How I fixed 15+ years of chronic ankle sprains in the same foot
Shared this with r/footfunction a few weeks ago but thought this would be useful here. Not a PT and this is more for folks who keep getting minor ankle sprains. If you have an acute ankle injury, you should go see a orthopedic doctor or physiotherapist.
I hurt my ankle badly 15 years ago and it never fully healed. And ever since then, I'd tweak my ankle once or twice a year like clockwork, mostly when trail running or rucking or walking on an uneven surface. Been to PT multiple times but it was hard for me to stick with a rehab program.
What causes chronic ankle sprains?
Once you sprain an ankle badly, the ligaments around get looser/weaker and the nerves around the joint get poorer at sensing its current position. So when your foot lands weird, your body is unable to react subconsciously and you roll it again.
My program/protocol
Single-leg kinetic chain strength
The most important thing I learned is that ankles don't stabilize themselves in isolation. Your glute and knee are upstream and if they're not strong, all the work in stabilizing goes to your ankles. You need to ensure this foundation is strong. Complementing a balanced strength training routine, I found these exercises to be effective for me:
- Weighted calf raises
- Single-leg RDLs (unweighted -> add weight)
- Forward step-downs from a 6-12" box, ensuring the eccentric aka lowering phase is controlled
- Tibialis raise
- Glute bridges
- Banded monster walks
Proprioception
The next component is proprioception, aka your body's internal GPS. Your nervous system needs to learn how to react fast enough to prevent rolls. Exercises that were good for training this:
- Single leg balance with head turns
- Single leg balance with head turns on a half bosu ball or uneven surface
Controlled plyometrics
This part teaches your ankles how to absorb impact. Example exercise:
- Lateral & forward hops with stick, need to ensure you can effectively stop and balance
Mobility (YMMV)
This wasn't a particular limiter for me, even with my bad ankle. But I know that this might be an issue for you. To increase your ROM, some exercises include:
- Banded ankle dorsiflexion mobilization
- Wall ankle stretches
Hope this is helpful! I'm still experiencing my ankle clicking or locking up occasionally but I've effectively stopped the same injury pattern. Every gym session, I try to do a handful of these exercises as preventative work as part of my warm up or cool down.