I think most of us, at some point in our lives have at least once, experienced and ankle sprain, twist. This can happen to anyone sometime for very little reason than stepping on a stone, tripping off a pavement, a hole in the ground or tackle in sport. The result is varying degrees of ligament strain all the way through to tears, and fractures.
The reason why I’m writing this post is because of a technique I have been using which is delivering very useful results in this condition. Some will claim to have gone through some sort of rehab process, generally with their Physiotherapist. But in spite of the ankle healing up, there remains a tendency to instability and repetitive ankle weakness. Wobble board exercises can be useful but they do not address the functional aspects of the foot alignment.
The approach to Ankle instability involves several steps.
- An appreciation of the foot type and foot posture of the individual.
- Leg alignment ie: bandy legs can contribute to a supinated heel strike.
- Heel Alignment ie: Rearfoot varus can contribute to an inverted heel strike.
- Lack of Ankle flexibility (Dorsiflexion) ie: tight calves/ Achilles
- Weak Peroneal muscle groups, or inadequate muscle response to ‘going over’ on the ankle
- High arched feet, have a tendency to ankle instability.
- Joint surfaces that may be ‘out’ or subluxed.
- Pelvic Anomolies leading to leg length issues.
The treatment approach.
- Improve ankle dorsiflexion with targeted flexibility routines.
- Improve calf flexibility with Soft Tissue Massage to iron out knots in the muscle.
- Mobilise the ankle joints.
- Mobilise the Fibula (where all the lateral ankle ligaments attach)
- Mobilise the Forefoot.
- NMES ( Compex Neuro-Muscular Electrical stimulation) to the Peroneals .
- Orthotics to balance the foot.
- Pelvic corrections through the use of a DPI ( digital pelvic Inclinometer).
- Peroneal muscle strengthening . (Compex, Wobbleboard)
As you can see there are a number of techniques that synchronise together to achieve the objective. No single treatment on its own works, there has to be an holistic approach to this condition. There is not longer any need to suffer from ankle intability.