-bearing activity, such as tracing the alphabet with the foot, in the day after a sprain. “That helps with the gentle range of motion,” she said.

Once the ligament has started healing, which happens in the first few weeks after a sprain, the next step is weight-bearing exercise. Like bones and muscles, Mr. Wagemans explained, ligaments will become stronger when you apply half the force.

Unlike bones, ankle ligaments need to be strengthened in multiple directions, because the joint is so mobile. One simple ankle-strengthening exercise is to loop a resistance band around the foot and attach it to something heavy, like a table leg. Then flex the foot forward, backward and sideways, aiming for 15 sets of 15 repetitions each.

If you are trying to prevent ankle injuries, these exercises should be done three to four times a week. If you are recovering from a recent ankle sprain, any exercises should be under the guidance of a physical therapist, who will tailor them to the injury.

Every time you step on an uneven surface or place your foot quickly, tiny nerves help your ankle stay rolling or twisting rather than constant. Think of them as the lane-assisted feature in some cars, which make tiny steering corrections to avoid drift, Dr. Except the nerves bring your ankle back to a neutral position, Peterson said. One of the major causes of wobbly ankles is when sprains also damage these corrective nerves.

“Without that feedback system, you’re more likely to roll your ankle again,” said Jeff Harvath, a physical therapist at Washington University. Louis.

If your ankle feels wobbly or unstable or has a habitat rolling, you need to retrain the nerves in that area. “It’s about teaching the muscles and the ligaments to coordinate in the right ways,” Dr. Robichau said.

One of the best ways to do this is to exercise a single-leg balance. To start, balance on one leg, reaching out with your arms in different directions, aiming for one set of 20 repetitions. It is important to use a lot of varied movements, such as reaching out for something with your hands, shifting your weight, closing your eyes or even standing on one leg while brushing your teeth. “The more real it seems, the more it transfers” to daily life, Dr. Peterson said.

Once you are comfortable with this, incorporate an element of instability by balancing on a couch cushion, foam balance pad or Bosu ball. For an additional challenge, add a light weight or medicine ball. Another difference is the standing leg star tap. Balance one foot and reach the other foot out in straight line, forward, to the sides and backward, in a clockwise pattern, aiming for 15 repetitions of two sets.

The muscles of your legs, ankles and feet also play an important role in ankle stability, which is why it is important to strengthen them. Whenever your ankle joint gets pulled in the wrong direction, your ankle and calf muscles help pull it back. “We don’t want to rely on ligaments for everything,” Dr. Harvath said.

This includes the muscles of our lower legs, which tilt in our feet, out, up and down. Stretching these muscles can help compensate for the weaknesses in the ligaments of the ankle. Dr. Harvath recommended lunges on an unstable surface, such as a couch cushion, foam balance pad or Bosu ball. He recommended two sets of 15 repetitions for each leg.

Another exercise for your calves and ankles is the standing heel raise, which can be done with a single leg or both legs. Stand with your feet shoulder-width apart. Simply rise to your tiptoes, then lower to your heels. 10 repetitions of Aim for three sets.

If done regularly, these exercises can both prevent and help you recover from injury. As for Dr. Peterson, his ankle instability forced him to stop playing football and persisted for about 10 years. It was only when he went to school for physical therapy that he began his own ankle-strengthening exercise routine.

Today, although his ankle in the ligament is still damaged, he has been able to compensate and create the stability he needs. He does all of his favorite activities, such as running marathons and rock climbing, without worrying about rolling his ankle. For many of the patients he sees, regaining strength and stability in his ankles is a matter of learning what exercises to do. “It’s often very simple,” he said.

Rachel Fairbank is a freelance science writer based in Texas.

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