Thursday, September 28

Why are my ankles so twisted?

Suffering from sprains is frequent and more so if jumping sports such as basketball or volleyball are practiced. But there are people who sprain their ankle every few days, for no apparent reason. They feel as if they had soft ligaments, which do not support them. And, on many occasions, they attribute it to poorly healed injuries that have left their ankles loose. Well no. The perception they have is wrong, sprains do not leave the ligaments ‘stretched’ as it may seem to us. What happens is that they cause our brain not to perceive the position in which we place the foot when walking. And that is the origin of the new twists. The good? That it has a solution and there are exercises that allow you to recover the correct footprint.

Sprains are no longer rehabilitated by immobilizing the ankle for weeks as before. “The protocols have changed. Now what is indicated is to support, walk and exercise from the beginning, unless it is a serious sprain that prevents stepping, “says Dr. Quim Chaler, from the Spanish Society of Rehabilitation and Physical Medicine (SERMEF). Bandages and immobilization are also not indicated for this injury, because they cause “greater muscle weakness” and “it takes us longer to recover.”

So if we twist our ankle, no lying on the couch with our feet up. “It is important to keep walking, stepping as much as possible, even with pain,” agrees Raúl Ferrer, from the Madrid College of Physiotherapists. And start with rehabilitation exercises.

outside anklets

But before starting to work on the recovery, we must be clear that it is not just a problem of the foot, but also of the ‘head’. The Catalan specialist in rehabilitation explains the consequences that the sprain has on our brain and how it influences whether we can (or not) get it ready again. “The ligaments are a kind of cord that stabilizes the foot. They have proprioceptive receptors and thanks to them the brain can identify in which position the ankle and foot are when they rest on the ground and when they are in movement. The sprain alters the proprioceptive system, the information that the brain receives about how the foot is positioned and creates instability in us », he details. Or, what is the same, we step badly –only with the side of the foot, for example– without realizing it and then we bend it more easily.

«A long time ago it was thought that after a sprain, the ligaments were loose but it is not like that. Either they break or they don’t break, but they don’t stay soft”, completes Ferrer. “The idea that we should strengthen the ligaments is abandoned. The key to rehabilitation is to work on balance and precision in support”, adds this physiotherapist.

A good recovery work requires both working “ankle mobility” and “postural stability in the tread”, Chaler agrees. Jumping on one foot or maintaining balance on an uneven surface are good exercises to regain the perception of our support, the specialist suggests.

And the ankle braces used by people who have that sensation of gum ligaments – after having suffered several sprains – are also not advisable. “They neither prevent, nor facilitate, nor recover. And they give a false sense of security. They can even cause chronic instability in the ankles. The reason? “The brain doesn’t get the actual information and perceives that the ankle is healed and not doing the job it’s supposed to do. There is a gap in learning to step well again, ”explains the Madrid physiotherapist.

The good news is that, although we have been accumulating sprains for years, there is a solution. The brain is capable of recovering that perception of correct footsteps, even in older people, experts agree.

These exercises help heal and correct sprains

Sprains require rehabilitation work. Iñigo Álvarez, a graduate in Physical Activity and Sports Sciences and founder and coach of SUT Training, proposes exercises that can be done daily. It would be good to accompany them with some physical activity: gym, swimming…

1. Work ankle mobility

Sitting or lying down with the knee extended, make turns with the ankle. A very simple way is to write the alphabet with your foot. And in this way we make sure to work all the ranges.

2. We exercise the strength of the foot

Sitting on a chair with a towel on the floor, we play catch the towel with our toes. We can do three series of twenty repetitions each one of them

3. Routines to increase ankle strength

We sit on the floor with the leg extended and parallel to a wall. With the ankle at ninety degrees, we push the wall with the foot (out) for five seconds. We do three sets of six to eight reps. We can carry out the same type of exercise by pushing the injured foot against the other, inwards.

4. Improve ankle proprioception.

To do this, we will walk with the tips of the feet and with the heels three series of ten meters. In this section we would include work on one leg. We play with opening and closing one eye, both… We do six to eight repetitions of about 30 seconds each and three to four series on each foot.


And in our daily life

In our daily routines we can also carry out some exercises. Raúl Ferrer, a physiotherapist at the Madrid school, explains that, after a sprain, the work done in the gym under the supervision of professionals is very important, but not enough. “That hour of rehabilitation is not enough, you have to exercise longer and for seven days a week,” he advises. Some ideas: “Climb the stairs two by two and three by three or use the bosu – a platform used to work on balance – and stay on top stepping on one foot.

The physiotherapist from Madrid points out that after the sprain it is important to progressively load the affected foot. And he proposes “to start with 20% of the body weight”.

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