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Why leaving a sprained ankle, may do more harm then good

Court-based sports can be extremely harsh on the joints of the lower limb. With the sudden deceleration, pivoting, change in direction and explosive repeated efforts, this excessive force can cause degenerative changes over time resulting in a large number of ankle sprains and various knee injuries.

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Many athletes sprain their ankle, spend a week or two hobbling around, applying ice and taking painkillers. Once an athlete loses the sensation of pain they often skip medical advice, self diagnose the injury and suddenly return back to the court in an effort to get more game time. Unfortunately, athletes are unaware that whilst the swelling may have reduced and the pain subsided, they are left with a weakened but also stiffened ankle.

With a reduction in ankle mobility, Newton's law suggests that there must be an opposite effect somewhere along the kinetic chain. Any action of the lower limb will cause overcompensation from other joints, placing increased forces on uninjured limbs. Due to the decreased ankle range, an athlete's knees, hips, lower back or even the other ankle are at much higher risk of injury. Problems occur both above and below the injury site starting proximally and spreading distally over time to other joints and structures further away.

With a reduction in ankle mobility (most commonly dorsiflexion) the foot often moves into excessive pronation causing a ‘flattening’ of the arches in an athletes foot. This is where the chain of reactions begin to develop and new problems surface. Excessive pronation often leads to plantar fasciitis or Achilles strains both of which can result in pain, requiring time off sport. Note; if the main cause (ankle immobility), isn’t addressed then these injuries can continue to flare up and degenerate further.

These poor mechanics at the foot and ankle result in the knee tending to turn inwards on the tibia or create knee valgus. This exaggerates the quadriceps angle ‘Q Angle’ and leaves the knee with an increased risk of injury. Furthermore, issues such as ITB friction/stiffness, patella tracking and ligament – mainly ACL injuries risk have increased. Continuing up the chain towards the hip joint, with the excessive internal rotation on the tibia the femur at the hip joint can also become internally rotated or the hip joint itself can rotate forwards. The outcomes of this are often lengthened glute muscles – the glutes act as important hip external rotator and stabilisers. In addition to the glutes the adductor muscles of the hip will become weakened and tightened creating even less stability of the pelvis.

The muscles in the feet, the VMO at the knee joint and the glutes at the hip joint are all known as phasic muscles, meaning they are made up predominately of fast-twitch muscle fibres and are suited to movement, but they are prone to inhibition and fatigue easily. In other words, they are very important muscles at conducting movement but if placed under excessive strain they will tire and become “lazy” or weak. The longer these dysfunctions continue these muscles will eventually lose their ability to control the faulty alignment that has been created, leaving the body acceptably vulnerable to more severe injuries to the bodily structures such as ligaments or soft tissue injuries.

ALL OF THIS, just because you DIDN’T REHAB your ankle sprain!!!!

Make sure you see a health professional who knows and understands the importance of the rehabilitation process and how you can avoid future joint injuries occurring.


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