MYTH While repeated ankle sprains can make the ligaments around a joint looser, this doesn’t necessarily equate to weakness.
Our bodies can fool us into being over protective
Who’s afraid of the big, bad wolf? So sang two of the Three Little Pigs, believing that their houses of straw and twigs couldn’t be destroyed by the wolf. I’ve never been hunted by a big, bad wolf, but I suspect that I would be at least a little bit scared. Even if he was outside my brick house trying to get in, I wouldn’t be that happy to see him. But what about when he goes away? What should I do then?
If you’ve never read ‘Why Zebras Don’t Get Ulcers’, by Robert Sapolsky, I suggest you do. It’s a fascinating book that looks at how elevated stress levels contribute to the myriad of chronic diseases affecting the world today. As the title suggests, despite what would appear to be a high-stress existence of constantly searching for food and trying not to be food, zebras suffer very little with stress-related illness.
It would appear that after being chased by a lion, a zebra’s stress levels drop back to relatively normal levels quite quickly, rather than dwelling on what just happened like most humans would. I find such revelations fascinating; the implications for research into physical- and mental-health issues are huge.
While large, sudden frights can obviously cause significant issues, smaller and even subconscious fears can be equally important, especially from a movement perspective.
Our bodies, like our brains, can be slow to forget. The most obvious example of this is limping. If you have ever sprained your ankle, you will know the pattern; ankle twists, pain and swelling follow, and you find yourself on crutches or limping around the house for a couple of weeks. The interesting thing to note though, is that the limp often outlasts the pain. This is more apparent with more significant injuries.
I broke my left leg badly about 20 years ago. Thankfully I made a good recovery and was able to get back to running and playing rugby and tennis reasonably quickly. But every so often I find myself limping; there’s no pain, no stiffness, just a limp. It seems my body hasn’t forgotten that it was afraid of something a long time ago. Thankfully, once I’m aware of it, everything returns to normal.
There are more common versions of the same issue. We all know someone who has a ‘weak’ ankle or dodgy knee. These people often like to point out their problems and cite them as reasons for not doing certain activities. But while repeated ankle sprains do have the potential to make the ligaments around the joint looser, this doesn’t necessarily equate to weakness.
Ligaments provide a passive restriction to movement, in that they are there to stop two bones from moving further apart when all else fails. For the person who has weak ankles it is the ‘all else fails’ part of that sentence that is important. Pain and swelling are known to inhibit muscle activity, but muscle activity can be improved by more muscle activity.
In short, in order to get muscles around a joint working, the best thing to do is to make them do some work.
In the early stages after an injury, it could be as simple as moving the ankle without any weight on the foot. As pain allows, standing on both feet, then one foot, then one foot with the eyes closed will force things to wake up. Similarly, we progress from walking to running, initially slow and straight, to fast with direction changes, often with some hopping and jumping thrown in. Once you are happy in a controlled environment, introducing variables like different surfaces, balls, other players and contact situations should be considered.
Similar issues arise all through the body. We are constantly taught to fear back and neck pain, to protect these valuable parts of our body, especially if we have ever had any pain there. But wouldn’t it make sense to get them stronger to protect from further injury?
Research has shown that strength training, can reduce injury risk, recovery time and pain for a multitude of injuries. In other words, take the third little pig’s approach. Build a sturdy house and you’ll have less to fear.
Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.