Ask the Doc Ankle Injuries



Ankle injuries are very common in tennis. The frequent start and stop, as well as the need for lateral agility, puts significant stress on ankles. Injuries can range from sprains and tendinitis to fractures and cartilage injuries. How do I prevent an injury? The best way to prevent injury is to have strong ankles, meaning the muscles stabilizing the ankle can support the aforementioned agility movements. These are the muscles that support and cushion the ankle with running, jumping and twisting. The main stabilizers are the peroneals, posterior tibialis, anterior tibialis, soleus, and gastrocnemius. Good flexibility and strength allow the ankle to feel supported and respond to quick movements. Additionally, wearing the appropriate insole (ex. arch support for an over pronated foot) and shoes for the court surface in order to have good contact with the ground will reduce the risk of injury. Finally, general leg strength and conditioning is necessary to get the body in position before striking the ball to make sure the feet and ankles are underneath you in an athletic position before striking the ball. My ankle(s) hurt… what should I do? The old “RICE” adage is a reasonable place to start. While icing has not been shown to promote faster healing, it can make you feel better in the moment and alleviate some pain. Compression is helpful to minimize swelling after an acute sprain. But most studies show, early range of motion is the best option after an injury not involving a fracture. And for a good general rule, if you cannot walk on the ankle, you should get an X-ray to evaluate for a fracture. The day after the injury, start trying to move the foot and ankle as much as pain allows. Try spelling the alphabet with the foot to get the ankle moving in all directions; when this becomes easy, try standing and balancing on one leg. Then move to tossing a ball or changing your center of gravity in some way to create even more proprioception (the concept of the ankle knowing where the body is and how to support it) and gentle stability of the ankle. At this point, a high top shoe or ankle brace may help you get back onto the court. Ultimately, we need the ankle to feel strong and stable on its own and that is when agility and plyometric exercises will get the ankle ready. Ladder drills (working on quick feet), hopping on one foot forward/back and side-to-side, box jumps and lateral jumps will provide the eccentric strengthening necessary to feel confident on the ankle again.
Physical therapy can be helpful to take you through this progression if necessary, and again if you are having difficulty putting weight on the ankle, an X-ray and evaluation by an orthopedic surgeon is recommended.
If you are experiencing pain and would like to receive one-on-one evaluation, we recommend calling Lexington Clinic Orthopedics at 859-258-8575 to schedule an appointment with one of our orthopedic physicians or Physical Therapists (doctor referral not required). Lexington Clinic also offers a Walk-in Clinic Monday-Friday from 7:30am-7pm (no appointment necessary).