Pickleball Magazine 6-3 | Page 82

ask the pickleball doctor

By Noe Sariban , PT , DPT , CSCS , Cert . DN www . thepickleballdoctor . com

Lateral Ankle Sprains :

Mechanism of Injury , Early Treatment , and Long-Term Plan

Lateral ankle sprains are common injuries in sports , and pickleball is no exception . Pickleball combines a lot of changes of direction — forward , backward , and side-toside movements , often in short bursts ( as in running or lunging for a ball ) and even jumping at times ( going for an overhead smash ). All these movements can lead to ankle sprains .

So , what is a lateral ankle sprain ? First , let ’ s describe the basic anatomy of the ankle . Our ankles are made up of our two lower leg bones , the tibia and fibula , and the talus . The tibia runs on the inside of the ankle to form the medial malleolus , and the fibula runs down and forms the lateral malleolus . The talus sits underneath the end of the tibia and articulates with both the tibia and the fibula . There are key ligaments involved around the ankle that provide stability of the ankle .
When a lateral ankle sprain occurs , the ligaments on the lateral ( outer ) side of the ankle are stressed / stretched and sometimes torn . There are three ligaments on the lateral portion of our ankles that provide us with lateral stability : the anterior talo-fibular ligament ( ATFL , which connects the talus to the fibular ), the posterior talofibular ligament ( PTFL , which connects the fibula to the tibia ), and the calcaneo-fibular ligament ( CFL , which connects the fibula to your heel bone ). When you roll your ankle laterally , the above ligaments are stretched ( or torn ) in the following order ( usually ): the ATFL , the PTFL , the CFL . Usually , the more severe the injury , the more ligaments will be involved and the more the stability of the ankle will be compromised .
While certain ankle sprains can be just bad luck , there are other factors that may come into play when trying to prevent them from occurring .
Footwear : Wearing proper court shoes is one of the most important steps you can take when playing pickleball in order to reduce your risk of falling . I often see beginners with regular sneakers on the court , which puts them at a high risk for an injury . The rubber on the soles of regular sneakers is very soft , and with the court surface almost being like sandpaper , these shoes will get caught on the court — leading to a possible ankle sprain , which may result in a more serious fall . Be sure to wear proper hard court tennis shoes to play pickleball .
Chronic Instability : Some people have chronic ankle instability , and tend to sprain their ankles multiple times over the course of their athletic careers . Many studies suggest that chronic instability in the ankles can be traced back higher up in the kinetic chain in the hip musculature . People with muscle imbalances and asymmetries in their gluteal musculature ( gluteus maximus , medius , minimus ), hip rotators , and hip abductors will have altered biomechanics and motor control , which in time lead to higher chances of ankle sprains and reinjury following the initial ankle sprain . Therefore , it is vital to consult a physical therapist to determine if any impairments or asymmetries are present in order to address the root cause of the chronic ankle instability .
So , what should you do when you sprain your ankle ? Most people have been conditioned to ice an injury right away . This stems from decades of doing this , but it is no longer the best practice in current sports medicine ,
80 TO SUBSCRIBE , CALL 888.308.3720 OR GO TO PICKLEBALLMAGAZINE . COM