How to Heal Chronic Ankle Sprains

by Owen Marcus on November 8, 2011

How many sprained ankles have you had? With 25,000 people per day spraining their ankles, chances are you’ve had a few sprains.

Every sprained ankle you have increases your chances of having another. Your connective tissue (fascia, tendons and ligaments) and muscles become either weaker or more brittle depending on how you sprained your ankle. Let’s assume your pattern is the most common one, where you twist your ankle to the outside of your foot. By landing on the outer edge of your foot or ankle, you stretch all the lateral or outside soft tissue of your foot, ankle, and lower leg.

Lateral view of the human ankle

Image via Wikipedia

With a severe sprain you more than strain the soft tissue, you actually tear your ligaments. The ligaments are the deeper soft tissues that hold your joints together. When severely sprained they can tear, and occasionally they completely tear off their attachment to the bone.

Immediate treatment

Most of us are familiar with the preferred immediate treatment to help reduce swelling and pain: RICE – Rest, Ice, Compression, and Elevation. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be recommended to reduce pain and inflammation. Because of the dangers of repeated use of these drugs and the increased effectiveness of systemic enzymes, more people are using proteolytic enzymes (scar tissue dissolving enzymes) to reduce the pain and swelling while aiding in the healing.

The chronic condition

Repetitive sprains increase the formation of scar tissue. Your body uses scar tissue to immobilize the joint as it lays down the infrastructure to mend connective tissue. All that is good, but as the sprains build up, so does the residue of the remnants of previous sprains. You body is unable to dissolve all the old scar tissue. What was your ankle’s natural Ace Bandage evolves into your ankle’s ski boot.

The chronic ankle instability, a condition marked by persistent discomfort and a “giving way” of the ankle, occurs because of the ankle’s tightness and weakness. Your ankle will not move freely in certain directions while being hyper-mobile in other directions. Rather than having a natural give, you now have an unstable ankle that is vulnerable to more sprains. What would have been a minor strain becomes a major sprain because the tight connective tissue doesn’t stretch like Spandex– it tears like a sheet.

Treatment and prevention of chronic sprains

Rehab exercises are important for the acute injury. They keep the joint from tightening up further while strengthening the weaken muscles. Unfortunately, rehab alone won’t prevent future injures.

To get the full benefit of rehab, you need to develop the strength in your core or intrinsic (deep) muscles of your body. Standing on one of those soft half balls requires your body to balance with these muscles. If your joint or your entire body is tight, this kind of balancing will be difficult.

The key to prevention is to release the scar tissue. Unfortunately stretching usually won’t do it for an ankle. You need someone with skilled hands to release it for you. The more that person understands the inter-connections of the entire body structure, the better the results. For example, I have seen that the tendency of many ankle sprains comes from a rotation of the femur; that is, walking pigeon-toed, or duck-footed (which is more common) rotate the femur unnaturally, and can cause instability that leads to sprains. For the greatest prevention you need to address all the primary and secondary causes.

A common secondary cause is improper movement patterns often caused by the body compensating from previous injuries. As you heal from an injury and/or protect that injured part, you develop movement patterns that become structural patterns that are inefficient and set you up for more injuries.

Owen Marcus, MA Certified Advance Rolfer, 30 yrs experience,, call if you have questions – 265.8440. This article and many more health and wellness articles are at the blog: Go to the blog to ask questions or add your comments on any article.

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{ 11 comments… read them below or add one }

Svayambhut Ghosh June 13, 2012 at 3:10 pm

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Owen Marcus July 30, 2012 at 11:58 pm

Thanks for the compliment. Please let us know how it the info helps you.

Aline P. Castaneda June 3, 2013 at 5:08 pm

When sprains occur some degree of subluxation (joint movement) can result. Overall failure of ligaments and tendons is usually sudden and is preceded by the micro failure of attachments between the collagen fibres within the tissue and loss of ability of the ligament to recover its length. Treatment of subluxation and ligament functionality and strength is necessary if the joint is to regain full function.

Owen Marcus June 4, 2013 at 1:45 am

I agree there needs to be a strengthening as well as a healing of the soft tissue immediately around the joint. There also needs to be releasing and reorganizing of the entire soft tissue system, particularly if there has been habitual compensation.

Thank you for your comment and specific suggestions.

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Owen Marcus July 9, 2013 at 5:03 am


Zachery March 29, 2014 at 4:22 am

This is the perfect blog for anyone who wishes to understand this topic.
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Owen Marcus March 29, 2014 at 4:24 am

Thanks Zachery. Glad it helped you.

arva October 14, 2014 at 3:06 am

hi, I am 34 year old and have twisted my ankle twice this. time I have developed pain throughout my ankle to my left hip arm to my neck. I have to do my house work like seeping and mopping and then rest a while but is it ok t

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