Winter sports’ greatest enemy…ankle sprain

Winter sports’ greatest enemy…ankle sprain

Blog, Sports Care

Winter sports’ greatest enemy…ankle sprain - 1

Winter sports’ greatest enemy…ankle sprain

Winter sports season means netball, footy and rugby union games galore (maybe even a spot of skiing!), but it also presents the increased risk of ankle sprains and strains…

“The chilly season means that muscles become cold. Without adequate warm-up exercises the muscles and connective tissue aren’t as flexible as they should be and this can lead to injury,” says Dr Brenden Brown, sports podiatrist and founder of A Step Ahead Foot + Ankle Care.

Dr Brenden is calling on health practitioners to “up their ankle game” beyond the simple “text book approach”.

“Ankle sprains are a common winter sports injury. They occur as a result of involuntary sliding or twisting of the feet when you step on slippery or unstable ground. The sprain happens when the foot is forced into an unnatural position

“The intensity at which the ligaments stretch can sometimes be so severe that it causes fracture or serious inflammation and pains. Doing whatever you can to prevent an ankle sprain is a no-brainer.”

Winter sports greatest enemy... ankle sprain - 2

Avoiding winter sports ankle injuries

Planning ahead is a great way to prevent winter sports injuries—particularly when it comes to ankle injuries. With the right preparation and precautions you can reduce the risk of an ankle sprain or strain.

“The common preventative treatment for ankle sprains is balance exercises, but while this might go some way to help reduce ankle sprains the approach really needs to be multi-factorial,” says Dr Brenden.

“To lessen the risk of injury you need to use taping, bracing and practice strength exercises.”

But be warned, Dr Brenden explains that many healthcare professionals—including, physios, chiros, sports coaches and others—at times only suggest doing calf raises. He says, “This is fine if the sport you’re doing only requires you to move the ankle up and down, but if your sport means moving your ankles side to side (for example, skiing, netball, rugby league, football and almost all sports!) then calf raises are of no use.

“A textbook response to ankle sprains will often end patients in trouble. If your health professional is merely suggesting calf raises, it’s time to look further afield.

“More and more evidence suggests we need to look much further up the body, toward the gluteal muscles and alike.

“As such, your strength training needs to incorporate more than just your ankle and should be more sport specific.”

Dr Brenden says you need to functionally challenge the ankle in order to strengthen it appropriately and a special emphasis should be on preparation.

“Those participating in winter sports (or any sports for that matter!) can benefit from completing a tailored muscle strength-conditioning program. This is particularly the case if you’ve suffered a previous ankle sprain or are at high risk of injury.”

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Points to note:

  • Ankle strengthening activities should include hoping, jumping and cutting movements if that is part of your sport
  • Strength exercises should include loading the muscles to be able to dynamically work as they would in your chosen sport
  • Loading the muscle prepares your muscles for the activity ahead. This may include using more than just weight-bearing exercises and incorporating resistance-based training.

Additional measures to help prevent ankle sprains include:

  • Warming up. Cold muscles are less flexible and more prone to injury
  • Wearing footwear appropriate to your sport
  • Making sure your footwear fits you properly (loose boots can cause falls, increasing risk of ankle injury)
  • Taking the time to cool down. Slow stretching can reduce post-sports muscle tightness and soreness and may help reduce future risk of injury
  • Knowing your limits and sticking to them

Treating your ankle sprain

The immediate treatment for an ankle sprain is the RICE approach. This incorporates: Rest, Ice, Compression and Elevation.

  • REST: “if it hurts don’t do it”. Giving your ankle a period of rest after the sprain can assist with healing
  • ICE: apply ice packs to the ankles, or area of discomfort
  • COMPRESSION: apply bandages over the injured area. Compression socks are available from your local podiatrist’s clinic
  • ELEVATION: lift the foot up above the waist or heart.

“Evidence shows that ankle sprains are unlikely to get better by themselves. Plus once you have an ankle sprain, you’re significantly more likely to have another sprain.”

“So just like the pre-sport preparation phase, it’s time to get back to strength and exercise-based rehabilitation as your next phase in rehab,” says Dr Brenden.

Related articles:

Your guide to rock-solid ankle stability

Your guide to choosing the best netball shoe

Your guide to choosing a footy boot

Think you have a heel spur, think again

A Step Ahead Foot + Ankle Care is one of Sydney’s leading foot and ankle clinics. Principal podiatrist and founder of A Step Ahead Dr Brenden Brown (AKA Dr Foot) has been taking care of people’s feet for more than 20 years.

With a background in sports medicine and having served as a former president of the Australasian Podiatry Council, Brenden is a wealth of information when it comes to foot and ankle care.

Your guide to rock-solid ankle stability

Your guide to rock-solid ankle stability

Blog

Your guide to rock-solid ankle stability - 1

Your guide to rock-solid ankle stability

Your feet and ankles are the foundation of your body so imagine the persistent feeling that your ankle is going to “give away” or actually having your ankle collapse under the weight of your body? Ouch!

Sports podiatrist and founder of A Step Ahead Foot + Ankle Care Dr Brenden Brown explains, “Ankle instability is that uneasy feeling that your ankle is going to roll out, particularly when walking or running on rough surfaces.

“We tend to think of these ‘rough’ surfaces as being a rocky terrain or very unsteady ground but for someone who has had a previous ankle sprain, a rough surface can simply be a bump in a soccer field.”

Your guide to rock-solid ankle stability - 2

So what are some key points about ankle instability?

  • Having an ankle sprain increases the chance of another ankle sprain
  • Those people who have an ankle sprain but don’t undergo physical therapy and rehabilitation are significantly more likely to re-sprain
  • Repeated spraining or injury to the ankle can lead to chronic ankle instability (this can seriously effect quality of life)
  • In fact, 33% of people with first time ankle sprains go on to develop chronic ankle instability.
  • You can’t cure ankle instability by doing nothing. Evidence suggests it’s very unlikely it will get better by itself.
  • Stopping exercise or playing sports won’t alleviate ankle instability but could cause other negative health impacts.

While many people underestimate the impact of ankle instability and simply don’t pay their ankles the attention they deserve, other causes include hyper-mobility (being double jointed), a very high foot arch and weak muscular control in a single leg.

Treating ankle instability

“When it comes to treatment, it’s important to note that it’s not just about the ankle – you need to consider the whole limb,” says Dr Brenden.

“Unfortunately, there’s also the common misconception amongst many health professionals that a single style of treatment will make ALL ankle sprains better. This isn’t so; treatment should be tailored to the type of sprain.

“Similarly, there’s the misunderstanding that wearing an ankle brace or taping the ankle will prevent ankle instability. Not so.

“We’re finding that the entire leg, in particular the glutes and all the muscles above the ankle are more vital than we ever thought before.

“If you have weak glutes or poor hip function on your left hand side you’re significantly more likely to twist your left ankle.”

Aside from just focusing on the ankle itself, Dr Brenden says there’s a growing body of evidence to support strength work through exercise.

This involves firstly identifying where the muscle imbalance is coming from and then performing targeted strength exercises.

“I have a real problem with healthcare practitioners who only ever tell people with ankle instability to do calf raises. If you’re a tennis player, calf raises are inappropriate because you’re jumping side to side rather than raising the feet up and down.

“Rehabilitation exercises need to be specific to the sport you play. You can’t take a ‘one-size-fits-all’ approach.”

Other methods of treatment include:

Footwear— A firm base and firm heel counter (we’re talking good quality trainers) is important while the ankle is unstable.

Orthotics—There’s a sound body of evidence that suggests looking at foot posture can be helpful. Over use of the muscles can affect the way the foot moves and, if left untreated, this can lead to ankle instability.

“The vast problem is that people delay treatment and end up having multiple ankle sprains, which not only damages the anterior talofibular ligament (ATFL) but the surrounding muscles as well.”

Ultimately, poor ankle stability can lead to a chain reaction of injury so it’s important to talk to your local podiatrist to find out the best method of action.

A Step Ahead Foot + Ankle Care is one of Sydney’s leading foot and ankle clinics. Principal podiatrist and founder of A Step Ahead Dr Brenden Brown (AKA Dr Foot) has been taking care of people’s feet for more than 20 years. With a background in sports medicine and having served as a former president of the Australasian Podiatry Council, Brenden is a wealth of information when it comes to foot and ankle care.

Find out more about ankle sprains and how to treat them

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