by Juliana Gildesgame PT, DPT

Do you often feel like you stepped on your foot a little funny? Do you feel uneasy walking barefoot or in new shoes? People with a history of ankle sprains often re-sprain ligaments regularly and feel a persistent sense of ankle instability. Ankle ligaments connect bones with other bones and are designed to protect the joint from forces in several directions. When ligaments are sprained, they lose their ability to transmit delicate messages about spatial orientation to the brain, which causes balance to feel less secure. If you consistently feel unsteady on your ankles, there are several steps you can follow with your physical therapist to make your ankles a solid link in your kinetic chain. Below are several key steps to follow, with your physical therapist.

  1. INFLAMMATION REORGANIZATION: The inflammation is your body’s way of removing dysfunctional tissue and building new tissue Too often, our bodies get overzealous about inflaming the damaged are and the inflamed area needs some help to calm down. Physical therapists use specialized modalities of ultrasound and laser therapy to increase the rate of metabolism damaged tissues, which helps dead cells return to circulation where they can be eliminated. As your swelling decreases you will have improved range of motion and can progress to the next phase of rehabilitation. Your PT can teach you how to manage your inflammatory process so that it can be constructive rather than overworked.
  2. FEEL YOUR BODY IN SPACE: Proprioception is a joint’s ability to feel where it is in space and effectively convey that information to the brain. Sprained ligaments become lax and do not effectively transmit information to the brain unless they are carefully retrained to do so. Physical therapists can help you retrain your proprioception with activities. The good news is, that studies show that 6-weeks of supervised ankle proprioceptive training after initial sprain can help to prevent future incidence of spraining.
  3. GET REACTIONS BACK: Ankles need to respond promptly to sudden changes in our environment like suddenly stepping off a curb or diving to catch a ball. When your proprioception is clear enough, your physical therapist will progress you to dynamic activities that force your neuromuscular system to coordinate with a rapid response. Get ready to jump, hop, cut and change directions rapidly. Your ankle rehabilitation is complete when your ankle can respond rapidly to unexpected demands without re-injuring.
  4. LOOK AT THE WHOLE BODY: Physical therapy is a comprehensive approach that rebuilds ligament stability while simultaneously analyzing the movement patterns of the knees, hips, ankle and back. When patients have previous injuries or instability in joints above the ankle, they can learn new movement choices that put less stress on the ankle and utilize stability of larger muscle groups. Your ankle may be the symptom of a larger problem elsewhere in the body.
  5. RETURN TO YOUR SPORT: Its important to return to your sport incrementally and with awareness of how to manage the new demands on your body. This might mean additional stretching or motor control exercises, or simply warming up your ankle before you place higher demands on it. Getting back into the swing of things should be a careful process where you stress your tissues appropriately. Caring for your ankle properly after a sprain can prevent instability, pain and frustration down the road. If you already have symptoms of chronic ankle instability, methodically progressing through rehabilitation can help to restore your ankle stability and put the pep back in your ankle’s step! Come see the ankle specialists at CCPT to maximize your rehabilitation!
  6. McKeon PO, Hertel J. Systematic review of postural control and lateral ankle instability, part II: is balance training clinically effective? Jour of Athletic Train. 2008: 305-315. CCPT IS OFFERING YOGA CLASSES: Strong & Slow Flow Tuesdays 6-7pm; Starting June 11 Focus is on alignment and moving safely between poses with stability. Appropriate for people with injuries whose work requires sitting at a desk.

CCPT continues to offer Awareness Through Movement™ Classes These classes are based on the principles of the Feldenkrais Method®. Drawing on the latest in neuroscience and child development, participants are guided through a series of slow/gentle movement puzzles to learn how to move better. These classes will help you: Enhance exercise and performance skills! Improve flexibility and posture! Ease pain, and promote being more mindful. Classes: Every Tuesday @12:30-1:30pm.