Athletes with Ankle Pain

Ankle injuries are very common. One out of three clients I work with reports having an ankle sprain in their lifetime. When I’m working with anyone with an history of ankle pain or ankle sprains, I’m working on getting them back to their previous activity level. Whether you’re a high school football all-star or a marathon runner, returning to full functional is mandatory. Unfortunately,  ankle sprains have a high re-injury rate. Functional tests are designed to simulate the activities performed by the person, truly testing if they are ready to return to full participation. However, depending on your goals, the functional test for one person may be completely different from another. Nonetheless, here are four functional tests we use for ankle sprains:

4 Functional Tests for Ankle Sprains

1. Dorsiflexion Lunge Test

Dorsiflexion is when your bring your toes closer to your shins, ex. when your heal lands first when walking. This test is a weight bearing test that test if you have a decrease in dorsiflexion.

How To Do It

    1. Put your foot near a wall about an inch away.
    2. Put the other foot a foot away from the front foot.
    3. Bend your front knee until it touches the wall; make sure your heel is still on the floor.
    4. Inch forward if you can’t touch the wall.
    5. Change feet and repeat the test.

How do you know if they pass this test? Compare to the other side? If they are lacking, what can they do to help improve these results?

2. Star Excursion Balance Test

This test is designed to increase strength, flexibility and proprioception in your ankle.  This can be a challenging exercise because if you have instability in the ankle it can be very difficult to accomplish. Research have suggested to use the Star Excursion Balance Test can be beneficial to ensure dynamic functional symmetry.

How To Do It

  1. Put 4 pieces of (6-8 ft long) athletic tape in an X pattern on the floor.
  2. Stand on one foot in the middle of the C pattern.
  3. Find your balance.
  4. Touch all the spots with the foot that’s off the floor.
  5. Repeat on the other foot.

How do you know if they pass this test? Compare to the other side? If they are lacking, what can they do to help improve these results?

3. T-Test

As athletes, we need to be to change directions on a dime. It is an essential component of team and field sports for a variety of reasons: neuromuscular control, injury reduction, and overall performance capabilities. The T-Test is strengthens your forward, lateral and backward movements.  

How to do it:
  1. Your need 4 cones
  2. Place Cone 1 at the start
  3. Place Cone 2 10 yards in front of Cone 1
  4. Place Cone 3 5 yards to the right of Cone 2
  5. Place Cone 4 5 yards to the left of Cone 2
  6. Start at Cone 1
  7. Sprint to Cone 2
  8. Shuffle from Cone 2 to Cone 3
  9. Shuffle from Cone 3 to Cone 4
  10. Shuffle from Cone 4 to Cone 2
  11. Back peddle from Cone 2 to Cone 1  
How do you know if they pass this test? Compare to the other side? If they are lacking, what can they do to help improve these results?

4. Standing Vertical Jump

This test is power test that involves strength and flexibility in the ankles. When we have imbalances in muscle strength, this may lead to an increase risk of injury.
How to do it:
      1. Stand with your feet shoulder width apart.
      2. Keep your knees bent in an athletic position.
      3. Hands to your sides.
      4. Squat down to a quarter squat.
      5. Explode up through your toes.
      6. Drive your arms up as you are exploding up.
      7. Reach as high as you can.
      8. Land back to an athletic position (Do not lock your knees)
How do you know if they pass this test? Compare to the other side? If they are lacking, what can they do to help improve these results?

Summary of 4 Functional Tests for Ankle Sprains

As strength and conditioning coaches, our main objective is to do no harm. When we are working with athletes that are coming off injuries, we need to not only strengthen the area that is hurt, but everything surrounding the injured area. We want to eliminate any setbacks. If that means holding the athlete out for a little bit longer, this can help them stay safe in the long run.
These are only four tests, many others exist. Also, the actual sport is another test, likely the most aggressive and specific for the athlete. This makes knowing the sport and being open minded to going to a practice helpful for the athletes. For you athletes, be smart, you know your body. Protect your body, if it’s not a 100% tell someone so theses injuries won’t prolong.

Reference: 

1. Clanton TO, Matheny LM, Jarvis HC, Jeronimus AB. Return to play in athletes following ankle injuries. Sports Health. 2012 Nov;4(6):471-4.

Written by Chris Barber, CPT