ONE SPRAINED ANKLE CAN HAVE
ONE SPRAINED ANKLE CAN HAVE
ONE SPRAINED ANKLE CAN
HAVE LIFELONG CONSEQUENCES
“Several new studies in people and animals suggest that a single sprained ankle can alter how well and often you move for LIFE. In one study, students with chronic ankle instability moved significantly less than the other students, taking about 2,000 fewer steps on average each day.”
Don’t Just Walk Off a Sprain, Gretchen Reynolds, The New York Times, September 9, 2015
“Several new studies in people and animals suggest that the effects of even a single sprained ankle could be substantial and lingering… A single sprain led to far more inactivity throughout their lives.”
Don’t Just Walk Off a Sprain, Gretchen Reynolds, The New York Times, Sep. 9, 2015
Three new studies, each co-authored by Tricia Hubbard-Turner, a professor of kinesiology at the University of North Carolina at Charlotte, has found that just ONE sprained ankle can have serious long term affects if NOT properly healed.
In the first study, Dr. Hubbard-Turner and her colleagues recruited 20 college students with chronic ankle instability, which is caused by a sprained ankle that was never fully or properly healed… (it means that the ankles were stiff, weak and had limited range of motion) and then the researchers chose 20 healthy students and asked all of them to wear a pedometer for a week. The researchers controlled for variables like sex, B.M.I. and general health.
It turned out that the students with chronic ankle instability moved significantly less than the other students, taking about 2,000 fewer steps on average each day. 1
In a second study, done with young adult mice, the researchers mildly sprained some of the rodents’ ankles and compared them to a control group that had no ankle injuries. They let the mice with sprained ankles rest for several days before giving all of the animals access to running wheels and also testing them for balance by inking their feet and having them skitter along a narrow beam. The researchers followed the mice for a year…
At the end of that time, the mice whose ankle ligaments remained untouched were:
- Running significantly more mileage on their wheels than the mice that had had sprains, even though, presumably, the injury had healed long ago.
- The animals with past sprains also continued to slip during balance testing far more often than the control mice. 2
In the third study, they continued to follow and test the same groups of mice until they passed away from old age. They found that the consequences of a single ankle sprain continued to impair their movement for the rest of their lives. The mice that had experienced an ankle sprain ran less and more slowly throughout their entire lives than the healthy mice.
“In these animals, a single sprain had led to far more inactivity” throughout their lives than among the animals with intact ankles, Dr. Hubbard-Turner said. 3
First of all, you have to respect and understand the body’s natural healing process if you want to fully recover from an ankle injury…
Step 1 of the healing process is inflammation and it is a vital part of the healing process… By the way, recent research has clearly shown that ice is NOT effective for reducing swelling or healing a sprained ankle.) For more on that, please read (Do NOT Ice a Sprained Ankle >).
So, right after the sprain, the injured area becomes inflamed and painful. Just stay calm… it’s just a natural part of the healing process! But, what should you do?
Let’s talk about REST first…
Rest is very important for healing a sprained ankle. No one in their right mind would dispute that fact. After an injury, your body has sustained damage and a certain amount of rest allows the body to start the repair process.
Without rest, your body will NOT have the time and ability to repair the damaged tissues, ligaments, muscles, etc. That is simple common sense.
But, the question is… HOW MUCH REST??
Unfortunately, many people assume that since rest is good, prolonged rest or complete rest must also be good. That is not the case. Prolonged rest actually does more harm than good when healing an ankle sprain. So, in a nut shell, rest is good, but too much rest is NOT good.
Why? YOUR ANKLE CANNOT HEAL BY ITSELF. And that’s what you’re forcing on your ankle by just resting it… Your ankle will atrophy and remain weak, immobile and unstable.
That’s why these studies are now showing that an ankle which never fully healed will negatively affect your overall movement for the rest of your life.
In addition, weak, stiff, unstable ankle have a few serious issues that can linger for life:
- They can be painful for months or even years
- They are at a high risk of re-injury
- They can negatively affect other areas of the body (i.e., knees, hips and low back)
So, healing an injury fully and properly is really important. If we are talking about sprained ankles, then it is actually extremely critical, because weak and unstable ankles will change how you walk. This can lead to pain in the knees, hips and low back.
So, prolonged rest is NOT the answer… it is a serious problem that can negatively affect your movement for the rest of your life. So, now let’s look at what you can do to fully heal your ankle, whether it is a new or old injury.
(Please, note: If you have a fracture, you DO NEED complete rest. It’s always best to get an x-ray and consult with your doctor after an injury. But, if you do NOT have a fracture and the injury is capable of rehab, then the sooner you begin, the better. If you have a fracture, as soon as it heals, your body will NEED ankle rehab as soon as possible, but just wait until it heals first.)
If you want to fully heal your ankle and not have all of these issues, then just follow this simple rule… let the ankle REST most of the day, but then add in some gentle and progressive REHAB techniques that reduce swelling, bruising and pain.
Then, slowly and gently move and strengthen the ankle in the coming days and weeks. You don’t need to rehab a sprained ankle for more than 20-30 minutes a day and then you can rest. Your ankle will get targeted rehab for strength, stability and healthy range of motion and then be allowed to rest again. This is a proven and safe formula for fully healing your ankle.
The H.E.M. Ankle Rehab System was designed as a simple, but powerful, scientifically backed 3 step system you can do at home to fully and quickly heal a sprained ankle. It is extremely effective at reducing swelling and pain quickly and also significantly improves strength, stability and healthy range of motion in your ankles to get you back to full health and protect against future injury without the need for ankle braces.
AND THIS IS RELLY IMPORTANT… H.E.M. ANKLE REHAB WORKS FOR OLDER INJURIES TOO. So, if you have an old injury that never healed properly, you can still regain stability, strength and healthy range of motion by using H.E.M.
And remember, a good ankle rehab program is much more than just a few random exercises you can find on the internet. It must be a step by step program that allows you to rebuild the strength, stability and range of motion in the ankles, from the ground up.
That is why the H.E.M. Ankle Rehab System actually contains a REHAB and PREHAB section. The rehab section shows you exactly how to heal your ankle after a sprain or the steps you take for an older injury. And then, once your ankle is healthy again, the prehab section shows you how to protect and strengthen a healthy ankle to improve overall performance and reduce the risk of injury.
Here are just a few benefits of fully healing your ankle:
- Pain Free Movement – walking, running, hiking, jumping, etc.
- Full Range of Motion in the Ankles – this helps the overall movement of your whole body (remember, the ankle joint is the base of your body) and helps PROTECT the knees, hips and low back from injury.
- Improved Speed, Agility and Quickness – a healthy strong ankle will perform better in sports & life.
- Increased Strength and Stability in the ankles – overall balance and coordination improves significantly with healthy ankles.
- Lower Risk of Future Injury without Ankle Braces – you won’t need inhibiting ankle braces that slow you down and weaken your ankles, while also putting your knees at risk of ACL and MCL injuries.
NEVER IGNORE PAIN
If you feel any pain, then back off. You are not ready for that stretch or exercise yet. Focus on the stretches and exercises that you can do with NO pain. Remember, a little bit of soreness is okay and to be expected.
Another important point… do NOT want to do too much, too fast. People sometimes get excited about seeing fast healing results when they begin a good rehab program and then start over-working their injury, which can cause more damage and force you to take a few steps backward in the healing process. So, take your time and proceed slowly and gently.
A good rule of thumb is to start some very gentle ankle rehab exercises and stretches on Day 1 and then see how your injury responds the next day. It may swell up a little bit, but as long as the pain does not increase, you have done well. That means you can continue. As time goes on, you will be able to challenge yourself more and more…
If however, you notice more pain the next day, then you have over-worked the injury and should back off for 1-2 days. You may need to rest for a few days before you get back to rehab. But, the goal should be to begin the rehab as soon as your injury allows it. Again, listen to your body and let pain be your guide…
If you would like you learn more about PROLONGED REST VS. REHAB, please check out some more studies below…
PROLONGED REST DELAYS HEALING
Immobilization and prolonged rest are extremely harmful to the joints and ligaments.
While muscles are very strong and have good blood supply, ligaments are much weaker and have poor blood circulation.
After an injury, the ligaments lose water and glycosaminoglycans (which help maintain structure) so there is a net loss of mass in the ligaments and degradation of collagen.
This means that after an injury, the ligaments become MUCH weaker.
In one study, knee ligaments immobilized for even a few weeks showed that the ultimate load, linear stiffness, and energy-absorbing capacity of the ligaments to be reduced to about one third of normal.
In a review of 11 trials involving 868 ankle sprain patients, results showed that those who included early mobilization compared to those following the standard R.I.C.E. treatment reported a shorter sick leave with faster return to sport participation.
In addition, they showed less days missed from work with less visits to a clinic for follow-up, and improved range of motion with better functional scores.
ANKLE REHAB ENHANCES LYMPHATIC DRAINAGE (REMOVAL OF WASTE & FLUID FOR THE ANKLE)
In other words, the swelling in your ankle traps waste and unhealthy blood. Since, the ligaments do NOT have good circulation, it is essential that we improve the healthy blood supply to the ankle.
Improved circulation gets the unhealthy fluid out and healthy blood and nutrients into the injury to help it heal fully and quickly.
The primary way the body achieves this goal of removing waste from the injury is through a process called lymphatic drainage.
Researches found that ice forced this fluid ‘in the wrong direction’ (back into the ankle), increasing the amount of local swelling and pressure and potentially contributing to greater pain. 4 That’s really BAD!
So, what helps lymphatic drainage the right way? Well, optimal lymph flow is effectively controlled by multiple factors including lymphatic muscle contractions. 5
In other words… ankle rehab, not prolonged rest is essential for proper removal of waste from the injury. We are talking about safe, gentle and effective rehab system that builds up the ankle step by step.
Unfortunately, most people either rest their ankle too long or use random exercises they find on the internet which may not be the right exercises for them and they may not use the correct form.
The key is to follow an excellent program that will safely and actively rehabilitate the ankle for short and long term results.
ANKLE REHAB IMPROVES ATHLETIC PERFORMANCE
After an ankle sprain, there is a lot of damage to the ligaments. They become weak, unstable and may even have scar tissue and neuromuscular damage.
Prolonged rest will ensure that your ankle has great difficulty regaining its pre-injury strength, stability and range of motion, because it does NOTHING to deal with this damage.
The only way to effectively get your ankle back to full strength is through a good ankle rehab program that can strengthen and stabilize the ankles as well as heal the neuromuscular damage and break up and remove the scar tissue.
According to research, “the effectiveness of the rehabilitation program after injury often determines the success of future function and athletic performance. Range of motion, muscular strength, power, and endurance must be returned to pre-injury levels so that full, asymptomatic functional activities may be performed to the pre-injury level and beyond.” 6
ANKLE REHAB LOWERS THE RISK OF RE-INJURY
If you do not follow a good ankle rehab program, your ankle will also be at a higher risk of re-injury, since it will stay weak and unstable putting you at risk for more sprains with impact on the ground or unstable surfaces.
In fact, according to the Journal of Athletic Training:
“Adequate strength is necessary for normal movement patterns. The importance of developing correct motor patterns while subjects perform flexibility and strength exercises cannot be overemphasized.” 7
Researches found that the risk of an ankle sprain was significantly lower if the ankles were stable within the normal limits.
In one study of127 soccer players, 42% of those who had unstable ankles got a sprained ankle versus 11% of those who had normal, stable ankles. 8
Again, only proper ankle exercises and stretches that build up ankle stability, strength and improve healthy range of motion can adequately heal the ankle and protect it from future injury.
If you found this article interesting, I hope you will share it.
Together, we can help others learn how to heal properly which will improve athletic performance, lower the risk of injury and help them avoid long term chronic pain.
- J Athl Train. 2015 Jul;50(7):742-7. doi: 10.4085/1062-6050-50.3.05. Epub 2015 Apr 21. Physical Activity Levels in College Students With Chronic Ankle Instability. Hubbard-Turner T1, Turner MJ1. ↩
- Med Sci Sports Exerc. 2015 Apr;47(4):866-72. doi: 10.1249/MSS.0000000000000466. Developing a mouse model of chronic ankle instability. Wikstrom EA1, Hubbard-Turner T, Woods S, Guderian S, Turner MJ. ↩
- J Sports Sci Med. 2015 Aug 11;14(3):556-61. eCollection 2015. An Acute Lateral Ankle Sprain Significantly Decreases Physical Activity across the Lifespan. Hubbard-Turner T1, Wikstrom EA1, Guderian S2, Turner MJ3. ↩
- The use of Cryotherapy in Sports Injuries,’ Sports Medicine, Vol. 3. pp. 398-414, 1986 ↩
- Dougherty PJ, Davis MJ, Zawieja DC, Muthuchamy M Am J Physiol Regul Integr Comp Physiol. 2008 May; 294(5):R1524-32. ↩
- Andrews J R, Harrelson G L, Wilk K E. 2nd ed WB Saunders; Philadelphia, PA: 1998. Physical Rehabilitation of the Injured Athlete. ↩
- J Athl Train. 2002 Oct-Dec; 37(4): 413–429. ↩
- Tropp H, Ekstrand J, Gillquist J Med Sci Sports Exerc. 1984; 16(1):64-6. ↩