Countless active people have suffered from at least one (if not multiple) sprained ankles in the past. They usually recover quite well, especially if these ankle injuries occurred in their teens or early twenties. However, these seemingly insignificant ankle injuries can lead to future problems.
Fast forward to the average recreational athlete, 25-50+ years old with a history of at least one sprained ankle. They are doing their best to stay active and are noticing occasional aches and pains in their legs and back. Sometimes, it presents as knee pain, and other times as low back pain after walking or running. There was no specific injury, so they are confused about why these body parts hurt. They start to wonder, is this what it feels like to get “old”?
Eventually, they land in our clinic at Juniper Physical Therapy and Fitness. We take them through our full body movement screen and evaluation and discover ankle stiffness. We discuss their injury history, and they reveal that they had at least one ankle sprain in the past.
We explain the mechanics of movement and how ankle stiffness impacts the rest of the body. We start addressing this lack of ankle mobility with hands-on treatment of their soft tissues and joints. They are then instructed in self-care techniques and exercises to maintain and develop this newly gained range of motion. Finally, they are progressed with some strength and balance exercises to restore the foundational control the rest of their body has been craving.
Of course, movement is complicated, and often the other joints (knees, hips, lower back, for example) must be addressed directly too. However, they often tell us that before seeing us, they tried everything for their knee/hip or back pain and that the ankle care we did was the missing link.
The importance of ankle injury prevention
For those of you with a history of ankle sprains and those who have never suffered from an ankle injury, it is imperative to prevent them. Not only because of their aftermath and effect on other joints over time but because they are much more difficult to recover from as you age. At Juniper, when our foot expert, Dr. Stacey Eck, works with her ankle injury or prevention clients, she often gives the following advice:
Maintain Big Toe Mobility
Your big toe mobility is critical for a normalized gait pattern, general movement, and balance. This joint cannot provide the control and power required to move well when stiff. Your ankle joint then compensates typically with overpronation (arch collapses). This affects all the joints above as they work to create the lost balance and power from below.
Keep Ankle Motion
If you have good ankle mobility, do your best to keep it. You must have flexible, strong lower leg muscles and a mobile joint for your ankle to move well. Massage, foam rolling, and vibration guns are all good ideas for maintaining supple muscles. Following these interventions, calf stretches, and ankle mobility exercises will help maintain good ankle motion.
Spend Time Barefoot
Most of our feet live in shoes all day. This is obviously necessary for protection from the elements and general hygiene. However, despite what the footwear industry says, wearing shoes for foot health is not always necessary. In fact, many of our body’s aches and pains stem from how much time we spend keeping our feet covered.
When appropriate, kick off those shoes and let your feet touch the ground. The closer you can get your feet to the actual earth, the better. This connection with our natural surroundings has many benefits. Physically, it stimulates the thousands of sensory receptors in your feet, which help with balance. It also enables your toes to spread and the multiple intrinsic foot muscles to do the work they crave when locked tight in your shoes. Walking barefoot on the ground, known as “earthing,” has many mental health benefits.
Avoid High Heeled Footwear
This recommendation is often challenging for people because most of our shoes have heels. When we refer to “high-heeled footwear,” we go beyond a cute pair of wedges or stilettos. High heels are any footwear where the heel is higher than the front of the shoe. This includes men’s dress shoes and most classic “running shoes.”
When your heels are pitched higher than your toes, several things happen. More pressure is put onto your toe joints, creating unnatural toe motion and can lead to faulty gait mechanics and the development of arthritis. This elevated foot position can tighten calf muscles and tendons that, over time, restrict ankle movement. Heeled running shoes can change your running form, causing you to overstride and waste energy.
If your goal is to avoid injury, then avoid these shoes. However, there are two things to keep in mind. First, the occasional dress shoe for a special event is completely fine. We would never suggest you avoid those sexy heels with a fancy dress or go barefoot when walking in New York City! Secondly, if you’ve lived most of your life in heeled shoes, you need to wean into a zero-drop or more minimalist shoe slowly. Your body will need time to adjust (this can take months) or injuries like Achilles tendonitis can occur.
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