What is the single most important test for a runner with an ankle sprain? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
If you’re a runner and you roll your ankle, you’re probably wondering what it is that you can do to test the ankle and see what’s wrong and more importantly, how likely it is that you’re actually going to get back to running and not have an issue again.
What do you think that the doctor is going to tell you if you go into the doctor and you’re an injured runner and you’ve sprained your ankle? What do you think the doctor is going to say? X-ray? Or maybe some kind of tests where we actually physically stressed the ankle like one of those tests is called the anterior drawer test. We literally hold your leg still, we grab your heel bone, and we try to dislocate your ankle by sliding your foot forward relative to your leg.
That’s one thing that we can do. It’s one thing that we often do, but it’s not the most important thing. That just tells you whether or not you’ve completely torn the anterior talofibular ligament. There’s another thing that we might check what’s called a tailor tilt and this is where we actually have an X-ray tech put on led gloves, so they don’t get radiation. Hold your leg, hold your foot, and actually twist the foot and actually see does the talus bone tilt within the ankle joint itself relative to the tibia bone sitting on top of it.
Another thing is an ankle arthrogram where we actually inject radiopaque dye into your ankle and see if the ankle joint compartment is leaking fluid outward, meaning that you’ve totally torn the joint capsule. Or maybe think you might need an MRI to really look at everything all at same time.
While the short answer is no, it’s none of those. So, these are all different tests the doctor might do. But to me the one tests that will really tell the runner whether or not she’s likely to actually sprained her ankle again, and in fact, even sprain it worse later, is a simple thing that you can do at home called the single leg balance test.
This test is really simple. All you do is you stand there, and you hold your arms out straight so that you’re going to get your balance and it basically looks like a roadside drunk test. All you’re doing is you stand there, you stick your arms out straight so that you can balance better. You get your balance first, and then once you have your balance, you pick up your injured foot first. And then you close your eyes, and you see how long can I stand and balance on one leg with my arms outstretched and my eyes closed.
If you look at the test, and you see how doctors do it, they’re looking at all kinds of stuff like your hip position, your shoulder position, all that kind of stuff, your upper extremity sway, none of that matters. What you’re really looking at, is how long can you stand there without losing your balance. The chances are really good that when you try it on your good foot, it’s actually going to be much better than your injured foot, the one that had the ankle sprain. So when you switch and you try to get on your ankle sprain side, meaning, you get your balance, you pick up your good foot now, you’re standing on your bad foot and you have your arms outstretched and you close your eyes, you see how much do you sway and if you really want more information, you can take your phone, and you can put on the video camera and actually videotape your feet and you’ll see like your foot like your toes are spastically trying to hold you still, you’ll see the tendons firing and moving.
When that happens, you know that you’re working a lot harder because you don’t have really good balance and that test alone is one of the most important things that indicates whether or not you’re actually likely to get re injured again later, because you damaged the proprioceptive nerve fibers in your ankle, if there’s a big discrepancy between those two things of your good foot versus your bad foot after an ankle sprain.
If you’ve done that and if there is a big discrepancy, it is crucial that you do the appropriate rehab to make sure that you retrain your body to tell the position your foot underneath you, so you don’t roll it again when you’re out on a run. That’s what I think is really the single most important test for any runner who’s had an ankle sprain. So, try it. Check it out. Let me know what you find in the comments, and I’ll see you in the next training.