Bear with me here for a moment because it’s likely that my first answer to the question ‘What’s the best treatment for stubborn ankle sprains?’ will seem a bit wishy washy. I can assure you though that in less than 500 words the conversation will lead somewhere. To what could be the most practical and specific ‘how to’ type answer you will ever hear on the twin topics of ankle pain and ankle sprains. Here goes …
A. Better understanding of the real cause of ankle problems, because this will determine what specific treatments you seek.
So, if this is my answer it obviously leads to some more questions pretty quickly like …..
A. There are 2 major causes that underpin almost all case of stubborn ankle pain and repeat ankle sprains. The first cause is weakness in the stabilising muscles of the leg. The second is a build up of scar tissue around the ankle ligaments.
Q. Okay, so I had an idea about weakness being part of ankle sprains but I didn’t realise it involved the whole leg. Does this mean there specific muscles outside my ankle that need strengthening if I want to be free of ankle sprains and ankle pain?
A. Yes for sure. Every muscle involved in the stabilisation of your body weight while you walk and run has a role to play in sprain prevention at the ankle. There are some major stabilisers though, and if we target those we can have a big impact on the likelihood of ankle pain and ankle sprains. These major stabilisers are the large hip and pelvic muscles like the gluteal muscles. And the thigh muscles like your quadriceps. Right in the mix if you want to be more specific are 2 important muscles called Gluteus Medius & Vastus Medialis.. they don’t work alone though, far from it.
Q. Okay that’s pretty clear, but haven’t you forgotten about the ankle muscles, surely they are important ?
A. Muscles that cross the ankle itself are involved more with propulsion than stability and injury prevention. Big hip and leg muscles that provide ‘global alignment’ of the leg prevent ankle issues. There is no real value in us getting too technical because that is time we could spend doing ankle and leg exercises. That said, when ankles roll, have pain and other issues it’s because of problems rolling side to side. Rolled ankles roll sideways not forward. To have much effect on ankle stability and injury prevention the muscles at the outside of the ankle and shin would need to be much bigger than they actually are. All that said I don’t want to diss those muscles because they do play a key role in injury prevention in their own way. The good news is that once you are doing the right exercises you’ll be targeting all these muscles anyway.
Q. Okay, and what that about scar tissue ?
A. The majority of people who have scar tissue in their ankle ( and that’s almost everyone with stubborn ankle pain ) find that releasing and stretching that scar tissue brings major breakthroughs in the management of their pain. There are 2 ways in which scar tissue can build up in the human ankle. the first way is after a major injury, the second way is repetitive strain through overuse or long standing weakness. Breaking up scar tissue for many is a superb and very relieving stepping stone towards the deeper rehabilitation that comes with strengthening.
So that’s what the best understanding of treatment for ankle sprains looks like in my book and for many other practitioners. I hope this helps you to orient yourself a bit more effectively towards what is involved in a serious attempt to seek the best treatment for ankle pain and ankle sprains. We rely so much on our feet and ankle for the enjoyment of a normal active life.. they are worth the effort all this stuff takes.