Ankle Sprains: The Pain in Sprain Stays Mainly in the Brain

“Hey, it’s just a sprain. No big deal. Walk it off. You’ll be fine.”

This all too common advice is followed all too often. The all too usual result? A lifetime of debilitating ankle pain and instability.

A fully functional ankle is an essential requirement for any sort of life that isn’t completely sedentary. But ankle sprains do happen.

And when an ankle sprain is severe, it can turn into a lifelong problem. Even an apparently mild sprain deserves prompt and thorough attention, treatment, and rehabilitation.

What is a sprained ankle?

Ligaments are anatomical cords made of a tough but elastic substance known as collagen. Ligaments connect bones to other bones. A sprained ankle is the result of overstretching or tearing of the ligaments that bind the bones of the ankle together.

There are 2 basic types of ankle sprains:

  • An inversion sprain occurs when the outside of the foot is forced down and inward.
  • An eversion sprain is caused by the inside of the foot being forced down and outward.

To establish consistency in reference and treatment, ankle sprains are sorted into 3 grades:

  • A grade 1 ankle sprain indicates an overstretching of an ankle ligament, without tearing.
  • A grade 2 ankle sprain includes a partial tear of a ligament.
  • A sprain with a completely torn ligament is labeled as a grade 3 ankle sprain.

60% of sports related injuries in the US are ankle sprains

And millions of non-sports related ankle sprains occur as a result of awkward impact between a foot and the ground.

Studies show at least 40% of acute (grade 2 and 3) ankle sprains result in residual ankle symptoms that persist for at least six months. And up to 20% of acute ankle sprains result in chronic ankle instability. Many cases of chronic ankle instability develop into post-traumatic ankle osteoarthritis.

The consequences of a significant ankle sprain aren’t limited to the lower leg. A study conducted by the University of Kentucky surveyed thousands of people. The results show that people who have severely injured their ankles thereafter have higher rates of disability from arthritis, cardio logical problems, and respiratory issues.

What is ankle sprain rehabilitation meant to do?

The goals of ankle sprain rehabilitation include:

  • Controlling the initial acute inflammation
  • Regaining full range of ankle motion
  • Increasing muscle strength
  • Improving proprioceptive senses

What is proprioception?

Proprioception is how our central nervous system integrates various forms of sensory input from our surrounding environment. The brain then uses that information to determine body position and appropriately guide our movements.

The concept of proprioception is well defined by the title of John McPhee’s book about pro basketball player/US Senator Bill Bradley’s uncanny ability to make baskets from anywhere on the court, often without looking: “A Sense of Where You Are.”

Your sprain is connected to your brain

 The brain plays an important, but often ignored, role in recovery of proprioceptive senses after an ankle sprain.

Why is proprioception important?

Sprained AnkleThe anatomical disruption that occurs during an ankle sprain usually includes damage to receptor nerves within the ankle. When these nerves are working properly, their signals enable the brain to perceive and control the body’s movements within the surrounding space.

Recent studies conducted at the University of North Carolina (UNC) suggest that our brain’s perception of our ankles’ location and movement is impaired by sprain-caused damage to nerves in the ankle. This causes our balance and bodily control to correspondingly decrease.

To compensate for the decrease in proprioceptive information from the ankle, the brain begins to rely on information from other parts of the body.

This can lead to a permanent breakdown in communication between the ankle and the brain

When your brain doesn’t know what your ankle is up to, ankle sprains tend to recur, and chronic ankle instability is looming.

Reuniting your ankle with your brain

The UNC research suggests that many programs of ankle sprain rehab skimp on the attention paid to regaining proprioceptive senses.

How to improve proprioception?

Manual manipulation of the ankle, massage, and comprehensive balance exercises seem to be complementary components of an effective program of ankle sprain therapy.

This sort of therapy protocol appears to help the brain receive more accurate information from nerve receptors in the ankle. With better information, the brain can improve its control over the ankles’ movement. This will reduce the likelihood of chronic ankle instability.

So if the pain of the sprain lasts more than a few days, don’t ignore it. Let us initiate a healing course of proprioceptive therapy.

Why choose University Foot and Ankle Institute for your foot and ankle care

If you’re experiencing foot problems, we’re here to help. Our nationally recognized foot and ankle specialists offer the most advanced podiatric care and the highest success rates in the nation. We are leaders in the research and treatment of all foot and ankle conditions.

For more information or to schedule a consultation, please call (877) 736-6001 or visit us here to make an appointment online.

Dr. Ryan Carter, DPM

Dr. Ryan Carter, DPM

Dr. Ryan Carter was born and raised in St. Louis, Missouri. He received his bachelor’s degree in Biology at the University of Missouri, Columbia, where he played on the men’s lacrosse team and was captain during his senior year.

After receiving his medical degree at Midwestern University Arizona School of Podiatric Medicine, Dr. Carter then completed a three-year surgical residency at Kaiser Permanente in Santa Clara, California. During his residency, he received comprehensive training in all aspects of the foot and ankle. During his final year of residency he served as chief resident.

In his free time, Dr. Carter enjoys running and spending time with his 10 year old corgi Kobe.
Dr. Ryan Carter, DPM

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