From the experts: high heels a key culprit in ankle sprains

PUBLISHED : Tuesday, 24 September, 2013, 12:00am
UPDATED : Thursday, 03 October, 2013, 5:05pm

Ankle sprains are common, accounting for more than half of all athletic injuries. Going over on your ankle usually implies that you had weak ankles in the first place. But how many of us actually focus on training and stabilising our ankles?

Your ankles are the foundation of your posture. Weak ankles lead to weak knees and weak hips. Those three major joints work in sync with each other, and require stability from top down and bottom up.

How many of us actually focus on training and stabilising our ankles?

I blame footwear for most of the ankle, foot and toe problems that I see. Athletic shoes are mostly made of non-organic matter and don't breathe, or adapt to the ground we tread on. They don't fit well, and they are generally too narrow, making us lose our stability. Toes start to cross over, bunions form from inflammation, and our stride length shortens.

High heels are another key culprit. A two-inch heel changes the body's line of gravity, and moves the pelvis forward by 18 to 20 degrees. That causes the ankles and feet to slip forward in the shoe, leading to hammer and claw toes.

The feet are the most important balance and stability part of the body, yet they get little attention until something goes wrong.

One of my Swiss clients was regarded as the fastest downhill runner in Hong Kong. He could shimmy down a mountain like a mountain goat, and could hit rocks and boulders of any size and at any angle, and carry on regardless. He had the strongest ankles I had ever seen.

The highest incidence of ankle injuries occurs in field hockey, followed by volleyball, squash, football, basketball, ice hockey, lacrosse, soccer, rugby, track and field, and gymnastics. Other reasons for ankle injuries among athletes include landing awkwardly from jumps, as in basketball where the landing forces can be six times your own body weight.

I also see injuries resulting from athletes stepping on each other's feet and toes. Running injuries occur on the heels, when landing too hard on the heels from overlong stride lengths or tight calves and soleus muscles.

Ankle injuries should never be taken lightly; too often they receive the wrong treatment, or no treatment at all. Once injured, re-education and retraining should take place immediately. Don't try to walk off the pain of a sprained ankle. In years past, that's often what athletes were advised to do, but it's the wrong approach.

And forget the traditional theory of Rice - rest, ice, compression and elevation. Instead, it's all about Mice - movement, ice, compression, elevation.

It's important to get active movement back into the joints as soon as possible, even if you can only achieve one degree of movement. Your nervous system can only change if you make it.

Apply cold treatment for 10 minutes at a time, then remove it for 10 minutes and reapply. When using an ice pack or chemical cold pack, cover the skin first with a wet cloth to avoid tissue damage. Ice can also be used to reduce discomfort before doing exercises prescribed to strengthen an injured ankle.

You may also want to raise the foot to increase the drainage and flow of the lymphatic system that works as one of the body's waste removal.

Seek a professional sports therapist to have the joint and tissues properly evaluated for heat, swelling, tenderness, discolouration and scarring.

As you gain more mobility, work on regaining ankle stability with your therapist by performing manual resistance exercises on the foot evertors, invertors and the dorsi and plantar flexors.

Practise balance training. Stand on a firm, even surface with the injured foot. Then stand on a foam surface or Bosu ball, first with your eyes open, then with your eyes closed. The idea is to force the ankle to move under unstable conditions. Ankle retraining should be done three times a day, until you can walk, and later jog, without feeling any pain.

Be patient and allow the injured ankle to heal properly. Don't risk another sprain by wearing unsupportive shoes or getting back in the game before the ankle is fully healed.

If you get back too early, the ankle will be prone to prolonged discomfort, re-injury, chronic disability and early onset of inflammation or arthritis.

For people who are physically active, and even for those who are sedentary, if you have previously suffered an ankle sprain, the chances of it happening again are higher.

This underscores the importance of giving ankle injuries the respect and treatment they deserve.


Chris Watts is the founder of Motion Dynamics (chriswatts.biz)