Why Is It So Hard to Return to Running After an Ankle Sprain?

Ankle sprains are commonly perceived as a mild injury, however, they often cause runners and other athletes to seek physical therapy.

The severity of these injuries are often downplayed as athletes return to running and sport far too quickly.

The most common form of an ankle sprain is an inversion sprain. In this instance, the foot is usually planted as the ankle turns inwards causing the outside edge of the foot to roll onto the ground (hence the term “rolled ankle”). As this occurs the ligaments on the outside of the ankle are damaged and usually torn to some degree.

The severity of the injury and number of ligaments involved dictate the grade of the ankle sprain, ranging from grade 1 through grade 3.

After an ankle sprain occurs, it is essential to rule out a fracture. An athlete is instructed to have an X-ray if he/she/they is unable to bear weight on the injured leg and/or has severe pain around the malleolus (prominent ankle bone on the outside of the ankle).

If an athlete does not have any of the findings mentioned previously or an ankle fracture is ruled out, then we can move on to returning to running!

When running there is not a single time when 2 feet are on the ground at once. Therefore, the body is constantly bounding from one leg to the other, forcing the ankle to repeatedly absorb the impact of the entire body.

Unfortunately, after an ankle injury the stress capacity (the amount of cumulative stress an area can handle prior to injury) is limited. For this reason, the recovery from an ankle sprain often takes much longer than necessary. Runners and many other athletes commonly attempt to run before the ankle is ready.

All injured tissues must progressively re-acclimate to the amount of stress associated with running or the sporting activity.

A thoughtful and progressive return to running may begin with non-weight bearing movements, then progressed to include non-impactful weight bearing activities such as squats, split squats, and lunges. Next, single leg activities can be included such as single leg balance drills and single leg squats before progressing to plyometric drills that involve jumping off 2 legs and finally, hopping on 1 leg.

Finally, activities such as jump roping, short runs, and longer runs are implemented into the routine!

In conclusion, every ankle sprain is different, and it is essential to ensure that a trained medical professional assesses the injury to rule out a fracture. Finally, the professional can design the optimal return to sport program for you.

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