Ankle sprains are one of the most common lower limb injuries with an estimated 2 million ankle sprains occurring annually in the United States! Majority of people consider an ankle sprain a minor injury and try to take care of it themselves without seeking help from a medical provider. The problem with this, is that they are likely missing out key components of the rehab process. I know this because I used to do the same thing prior to becoming a physical therapist. If you’ve ever treated yourself for an ankle sprain, you’ve likely used iced, compression, elevation and missed out on the key exercises you need to restore ankle joint mobility, strength, and stability. In this blog, I’m going to focus on the rehab piece that I find that most people fail to incorporate into their recovery….proprioceptive training.

Have you ever had the experience of tripping over nothing? f you have, then you have likely suffered an ankle sprain at one point or another and your proprioception might not be where it needs to be. Proprioception is our sixth sense and is defined as “the neural process by which the body takes in sensory input from the surrounding environment and integrates that information to produce a motor response.” All that means is that, proprioception is the ability to sense position and movement of a joint or body part in space. This happens thanks to sensory receptors located throughout the body that respond to different stimulus (stretch, tension, pressure), which in turn send a signal to our brain telling us where our joints are in space. When we sprain our ankle, we can tear the nerve endings which communicate with our brain leading to impaired proprioception. The good news is that proprioception can be trained through the use of balance work.

Prior to starting these exercises, it’s important that you can tolerate standing on one leg without aggravating symptoms (increased pain, swelling, etc.). Depending on the severity of ankle sprain, this would be around the 2-3 week timeframe.

Exercises for Lower Extremity Proprioception

In the videos below, I demonstrate different exercise variations that can be easily performed at home with minimal to no equipment!

1. Single leg balance push-press

2. Single leg balance halos

3. Single leg balance cone touches

4. Hip airplanes

Start by performing 2 sets of 20-30 seconds of each variation. These can easily be progressed by further challenging the proprioceptive system and visual system.

• Proprioceptive challenge—perform on soft surface like a pillow, cushion, BOSU ball, wobble board

• Visual challenge—close your eyes

Marching Drills

Here are two examples of marching drills that are a bit more advanced than the exercises above and do a great job at challenging your balance! The standard march is a good starting point to get comfortable with balancing on one leg while moving. The key with both of these is to move slow and controlled!

The loaded march will further target your core, back, arms, and grip strength just to name a few! Start by selecting a weight that feels like an effort of 7/10 (0=easy, 10=hard). It’s always better to start with a better load to practice form, as opposed to going heavy and being all over the place with your balance. I’d recommend performing both variations barefoot (if you trust yourself not to drop the weights) so that you can receive further sensory input from the ground, after all, that’s exactly what we are trying to restore!

There are countless ways to challenge your balance! I also incorporate single leg squats, split squats, single leg deadlifts, and step downs as part of mine and my runners routines when rehabbing an ankle sprain. Those exercises target lower limb strength and balance at the same time! If you’re dealing with a recent ankle sprain and don’t know what to do next, I’d love to help. Schedule a complimentary call and start your journey back to running! Thanks for taking the time to read! If you found this helpful, be sure to sign up for my newsletter below.

REFERENCES

Rivera MJ, Winkelmann ZK, Powden CJ, Games KE. Proprioceptive Training for the Prevention of Ankle Sprains: An Evidence-Based Review. J Athl Train. 2017 Nov;52(11):1065-1067. doi: 10.4085/1062-6050-52.11.16. Epub 2017 Nov 15. PMID: 29140127; PMCID: PMC5737043.

Mackenzie M. Herzog, Zachary Y. Kerr, Stephen W. Marshall, Erik A. Wikstrom; Epidemiology of Ankle Sprains and Chronic Ankle Instability. J Athl Train  1 June 2019; 54 (6): 603–610.

Han J, Anson J, Waddington G, Adams R, Liu Y. The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury. Biomed Res Int. 2015;2015:842804. doi: 10.1155/2015/842804. Epub 2015 Oct 25. PMID: 26583139; PMCID: PMC4637080.