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Centre for Orthopaedics
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I'm a running back on a college football team. I sprained my ankle last season, and I still haven't gotten back my ability to make quick movements and change direction fast. No matter how much I practice my agility drills that ankle still gives me fits. Is there anything else I can do to get back what I've lost?

Many experts have looked at this question with an eye toward improving rehab for athletes such as yourself. A recent study from a group of physical therapists in Ireland may have some new information to help.

They studied two groups of adults in a controlled laboratory study. One group had recurrent ankle sprains (at least two). The other (control) group had no history of ankle sprain.

Both groups were tested on a treadmill walking four kilometers per hour. Measurements were taken of muscle activity and joint position throughout the testing.

They found that the ankle sprain group had a tendency to hold the ankle in a slightly inverted (toe in) position. This was especially obvious at the point of heel strike when the ankle should be in neutral. They also found that this position put the outer border of the foot closer to the floor with lower clearance during the swing-through phase of gait (walking).

The results of this study show that athletes need to start with basic retraining of their walking pattern after chronic ankle sprain. This step is advised before doing jump landing and agility drills.

It's probably not too late to go back and add this into your program. A physical therapist can help you get set up to do this with minimal supervision. Taping and bracing may be needed at first to get the ankle back to a more neutral position.

The muscles along the outside of the ankle must be retrained to control and correct the ankle position at all points of the gait cycle. This includes the swing through phase as the toe pushes off and the lower leg moves forward up to and including the moment the heel strikes the ground.

Motor reeducation to restore normal motor control is often overlooked in an athlete's rehab from acute ankle sprain. Even though you are past the acute phase of ankle injury, it's probably not too late for you to recover these important skills.


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