Rehabilitation: Preventing Chronic Ankle Instability
Immobilisation used to be, and still may be, a go to for a lot of clinicians. However, it has been seen to cause long-term adverse effects for a vast amount of injuries. Early protected motion is now key to a successful rehabilitation outcome. This where POLICE (Protection, Optimal loading, and Integrated Control Exercises) plays a pivotal role.
If ankle sprains aren’t treated correctly, they can become more complicated, leading to reoccurring sprains and instability. chronic ankle instability (CAI) is a rising problem with up to 40% of ankle sprain patient report a development of CAI. With the stats being so high, we need to look at where is the issue in our rehab programmes…
Rehabilitation in the past has been thought to be mainly focused on regaining strength, stability and power. However, McKeon P. and Donovan L. (2019) discuss how biopsychosocial model should apply to rehabilitation programs for ankle sprain in order to prevent/address CAI. This should be an essential aspect of the rehabilitation.
With the development of the biopsychosocial model (the biological, psychological and social factors that affect injuries) our understanding of injury and disability has massively improved.
McKeon and Donovan (2019) provide 4 factors that should be addressed during the rehab process to stop this CAI continuum:
- Controlling pain – using POLICE and EASY (External Ankle Support for up to a Year)
- Early protected motion
- Coordination training – helping to promote body-self connection throughout progression. This aims to address the changes in neurosignature patterns (memories and emotions from a specific stimuli)
Continual management throughout the first year using EASY and POLICE. The significant amount of evidence shows a decrease risk of recurrent ankle injuries.
Do I have CAI?
These are the common symptoms of CAI:
- A history of reoccurring ankle sprains
- Repeated turning/rolling of the ankle – especially on uneven surfaces and within sport
- Persistent swelling and/or discomfort
- Feeling unstable and “Wobbly” at the ankle
REMEMBER: Always seek professional advice and help!
Take Home Message:
Sam & Zoe – Fulcrum Sports Rehab
Rehab goals shouldn’t be solely focused on increasing strength, balance and power, but also to encourage patients’ perceptions to influence neurosignature patterns and the body’s perception of itself.