Ankle Sprains

Question:

I have a 15 year old client who plays football and baseball. He is forever spraining his ankles. Are there specific exercises for the ankles? If so, what are they?

Answer:

Addressing flexibility is definitely important. I would first do an overhead squat assessment to locate specific muscle imbalances. An ankle sprain could definitely be attributed to flexibility problems around the foot/ankle complex, but you will also want to address the hips. Weak glutes contribute to faulty movement patterns that can affect the ankle complex. By looking at the whole kinetic chain, you can address the problem more thoroughly. Here are a few tips to help address your client's needs.

Basic Squat Assessment

Have your client stand with his feet shoulder width apart and arms held overhead by his ears. Ask him to squat down to where he feels comfortable and return to his standing position. Have him do a few reps, so you can get a good look at what his body is doing. Here are some things to notice:

NOTE: For a more detailed description of the above, see Lenny Parracino’s article "Overhead Squat: Total Body Profile."

Example Program for Ankle Sprain Rehabilitation

Here is an example program with exercise recommendations to help address your client’s needs:

Warm Up:

• Self myofascial release (SMR) tight muscles (see above)
  • Hold each tender spot for 20 to 30 seconds

FLEXIBILITY (SMR, static stretches)

STABILIZATION TRAINING (core, balance and reactive training)

Please remember to choose only one to two exercises for core, balance and reactive, each workout,

STRENGTH TRAINING (circuit training format)

Cool Down:

SMR/Static stretch tight musculature worked in program.

As with any client, you will want to address flexibility and strengthening the whole kinetic chain. With a client with persistent ankle problems, you will definitely want to address the foot/ankle complex by stretching the gastroc/soleus to allow for more dorsiflexion. Loss of dorsiflexion results in frontal and transverse plane compensations in the tibia, femur and lumbo-pelvic-hip complex. Increased femoral internal rotation results in increased eccentric overload to the gluteus medius/maximus, piriformis and bicep femoris. This can lead to synergistic dominance of the TFL, adductor complex, quadratus lumborum and glute minimus. This alters neuromuscular control of the lumbo-pelvic-hip complex and control of the lower extremities, which can perpetuate ankle sprains. Proper flexibility, using the right techniques, increases range of motion for proper joint movement Stabilization exercises target weak structures of the core and provides a solid foundation for the limbs to move from. In other words, it makes you more sturdy. The strength exercises increase the ability of the core muscles to work together with the prime movers. This helps ensure that the entire body has proper range of motion and strength. Make sure your exercises are safe and progressive. Only place your client in an unstable environment if he can safely handle it!

* These exercises can be viewed in the PTN Exercise Library.