Ankle injuries, particularly injuries to the ligaments on the lateral side of the ankle joint are one of the most common sports injuries that occur when the ankle "rolls" under the athlete. Scored in three grades, 1 to 3, ankle injuries can compromise not only the connective tissues, but also the nerves, blood vessels, and muscles around the joint says Dr. Karim Khan, author of "Clinical Sports Medicine." Specific stimulation both via machine and by exercise can be utilized to help improve outcomes following ankle injuries.
Electric Muscle Stimulation and Circulation
Swelling is a common occurrence immediately following ankle injury as the body responds to tissue damage and begins clearing out debris. Inflammation and swelling can be managed using electric muscle stimulation to encourage blood flow above and below the injured area to facilitate debris removal says Khan. In the acute stage of healing, lasting 24 to 48 hours, EMS can be used for periods of up to 15 minutes in length to encourage controlled swelling at the ankle provided it elicits no additional pain.
Electric Muscle Stimulation and Nerve Injury
A number of sensitive nerves pass around the ankle joint that can be compromised following an ankle injury, particularly one on the lateral aspect of the leg. A severe, grade 2 or grade 3 injury may result in the temporary cessation of blood flow to the nerve, resulting in nerve damage. Research in 2009 by Dr. Elisa Asensio-Pinilla demonstrated that low intensity, long duration electric muscle stimulation can reduce the nerve's healing time and improve function. Asensio-Pinilla suggests using 1-hour bouts of 3 volts for four weeks or longer to improve function of the nerves.
Exercise and Nerve Injury
Nerve injury following ankle sprains and breaks may be the most difficult and slowest healing component of the ankle. In addition to long duration electrical stimulation, exercise is necessary to stimulate the muscles and increases healing rates, according to Asensio-Pinilla. Easy aerobic exercise for durations over 30 minutes increases production of a number of nerve cell fertilizers that can speed recovery. Asensio-Pinilla suggests at least four separate 30-minute exercise sessions done at a low to moderate intensity each week to enhance nerve recovery.
Exercise and Muscle Stimulation
Stimulating muscles through exercise is a final piece of the puzzle following an ankle injury. Given the multitude of damaged structures, careful implementation and exercise selection is critical. In early recovery stages, sensorimotor training done by single leg standing or by balancing on a balance disk can reduce injury recurrence says Dr. Vladimir Janda, a pediatric neurologist and the father of modern orthopedic manual therapy. Begin by balancing on one foot on a flat floor. When you are capable of standing for 45 seconds, progress to a wobble board with two directions of instability, and then ultimately to a balance disk that is unpredictable in all planes of motion, says Janda.
Attempting to rehabilitate an ankle injury without first seeking proper guidance of a well-trained sports medicine professional is ill advised. Be certain to rule out any more serious injuries like fractures, tumors, or nerve disease and consult with your physician following serious ankle injury.
Is This an Emergency?
- "Assessment and Treatment of Muscle Imbalance: The Janda Approach;" Philip Page, PT, Clare Frank, PT; 2010
- "Clinical Sports Medicine;" Peter Brukner, OAC and Karim Khan, M.D.; 2001
- PubMed: Effects of Balance Training on Gait Parameters in Patients with Chronic Ankle Instability: A Randomized Controlled Trial