Weak Ankles
Saturday, February 24, 2007
Paul Auerbach, M.D.
If you have a tendency to twist your ankles while hiking or running, you may be prone to sprained ankles. This is an extremely common affliction, and ruins outdoor adventures and athletic endeavors on a regular basis. Are high-topped hiking boots, tape, or ankle braces the only solutions?
Unfortunately, there aren’t any great exercises to strengthen an ankle joint, because the structural integrity of the joint is provided by ligaments, which cannot be strengthened or tightened by exercise. If your ankle tends to twist and “sprain,” which is stretching and/or tearing of the ligaments, then you need to keep it in a stable situation. For climbing and hiking, this is best accomplished with high-topped shoes or boots. They don’t necessarily need to be heavy and clunky – they just need to provide enough support so that your ankle can not be easily twisted (or bent) in or out. Thin-fabric high-topped sneakers won’t give you much support, but some of the intermediate weight hiking shoes are excellent. Be certain that the base of the shoe is wide enough to provide good lateral stability, and that the shoes have a decent arch. Wrapping (e.g., with an elastic bandage wrap) or taping your ankles, as do athletes prior to competition, also provides support, but this requires expertise and an extra effort. There are lightweight cushioned splints that can be worn over your foot and ankle while inside a low-topped shoe, but they are not very comfortable when worn over a great distance.
How else do you protect your ankles? Be careful on rocky, steep, and/or slippery terrain. Use adjuncts, such as hiking poles, to prevent falls. When you are tired and more prone to be weak, achieve a rest period. Train for the environment and anticipated level of exertion.
Tags: ankle sprain, ankle, medical, sprain, health, wilderness medicine, outdoor medicine, healthline
photo courtesy of Hiking in Colorado
4 Comments:
At Tue Feb 27, 08:20:00 AM 2007,
Anonymous said…
What do you if you are on a hike and you twist your ankle? If you feel your best solution is to "rough it out" what are the best methods to minimize ankle damage in order to be able to to continue your activity?
At Tue Feb 27, 12:39:00 PM 2007,
Paul Auerbach, M.D. said…
Once you have sprained an ankle, you would optimally allow it to rest and heal before any activity that might delay healing or increase the injury. Recommended treatment is rest, immobilization, elevation, application of cold and pressure (all of these to decrease swelling and re-injury), and pain medication as necessary. If you decide to keep walking for whatever reason, you should seek to take as much pressure as possible off the ankle, wear a supportive boot, use crutches or a walking stick, and allow frequent rest periods for the therapies noted above. In the acute phase of injury (1st 48 hours), avoid aspirin-containing products.
At Tue Mar 06, 09:15:00 AM 2007,
kneedoc said…
The problems caused by a chronically (or recurrently) sprained ankle are twofold. There is laxity or looseness of the ankle ligaments. Additionally, there may be diminution or loss of position sense or proprioception. This is due to tearing of small proprioception nerve fibers which are within the ligament fibers. It is this proprioception which allows you to walk on uneven ground without looking at your feet. While it is true that lax ligaments cannot be tightened or strengthened by exercise, the surrounding muscles which act across the ankle joint CAN be strengthened. And by doing so, one can sometimes compensate dynamically for the loss of static ankle stability (the lax ligaments). Additionally, exercises on a balance board can be helpful in restoring some of the lost "position sense" and training the supporting muscles to respond dynamically to changes in foot position such as one would experience hiking on uneven terrain. Since the most common mechanism for an ankle sprain is with the foot flexed and inverted, the muscles that should be strengthened would be the calf muscles, the dorsiflexors (muscles that pull your foot up) and the evertors (muscles that pull your foot up and turn it out).
At Tue Mar 06, 08:59:00 PM 2007,
Paul Auerbach, M.D. said…
Kneedoc offers excellent commentary. Thank you very much.
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