Falling downhill, and the chronic ankle sprain

Posted by Liz Sims, PT, DPT - Redpoint Physical Therapy, Plymouth, Massachusetts

There was this one time when I was running late for work.  As I quickly walked down the 3 foot hill I had walked down so many times before, something went wrong, because the next thing I knew, the contents of my bag were scattered in the parking lot, I was sitting at the bottom of the hill, and my ankle was in searing pain?

What happened?

The chronic ankle sprain happened.

Remember all those times when you were a kid and you “played through” your ankle injuries because you were tough?  Yeah, that’s coming back to bite you.  

Maybe you didn’t have a dramatic injury, like the time I thought I was Pele and I was practicing my cool soccer tricks at the park and came down on top of the soccer ball, landing in a fantastic heap of pain and embarrassment.  Maybe you just have weak ankles (or, weak hips, believe it or not!), leading to poor balance and occasional falls.

Regardless of how you ended up this way, it’s a problem that can be rectified.  If you don't address the issue, you run the risk of injuring yourself with simple tasks like walking on grass, walking in the dark, and running.  

Here’s what happens…

There are sensors in your muscles that are sensitive to stretch.  So, for example, in a normal ankle, if you’re walking outside and step on a rock, when your ankle starts to roll, the quick stretch is detected and you reflexively pull your ankle the other way.  If you have sprained your ankle one or more times, these sensors may have become less sensitive, thus unable to detect such movement.

What can you do?

You can tighten the sensors in your ankles again by performing balance exercises on progressively challenging surfaces.  Making your ankle “more aware” of its location in space will improve your stability when walking or running over variable terrain.

Start easy:

Single limb stance:

Start by holding lightly onto a counter, if you need to.  You can progress by letting go, or closing your eyes.  When that gets too easy, try balancing on a soft surface such as a foam pad or a pillow.

Then, add some movement...  

Standing on 1 leg, lift your other leg up to tap a target (we use cones or steps, usually) before returning to standing.  Too easy?  Try hitting 3 targets before returning to standing.

As always, if you need advice or are having trouble progressing, ask for help from a physical therapist.  

What are your favorite (or least favorite) balance exercises?