Don’t Do the Twist

The snow has melted in the colder regions of our country and it’s just about time to give our legs a break from the roads and get back to the trails. But with trail running comes the risk of ankle injuries. Rather than focusing on how to manage ankle injuries, let’s consider the best ways to avoid them. To ward off twisted ankles, you need to use your senses – literally – by engaging your proprioceptive system.

What is proprioception?

Proprioception is the body’s sensory system that provides us with information as to where our body parts are oriented in space. Try closing your eyes and flexing your index finger. You can distinguish that your finger is flexed rather than extended. The proprioceptive system is composed of receptors in the muscles and tendons that inform the nervous system of the changing lengths of the muscles through movement, as well as force loads travelling through the tendons.

How does proprioception work?

These sensory receptors act as a protective mechanism for the body. Excessive lengthening of a muscle initiates a reflex to contract that  muscle to prevent a ligament sprain or muscle strain. A similar regulation system exists in tendons, but instead is dependent on the force loaded through the tendon rather than on its change in length. These two regulatory systems contribute to what is known as proprioception.

As you’re running through the trails, your foot lands on a root. The fibularis muscles on the outside of your lower leg lengthen, triggering the sensory receptors in the muscles and their tendons. These receptors send a signal to the spinal cord, which then alerts the fibularis muscles to contract. This will shorten the muscles, subsequently preventing the ankle sprain.

Healthy blueprints

Training, injury prevention and rehabilitation programs are now focusing their attention on muscle co-ordination and muscle inhibition with the intention of improving muscle firing (contracting) patterns. Throughout our lives, we develop motor patterns, which are essentially the blueprints that muscles adhere to in order to move through tasks, such as tying your shoelaces or bounding. Typically, muscular weakness, muscle inhibition (muscle not firing properly), unhealthy muscle tissue (scar tissue) and pain will cause a normal motor pattern to become abnormal.
When a runner’s balance is thrown off by an external factor, such as stepping on a root, the correct muscles must be prepared to engage immediately to prevent injury. Proprioceptive exercises focus on training muscles to achieve maximal and rapid contraction.  By training on an unsteady surface, the challenge of maintaining balance is intensified. The unconscious system exists through every muscle and across every joint in the body, so a well-developed and healthy proprioceptive system is paramount for runners to avoid injury and run more efficiently.

Healthy tissue=effective training

Unhealthy tissue decreases the muscle’s aptitude to contract appropriately, often creating abnormal muscle firing patterns. With proprioceptive training, it’s important to ensure that the muscles are as healthy as possible before training. This means that scar tissue and trigger points have been treated, since they can alter the ability to perform appropriate muscle firing patterns. Treatments such as Active Release Technique (A.R.T.) and Graston Technique are effective methods of ridding the tissues of such interferences. Kinesio Tex Tape can also be used to aid in recruiting the accurate muscles both pre- and article-injury.

How to improve ankle proprioception

Balance training has been proven effective in the prevention of ankle sprains, and can be as simple as standing on one foot while waiting at the bus stop. By taxing your body’s ability to balance, you’re improving your muscle’s capability to react to unexpected forces as you run, such as stepping on a root on the trail.

Try these simple exericises:

1. Close your eyes and stand on one foot

2. Throw a ball against the wall or play catch with a friend while on one foot

3. Move your arms as though you are sprinting while preserving your balance on one foot with your eyes closed

Equipment such as wobble boards, foam stability pads, Bosu balls and DynaDiscs increase balancing demands, which will take your training to the next level.  You could try the exercises above while standing on any of these devices.  Ten minutes a day would be ideal. Try to build your balance so that you can manage at least one minute at a time on each leg. Get creative and have fun with it. This sort of training will not only improve your balance and ankle proprioception, but it will also boost the motor firing patterns through your legs, pelvis and core.

These preventative techniques are also used as rehabilitative exercises article-injury. If you’ve suffered an ankle injury, first get the ankle joint and muscles surrounding it healthy, and then get on the proprioceptive training train.

Dr. Carla Cupido is a Vancouver-based chiropractor (www.drcarlacupido.com).