How important is balance retraining following an ankle injury?

The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: A systematic review and meta-analysis

Gabriella Sophie Schiftan, Lauren Ashleigh Ross, Andrew John Hahne

The most common sports-related injury is ankle sprain. If you are or have ever been involved in any sport requiring jumping, pivoting or quick directional change, there is a high chance that you may have ‘rolled’ your ankle in one way or another.

The most common way the sprain occurs is with foot inversion (sole of foot facing inward) and plantar-flexion (sole of foot facing backward).

Ankle sprains usually lead to pain, swelling and restricted foot movement, and subsequent lower limb dysfunction.

The spectrum of severity varies significantly depending on the context of incident. Also, depending on assessment and rehabilitation, symptoms may persist from anywhere between 6 weeks to 18 months.

There is evidence showing that the risk of recurring ankle sprain is doubled in the year post initial injury. This is believed to be a result of compromise to proprioception in the injured site. Proprioception is basically the internal awareness of body/joint position and movement. The fact that you can point your index finger to your nose while closing your eyes is dependent on proprioception. It becomes more crucial when you are pushed in mid-air, and need to land on ground without having to think about your ankle position.

In the physio clinic, we often come across patients who stop their rehabilitation because pain stops affecting their life, without recognising their proprioceptive functions are down. It has been shown in a recent study that properly directed proprioceptive exercises significantly reduce further recurrences of ankle sprains.

So what are these exercises? You may have come across wobble boards, ankle discs, balance pads etc. These are a great start, but you need to make sure exercises are progressed to meet your functional/sporting requirements.

Here is a quick test that you can try at home: Stand on one leg in front of your kitchen counter. Close your eyes. How steady are you?