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Improving Ankle Proprioception

The ankle is one of the most commonly injured joints, with the ligaments on the outside of the ankle being injured most frequently. We have all felt our foot roll over onto the outside edge whether playing football or just walking to the shops. Sometimes we catch ourselves in time - and sometimes not.

The ligaments of the ankle are full of nerve endings which detect our balance. This sense of where our body is in space is called proprioception and works together with our eyes and the balance apparatus in our ears. When the ankle is damaged, this part of our balance mechanism is also damaged and becomes "out of sync", which is why people who sprain their ankle often go on to sprain it again and again. Retraining the balance mechanism helps reduce the chance of it recurring.

The following exercises help retrain the mechanism once the physical injury has been repaired. They should not be undertaken whilst the inflammation process is ongoing. The ankle must be strong enough to support you on one leg, and care must be taken not to fall and injure yourself.

  • Stand on one leg, using the ankle to be retrained as support. You can compare your balance with that of the other leg. Repeat this exercise several times a day until the balance is similar to that of your good ankle.
  • The next stage is to perform the above exercise, but to close your eyes. This removes the visual component of your proprioception, and relies much more on the mechanoreceptors in the ankle and supporting muscles.
  • The next stage is to repeat the above, but to stand on a pillow or foam block - start off with eyes open, and then progress to eyes closed. This gives a less stable platform, which requires more dynamic feedback to the ankle to maintain balance.
  • A wobble board can also be used. These consist of a flat surface to stand on, mounted on a small central pivot which allows the board to move in all directions. You stand on the wobble board with both feet and allow the board to move, while still retaining balance. There are now wobble boards with "ball-in-a-maze" type games built in to encourage more dynamic movement. A wobble board can also be used seated in the early phase of recovery, where the ankle is not yet strong enough to support the full weight.

Hitchin Osteopathic Clinic, Old Park Dental Surgery, 72 Old Park Road, Hitchin, Hertfordshire SG5 2JT 01462 432609