Ankle is feeling much better today. Its been 4 days since the injury, the swelling and inflammation have gone done considerably. The ankle is still stiff in some positions, but for having feel on my ankle four days earlier it is in pretty good shape.
I want to do what I can but I still do not what to use my ankle for much. It still needs to heal and I'm worried about using compensatory patterns while training. The body has natural software it loads when there is an injury present. Especially on a weight bearing joint, like the Ankle. It will move the rest of the chain of joints differently to accommodate the current limited ability of the injured area. This software is needed because it tells you when you put the joint through too much range of motion or stress. You feel tightness or sharp pain. This is to prevent you from further injuring the joint before it heals. It's an Injury Protected Software.
There are pitfalls to this protective pattern. It is in fact a pattern and like any pattern if its repeated enough it could start to ingrain and this new pattern becomes the new normal. This will happen if the person returns to training before the injury is healed and it also happens when the injury is healed but proper function is not returned to the joint, but training resumes anyway.
Take my ankle for example. If I start normal training again while the injury is not healed I will definitely compensate during my movements like front squats, single leg squats, lateral bounds and other ankle demanding exercises. Also the possibility that I could get re injured again.
The next scenario might not be as obvious. Lets say my ankle is fully healed. Pain no longer exists and with an MRI the joint's integrity is back to 100%( we got lucky here). Let's say you have back full range of motion in all planes. There is a chance you could be good from here, however just because you have full range of motion when you test, does not mean your body will use that recovered ROM. The brain can still be working on the injury protected software. It is still running on that conservative software that assumes the ankle is still injured and will naturally limit its range of motion, with no pain. Well if you go into exercises that are explosive and dynamic; like sprinting, regular sports, Olympic lifting, plyo. These will put you in high threshold strategies. This is where your brain makes a decision to go with the path of least resistance. If you are on a good movement program than it will be good efficient body mechanics. However this may not be the case if you train with sloppy form and no attention to true functional movement or If you are coming off an injury and still on outdated Injury Protected Software.
Let's take Ankle Dorsiflexion for example, because it's easy. During one of these high threshold movements if my brain still think that the ankle is not capable of going into full dorsi flexion it is going to get the mobility from somewhere. Most likely it will cause the knee to cave in while the ankle is turned out, creating or further ingraining a valgus pattern. This raises the chance for re injuring of the ankle, the knee or any other joints up the line that will be compromised from this.
For me to get back to training two things need to be considered.
Have I healed from this injury?
This is easier to answer. with adequate rest, nutrition, soft tissue work and time it should heal up fine. It won't be too hard to tell after a couple weeks or recovering where my foot is , in terms of healing. I just have to be completely honest with how I feel, not how I want to feel.
Does my ankle have proper function, again?
This second question is much trickery. Not only do I want to make sure that I get soft tissue and stretching done. I want to make sure I get full range of motion back before I start regaining function. Yes each one needs the other. Another layer to this is to make sure I am using the right patterns after it has healed. Switching out the old and useful injury protected software for new software that takes into account the regained integrity of a joint. Retraining patterning of movement. In the FMS paradigm, mobility first than through strength and correct patterning, stability to further ingrain good movement.
I'm still thinking of ways to measure good proper function, obviously the dori flexion wall stretch. I also think monitoring my gate and just how I move. Attention to detail is really going to be the key in making sure the ankle is fully rehabbed before training.
I'm open to suggestions though
Another problem with being injured and training, I have the ability to over analyze an ankle sprain. Than turn it into a long winded blog post like this one.
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