How to Fix Ankle Pain for Climbers (Ankle Sprain, Twisted Ankle, Ankle Injury)

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// TIMESTAMPS //
00:00 Intro and Video Overview
00:52 Part 1: Ankle Anatomy and Mechanism of Injury
03:14 Part 2: Ankle Injury Risk Factors
05:15 Part 3: Differential Diagnosis: Ruling Out an Avulsion Injury
06:51 Part 4: Testing Sprain Severity
09:59 Part 5: Basic Rehab
11:19 Part 6: Balance Rehab
13:26: Part 7: Strength Rehab
14:41 Part 8: Return-to-Sport Training
15:42 Part 9: Prognosis
16:12 Outro and Bloopers

// SHOW NOTES //
Episode 95

INTRODUCTION

To all the struggling ankles out there: you didn’t deserve to land on the edge of that giant pad stack, you couldn’t have known that rock on the trail was loose, and you can’t be blamed for forgetting how to walk correctly when loaded down with climbing gear. My dearest ankles: this one’s for you!

Lower extremity injuries account for ~25% of all injuries reported by climbers, and ankle injuries make up nearly 50% of those reported! So you could say this video is a bit overdue. For that reason we’re going to cover some common causes of lateral and medial ankle injuries for climbers, a bit of testing to determine how severe an injury is, and finally how to get those ankles strong again!

Note: we will not be covering a syndesmotic aka high ankle sprain in this video.


WHY ANKLE INJURIES NEED REHAB

When we suffer an ankle injury we typically lose proprioception, muscular strength AND ligamentous stability! These are things that don’t always just magically heal; we need to do specific rehab activities to get back to full function. So let’s break down those terms real quick.

Proprioception is the awareness of the position or movement of the body. Research has shown that proprioception is decreased in those suffering instability after an ankle sprain. The ankle is a complicated joint and must move through many extremes while climbing. Losing awareness can lead to decreased function and performance of that unit while climbing.

A reduction in strength after an ankle injury is also shown in research and is related to prolonged feelings of instability. This strength reduction may be related to being immobilized (such as with casting or bracing), from purely resting the injured ankle, or simply from injuring the muscle with the initial injury.

Finally, when you sprain your ankle, you’re typically injuring one or more ligaments by overstretching them. That injured ligament is now not as strong and taut, meaning it has excessive mobility which will create excess mobility of the joint it supports. When an injured ligament starts to repair itself, it replaces strong, dense type I collagen with looser type III collagen. Without proper retraining, the ligament will retain that higher percentage of type III collagen, meaning the ligament will remain looser and the joint will remain hypermobile. This may set you up for a future repeat injury if you don’t properly retrain the tissue.

Ran out of room!! For the rest, please check out the show notes:
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// DISCLAIMER //
As always, exercises and rehab programs are to be performed assuming your own risk and should not be done if you feel you are at risk for injury. See a medical professional if you have concerns before starting a new training or recovery program.

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// PRODUCERS //
Jason Hooper (PT, DPT, OCS, SCS)
and
Emile Modesitt (@emile166)

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