Ankle sprains are a common occurrence among athletes in all sports. Whether going up to catch a football, heading a soccer ball or dunking a basketball there always exists a possibility of landing incorrectly and injuring the ankle. This action typically results in an inversion ankle sprain which can take 2 days to 2 weeks to heal depending on how severe the injury was. But in all reality this is a relatively short period of time. Unfortunately, there are more serious sprains including the High Ankle Sprain.
There are many ligaments in the ankle holding all the bones together, one of those being the Interosseous Ligament. This hard to pronounce ligament spreads like webbing between the two bones in your shin and runs from the top of the ankle to the bottom of the knee. To injure this large ligament, a tremendous amount of force must be applied and typically involves rotational force on top of jamming the ankle into the ground during a landing. The actual mechanism of injury occurs when the tibia and fibula are pushed apart stretching and even tearing the interosseous ligament if enough force is applied. Unlike the inversion ankle sprain, an injury to the Interosseous Ligament has a much longer recovery time, lasting anywhere from 4 to 8 weeks. Fortunately, this injury oftentimes does not require surgical intervention and responds very well to physical therapy.
While transitioning back to normal activity, the athlete may need to wear a boot in order to stabilize the ankle and limit the amount of weight the joint absorbs. Throughout the rehabilitation process, the physical therapist will progressively increase the amount of load the ankle can handle until the athlete is back to full weight bearing. The first goal is returning the ankle back to its previous range of motion in all directions. In my experience as a ProSport / STACK Physical Therapist, pain is the largest limitation in an athlete’s recovery. I have found that the ZAMST A2-DX brace helps support the interosseous ligament reducing pain significantly without completely limiting range of motion. Once basic strength has returned and weight bearing is pain free, dynamic strength control and single leg balance exercises are next. Lastly, in the final stages of the athlete’s rehabilitation a progression through agility and plyometrics should be tested and built before returning to sport.
Of course the best rehabilitation for any injury is prevention. Although it is impossible to eliminate the random occurrence of every injury, there are some steps you can take to reduce the chances. This involves dynamic single leg balance, proprioceptive awareness and lower extremity strength training. A well planned offseason performance program is the answer and will minimize the incidence of injury and extend an athlete’s career.
Patrick Everett DPT, PT, MSAT, ATC
Hi I need some excercise ‘tips to strengthen an ankle after an injury, especially the ligament and tendon behind the foot/ankle.
In our blog post “How to Improve Ankle Stability” I discuss 2 ankle exercises you can use to strengthen the ankle post injury.
Just be sure to take these exercises slow at first after an injury!