Balance is a challenge even after physical therapy for an ankle sprain, and proprioceptive exercises can address this issue. Proprioceptors are small structures within the ankle joint that provide information about position, coordination and agility. Proprioceptive exercises retrain proprioceptors to provide feedback on joint position, coordination and agility. This feedback is crucial to performing mobility, recreational exercise and competitive sports safely. When an ankle is sprained, proprioceptors also sustain injury and malfunction. Do proprioceptive exercises after you warm up but before you fatigue. During the cool-down, try basic static balance exercises but avoid dynamic exercise.
Static Balance Exercises
Static balance exercises improve your stability while you remain stationary. Start balance exercises by standing on a stable surface with both feet. Alternately shift your weight forward and backward to practice regaining your balance when displaced outside your base of support. Progress to weightshifting side to side when you master forward and backward weightshifting. Use couch cushions or a balance pad to increase the difficulty by creating an unstable surface. Stand on the cushion and shift your body weight forward, then backward. Progress to side to side shifting when you can tolerate forward and backward shifting without aggravating your symptoms.
Dynamic Balance Exercises on a Stable Surface
After mastering static exercises, the next step is to perform dynamic exercises on a stable surface. Dynamic balance exercises improve proprioception. Stand and hold the ends of a piece of elastic resistance, such as a stretch band, that is anchored to a door knob or eye hook. Take up the slack and pull backward repeatedly with increasing speed. This motion challenges your ability to maintain your position and strengthens your core. Your balance improves when you overcome external forces that attempt to displace you. Progress to using a single leg for the same exercise when tolerable. Another exercise involves standing and throwing a small medicine ball into an inclined trampoline. Catching the ball challenges your balance. Incorporate sudden stops when moving to train proprioceptors to detect directional changes. Good dynamic balance improves sports performance.
Single Leg Balance Exercises
Single leg balance exercises are the next step in rehabilitating an ankle sprain. To start, stand on one leg on a stable surface such as a level floor and hold this position. Start with five-second holds and progress to longer holds. Once you tolerate single leg balance on a stable surface, progress to single leg balance on an unstable surface like a trampoline. The objective is to maintain your position with as little movement as possible. Increase the intensity of this exercise by tossing a medicine ball against a wall or to another person while holding your stance on the trampoline. Start with 10 repetitions and build to three sets of 10 reps.
Balance Exercises on an Unstable Surface
It's difficult to maintain balance on an unstable surface. For example, stand on grassy areas or hard sand and remain still. Such unstable surfaces are unpredictable, making it difficult to react to surface changes. Progress to walking in the grass, gravel or soft sand. Try balance equipment like rocker boards, which move forward, backward and sideways. Try a wobble board for multidimensional balance. The objective of balance boards is to balance on the board without its edges touching the floor. Walk on an air mattress or with your kids in a moonbounce for multidimensional proprioceptive challenges. Removal of the visual system is the last modification to increase proprioception. Good proprioception is knowing where you are without looking. Once you master balance blindly, you can return to full activity levels with confidence.
References
- "Clinical Orthopedic Rehabilitation"; S. Brent Brotzman and Kevin Wilk; 2003
- Idea Fitness Journal: "The Ankle Joint"; Catherine Logan; 2005
- Idea Health Fitness Source: "How To Improve Proprioception"; Michelle Tarrant; 2003
