Should I do proprioceptive retraining exercises for my ankle before or after I run? Well, that is a great question and that is what we’re talking about today on the Doc On The Run Podcast.
Last night I was on a follow-up call with a trail runner who had chronic ankle instability, and we had met and gone through a number of different things she could do to get back on trails without worrying about rolling her ankle. And one of the things that we talked about was proprioceptive retraining. One of the reasons that you get chronic ankle sprains and chronic ankle instability after a severe ankle sprain is that you damage the proprioceptive nerve fibers in and around the ankle.
Proprioception just means your ability to tell position and space. So, if you close your eyes and I grab your thumb and I pull it up, you know that it goes up because you stretch the bottom of the joint capsule and you feel that it is stretched there so you know the toe is up. And when I pull it down, same thing, it stretches joint capsule on the top and you can tell that I have moved it down because it is stretched on the top.
But when you rip the joint capsule, when you roll your ankle and it flips underneath you and you damage all those nerve fibers, you can’t really tell the position in space anymore. So, one thing you can do is some proprioceptive exercises that retrain your brain to notice where your foot is relative to you when you’re walking, when you’re running, when you’re standing. These are very specific exercises to do.
So, there’s a whole bunch of different exercises I gave her to do that I thought would help. And she called me about a week later and she was doing well, she’s been running, but she said, “Should I do this before or after I run?” Well, that’s a great question and so here’s how I think about this.
If you do the proprioceptor exercises right before you run, I think, I don’t have any proof, but I think you might reduce your risk of getting a sprain because you’ve activated those stabilizing muscles, and you sort of prime the system to pay attention. Think about what happens when you do running drills before a track event. So, lots of athletes do lots of activation drills right before an event, high stepping, side stepping, all of these different drills that tune your system and get it ready to go.
If you’re activating and tuning your proprioceptive system by doing some exercises that get you ready for running, I think that you might be at lower risk of getting a sprain while you’re doing that. Again, I don’t have proof of that. I don’t have research to back that up, but that’s what I believe.
The thing you should not do is that some of the exercises I gave her to do are strengthening exercises that make your body stronger to be more stable when you run, to wobble and sway less when you run, to have a stronger glute Medius muscle and stronger peroneal muscles. Those exercises that build strength, you do not want to do those right before you run.
Why? Well, really simple. If you’re running and you get to the point where you fatigue and your form starts to fall apart, think about what happens. Your form gets worse. You wobble, you sway, you load things more. And the more you sway, the more at risk you are for reaching that point where you can roll your ankle all the way over. So, if you’re doing strengthening exercises right before you run, I think you’re going to be at higher risk of injury because you fatigue faster and you load structures asymmetrically and at higher peak forces when you wobble and sway because you are fatigued. You don’t want to do that fatigue before.
You would never ever go to the gym and do leg day and work to fatigue doing squats and high weights with low reps and then go for a long run. That would be crazy. It would make a lot more sense to run first and then do those strength training exercises. So, in short, you should do strengthening exercises after you run and you should do the proprioceptive exercises that only work on retraining your neurologic system to recognize where your foot is underneath you before you run.
That’s a great question, but if you want to learn more about the ankle sprain stuff that I do to the strategies I use after you have an ankle sprain, you’re trying to make sure that you can get back on running on trails instead of just running on the road or not running at all. Well, you can come join me and learn those strategies in the Ankle Pain Masterclass. It’s free and you can get it at www.docontherun.com/anklepainmasterclass. So, come sign up and I’ll see you in the training.
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