That Ankle Sprain affected more then just your ankle...
The Foot and Ankle in my opinion are severely under appreciated in there impact on our body, especially when it comes to restoring normal biomechanical function after an injury. Current orthopedic data estimates that there are 25,000 ankle injuries each day in the US alone. Of that 80% are inversion (supinated) ankle sprains, that's 20,000 a day and unfortunately back in 1995 I was a victim of a sprained ankle.
So what is the big deal, it was just a sprained ankle and it will heal right?
Well everyone I've ever talked with that's sprained an ankle did the same thing as I did to recover. Remember that fancy acronym RICE...Rest, Ice, Compression and Elevation. That's what I did and for rehab, well all I did was wear a soft brace and pop anti inflammatories when I continued to play sports.
According to Dr. Gary Gray PT (founder of The Gray Institute and developer of Applied Functional Science) has stated that RICE for an ankle sprain is the worst thing any PT can prescribe for recovery. Dr. Gary Gray through his work has found that restoring eversion (pronation) is critical for improving normal biomechanical function and the prevention of injuries and orthopedic changes in the joints above the ankle.
After my ankle sprain back in 1995 it took only 4 years before I started to develop knee issues on the same leg as the sprained ankle. When I started personal training in 2001 I learned that the issues I had was called patella tendinitis or runners knee pain. I also learned that I needed to stretch my lateral quad, IT band, TFL and strengthen my glute med to get rid of my symptoms...ha ha ha ha. Did you get that, get rid of my symptoms. But what's causing those muscles to be tight in the first place???
So that's what I did and yes it got better but it would come back and I've had a few major flare ups while playing sports since then. Sound familiar?
So what does the ankle sprain have to do with this?
Earlier this year I was taking some courses from the Gray Institute and the knowledge I've gained from it has not only transformed my leg but also my approach with clients and its made a profound impact on improving my clients lives.
So here is what I learned...
If your reading this I want you to quickly stand up and just take a short walk about 10-20 feet and pay attention to where your weight is resting on your feet as you walk. Then come back and continue reading.
If you noticed that your weight is on the outside of your feet then your foot is in inversion (supination) which is the same position as a sprained ankle but most likely not as extreme. In my case the ankle I sprained back in 1995 is still stuck/locked in this position while my other foot is able to evert (pronate).
With the foot/ankle in a position of inversion (supination) the chain reaction up the body causes the lower and/or upper leg bones to externally rotate and potentially causing the hip to externally rotate as well. Consequently those bones that are externally rotated will be limited in their ability to internally rotate during ankle/knee/hip bending (flexion) movements such as walking, running, lunging, squatting etc. The restriction to internally rotate will reduce the muscles ability to lengthen and load (eccentrically load) properly thereby causing the muscles to tighten up.
When I learned this I realized that my daily routine of rolling out my outer quad/IT band and TFL which by the way were tight as steal and sore as heck, was only treating the symptoms caused by my sprained ankle over 20 years ago.
So what is the treatment?
It's super simple, restore the foot and ankles ability to evert (pronate) with exercises/movements/stretches. If your unable to get a few sessions with a movement therapist/PT that understands this such as myself, a place to start is by standing on 1 leg and focus on using your big toe to push into the ground a little bit. If your getting in/out of a chair, push the big toe into the floor. Now this is not the optimal approach or thing to do but its better then nothing until you can get in with a professional for an assessment/evaluation and proper exercises.
PS. going out and getting an orthotic is not the answer, they are a tool designed to help the foot when the foot and ankle are not able to function. Do everything you can to restore foot/ankle functioning first.
I hope you found this to be helpful...
remember - "if you can move better, you will feel better"
-Jon
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