So, how do you prevent repeated ankle sprains? If you are like most people, you initially use the ICE (ice, compression and elevation) treatment. Once the swelling and pain go away, you limp around for a few more days and then gradually your walk is normal and you can get back to your typical routine. The problem with this treatment is that you haven’t done anything to address the damage that was done by the injury. 

Pain and swelling signal your body to “shut down” to protect the injured area. So, now you need to fight both the injury and the resulting weakness and balance issues. A muscle can be strong enough to support your ankle but if it has lost its ability to quickly communicate with the other muscles and your brain, it will not be able to adjust to movements or uneven ground and you will be at risk for another injury. There are specific exercises that help you regain the muscle strength (hyperlink) and some will help with balance as well. However, to really get those nerves and muscles talking again, you need to do some focused exercises.

Muscles, for the most part, do what they are told. Messages get to the muscles through nerves that carry electrical impulses. In general, muscles contract, or increase the tension in their fibers (like all the fibers in a rope) when they are told to do so. The tension can occur to shorten the muscle (concentric movement), to control the lengthening (eccentric movement) or to hold the muscle steady at the same length (isometric).

Let’s say you are walking along the sidewalk and there is a hold. As your foot hits the sidewalk at the edge of the hole, it turns your ankle inward. Normally, this quick stretch would cause a ‘reflex’ signal through your spinal cord and back to your ankle, telling the muscles on the outside of your ankle to CONTRACT (yes, that loudly!). This hopefully prevents your ankle from turning in too far and causing tearing in the ligaments (hold one bone to another but don’t ‘move’) which is called a sprain. In an injured ankle, that reflex communication is either lost or it occurs like bad reception on a cell phone so the muscle can’t react quickly enough to save your ankle.

Neuromuscular control refers to the nerve-muscle communication loop that controls all movement and is critical in protecting the body from injury. Just as with other types of exercises, practice makes permanent. If you practice and exercise incorrectly, then when your ankle turns in while walking, the nerves and muscles will only react as they were trained and you will most likely get injured. This is why your technique is so important when you are practicing…so when your performance matters, you get it right!

Damaged tissue (from any type of injury) will cause the normal ‘Neuromuscular Control’ mechanism to be altered as well.  As such, an important part of any Rehabilitation program is to include exercises that address this critical feedback loop.  While some of the nerve endings may be permanently damaged, you can make the remaining ones better and more efficient through proper exercises.