November 24, 2023

You See Me Rolling…My Ankle. Make It Stop! (Part 1/2)

Training in martial arts can be an intense and rewarding pursuit. Competing for both pride and the occasional small trophy is part of the process for many athletes. Studying multiple styles is common, but for some, Judo becomes the primary focus. There is something deeply satisfying about getting inside an opponent’s head and navigating every move and counter move. It often feels like chess, but with physical combat and no getting punched in the face.

This article is not about a love for throwing people. It is about repeatedly dealing with ankle sprains every few months.

One wrong step. One moment of lost focus. Suddenly, an athlete can be off the mat and out of the gym for two to four weeks. This frustrating cycle prevents consistent progress in strength and skill development and can leave people feeling fragile. It raises an important question: what is the point of training so hard if something so simple can take you out so easily and so often?

Many people no longer deal with this problem, but if any of this sounds familiar, keep reading.

Understanding Ankle Sprains

There are several types of ankle sprains, but this article focuses on inversion sprains since they are the most common. An inversion sprain occurs when the heel rolls inward and the outside of the foot collapses toward the ground.

This usually happens for one of two main reasons. Either the center of mass shifts outside of the base of support, or the peroneal muscles on the outside of the lower leg do not activate quickly enough as the ankle begins to roll.

The peroneal muscles work to evert the foot and ankle, essentially resisting the exact mechanism that causes an inversion sprain. These muscles play a critical role in protecting the ankle. For the purpose of this article, the primary focus will be on delayed muscle activation.

The term sprain means damage to a ligament. Ligaments are connective tissues that attach one bone to another. When it comes to inversion ankle sprains, the ligaments most commonly involved are the anterior talofibular ligament and the calcaneofibular ligament.

Unlike muscles, ligaments do not contract and they do not have their own direct blood supply. Because of this, they heal more slowly and they cannot actively change their length once healing has occurred.

Here is an important and often overlooked fact.

The number one predictor of a future ankle sprain is a previous ankle sprain.

Let’s unpack why that matters.

Why Ankle Sprains Keep Coming Back

Ligaments are often described as the structures that hold the body together, but that is only partially true. Ligaments are not especially strong. Muscles are what truly stabilize the body and allow it to move through the world.

Ligaments do have an important role though. They are loaded with mechanoreceptors, which are sensory structures that help the brain understand where the body is in space. As joints move, ligaments stretch and send signals to the brain, providing constant updates about joint position. This sense of body awareness is called proprioception.

Without proprioception, movement would be clumsy and uncoordinated.

When a ligament is sprained, it is forcibly stretched and partially torn. As it heals, it does so at a slightly longer length than before. Ligaments cannot shorten themselves after healing.

This means that after an ankle sprain, the ligaments are slightly looser than they used to be. Because these ligaments help provide positional feedback to the brain, the signals they send are now slightly delayed. The delay may only be fractions of a second, but during high speed or high intensity movement, that delay matters.

Here is the good news.

Muscles also contain mechanoreceptors.

By retraining the muscles of the foot and lower leg, especially those on the outside of the ankle, it is possible to help make up for the lost feedback from the injured ligaments. This is why proper rehabilitation is not just about strength. It is about timing, awareness, and control.

What Comes Next

Now you understand why ankle sprains tend to repeat themselves and why simply resting until the pain goes away is not enough.

In Part 2 of this series, Next Level Physical Therapy will walk through a few foundational exercises that are considered mandatory in a complete ankle rehabilitation program. These drills are designed to restore confidence, improve control, and help stop the cycle of repeatedly rolling the ankle.

Stay tuned.