Ankle sprains are one of the most common injuries and can be suffered in a vast range of active settings; whether running around at recess in 4^th grade, shooting hoops in a pickup game of basketball, or running on your favorite trail. The majority of us have experienced rolling an ankle and the pain, swelling and bruising that follows. Typically we “RICE” it. Rest, ice, compress, and elevate the ankle to help it heal and as we can, we slowly put more weight on it until we can tolerate returning to all of our activities. Although ankle sprains are very common they are NOT commonly rehabilitated. A sprain is an injury to one or more ligaments, which provide support and stability to the joints. When sprains are not treated, changes in stability, balance and range of motion occur and can negatively impact your running gait.  

As a physical therapist, I clinically see that knee pain is commonly traced to ankle sprains, and runners are surprised to learn that it doesn’t have to be a recent ankle sprain that is responsible for the pain; Often it is an ankle sprain from ten years ago that comes back to haunt you. There are many compensations that can occur, but here are two of the most common. First, the loss of ankle motion that can occur requires compensation through increasing pronation at the foot, which then travels up the entire lower extremity and can place excessive forces through the knee that cause irritation. Second, the lack of stability or balance at the ankle can cause the muscles at the hip and knee to not work as effectively and create excessive stress at the knee when running. Any increase in speed or hill work can make all of these compensations worse as these challenges require more range of motion and stability. Always make sure that you are adding hill or speed work in a sensible way that gives your body a chance to adapt and not breakdown.  

If you ever have an ankle sprain, make sure that you take the initiative to get the ankle rehabilitated so you can stay healthy out on the running path over the long term. If you have a running injury and have a history of an ankle sprain, make sure you tell your physical therapist so they can assess your ankle and treat it appropriately.

Anne McJimsey, PT, DPT