Ankle sprains and strains are a common everyday occurrence. In most cases, the injury is nothing more than a nuisance that temporarily affects your training and mobility.

However, severe cases can lead to a lengthy rehabilitation and even surgery.

Once you have experienced an ankle sprain, you’re at a higher risk for repeated injury. Even a minor sprain can derail your training or race day preparations.

How to Prevent an Ankle Sprain

In order to avoid an ankle sprain, it’s critical to adopt a prevention strategy as part of your cross training routine.

Strength, balance, and adequate foot and ankle mobility are the key components to preventing an ankle sprain/strain.

• Strength is a broad term. In the case of a lower extremity injury as well as an ankle injury, the key is to maintain adequate strength in the foot ankle complex to all the way up the chain from the knee to the hip to the core. The core and lower extremity chain work together for all mobility. If there is a weak spot in the chain (whether it’s in the hip or the ankle), your risk of injury increases.
• Balance is a general term indicating the integration of the neuromusculoskeletal system which includes one’s eyesight, vestibular system, proprioception, muscle strength, and neurological system. With proper training, all of these body systems will function at a high level and help you avoid injury.
• Foot and ankle mobility must be normal to insure that your foot and ankle can easily adapt to its terrain during activity.

Strength

Your body must always have sufficient strength to perform your desired task or sport (such as running) as well as maintain adequate reserves. This means that you always need at least enough strength to do whatever it is that you are asking your body to perform. Ideally, you’re strong enough in order to insure that if something goes wrong, then your body has the strength to handle it. Often an injury will occur when the task is harder or takes more effort or strength than the body can produce.

Barbell training is the most effective method to increase strength due the progressive load on the skeletal system and the muscle pull which is exerted on the bone. It increases your body’s margin for error when illness or injury occurs.

Resistance training (other than through barbell training) is also beneficial. An example of resistance training would be any type of pushing or pulling exercise that exerts a force on the muscle, which causes it to work harder than it would normally.  The key to all training is that the system must be properly overloaded to produce the desired effect.  Too little, and you will not receive a positive benefit.  Too much, and you risk injury.  This overload principle must guide all exercise routines if there is to be actual success and benefit from the program.  The most effective exercises either activate large muscle groups and/or load the skeletal system.  Examples include squats, lunges, and dead lifts.

In order to prevent an ankle sprain/strain in general, work on your strength. Being stronger will always better prepare you for the terrain you will run on and the obstacles and/or sports performed.  Weight training will also help to increase your body’s margin for error when illness or injury occurs.

As part of preparing your body to generate a rapid force, I also highly recommend plyometric style training which should be sport or activity specific. Implement both forward and backward motions as well as side-to-side movements. Usually this only needs to be performed once per week as part of your normal cross training routine.

Balance

When addressing balance for prevention or sports performance, it’s important that you look at all areas of the sport or activity you will be participating in and add balance drills that require a higher difficulty level than what is typically found during the event.
Manipulate the different variables and components of balance. For example, when you’re standing on one foot, move your head up and down and left and right. While standing on one foot, jump up and down or throw a ball back and forth. Try to balance on one foot while stand on a water noodle and throw a ball.

During balance training, you’re attempting to work on different aspects of balance such as proprioception or vestibular function. This is not the time to develop strength. People often confuse the two and attempt to work on “functional” strength by trying to do something fancy like squat on a Bosu Balance Trainer.

It’s best not to mix the two types of training. When working on strength then work on strength, when working on balance then work on balance.

The best way to improve balance is to embrace your inner child. Balance on curbs, jump up and down on stumps, and vary the terrain. Even close your eyes and spin or jump up and down. By making play a part of your life and routine, you stimulate all aspects of your balance and engage all your systems (eyesight, vestibular, proprioception, neurological, and muscular).

Foot and Ankle Mobility

When running or hiking on uneven terrain, be sure that you’re utilizing the natural ability of the foot to bend, maneuver, and contort over uneven terrain. If you land with a mid-foot strike, your foot has a much greater ability to adapt to its terrain versus landing heel or toe first. If you find your foot or ankle complex seems stiff or immobile in anyway then addressing the mobility is critical to avoiding injury. A mobile foot can easily and confidently adapt to its terrain.

Training and practice of these strength and balance activities will help you to avoid an ankle sprain/strain. Once you have experienced an ankle sprain, you’re at a higher risk for repeated injury. However, you can significantly reduce your risk of another ankle sprain by implementing a prevention strategy.

If you have already suffered an ankle sprain, knowing how to effectively self-treat and manage ankle sprains and strains is important in order to resume your training and normal activities without the risk of additional damage, injury or re-injury. When you can confidently self-treat, you can limit pain levels, return to activity faster, and prevent reoccurrences.