Rehabbing an Ankle Sprain on Your Own: Part I – Understanding the Injury

Rolling an ankle—what we call an “ankle inversion injury” in the medical world—is one of the most common traumatic musculoskeletal injuries.

The anterior talofibular ligament (ATFL) is the main supporting ligament of the outside of the ankle and is most commonly affected. Depending on the exact mechanism and severity of the injury the secondary ligaments, called the calcaneofibular ligament (CFL) and posterior talofibular ligament (PTFL), can also be affected.

In practice, what matters most is not which exact structure gets damaged, but the severity of that damage and how we go about rehabbing it.

What is a Ligament?

A ligament is a tough, fibrous tissue whose role is to passively resist mechanical forces placed on the joint, i.e. a connection between two bones. Think of them like a cable on a suspension bridge. If one of those cables gets stretched to the point of deformation, or even tears, the portion of the bridge supported by that cable will become unstable and potentially even collapse.

Why Rehab an Ankle Sprain?

If most ankle sprains get better on their own, why bother rehabbing yours? The major reason is that once you sprain your ankle you have a high likelihood of doing it again unless you properly rehab it.

The reason behind this propensity for recurrence is twofold.

First, an injured ligament will not heal with the same structural integrity as it had pre-injury by itself. We need to make a concerted effort to progressively apply the appropriate loads through it to regain this integrity. To understand this process more fully, I suggest reading my article on the topic. The bottom line is that a weak ligament is more likely to break in the future than a strong one.

Second, ligaments play an essential role in proprioception, i.e. the sense of the body’s position in space. We know where our bodies are in space without looking. This is because our brains can sense the stretch on the various soft tissues—above all the ligaments—crossing each of our joints. When a ligament is damaged, its ability to communicate the position of the joint(s) it crosses in space also becomes diminished. This means tasks requiring precise coordination of the ankle such as balance, generating explosive power, or performing a skills such as a kickflip all become impaired unless we actively work to restore them.

In conclusion, a non-rehabbed ankle sprain means a weaker, less coordinated ankle that is more likely to break in the future.

In Part II we will examine how to structure a rehab program on your own.