Neglecting Ankle Sprains, could cause knee and hip issues in the future

Ankle sprains are common injuries that can affect anyone of any age and activity level. For most of us, they are minor injuries that don’t affect us after two weeks. While we may seem fine after two weeks and can walk and go about our day without much issue, the injured ankle remains unstable and weak. To compensate for this instability and weakness, the knee and hip work harder to return the body to normal function.

As ankle sprains are commonly recurring injuries, these compensations can build up and eventually manifest as injuries in the knee and hip. These injuries, such as knee ligament sprains, Patellofemoral Pain Syndrome or Greater Trochanteric Pain Syndrome, often result in a longer time away from activities you love than the initial ankle sprain.

Rehabilitation for these conditions often takes a while as they require a period of rest, followed by a structured personalised strengthening programme. The rehabilitation programme will focus on addressing and correcting the pre-existing ankle issues to prevent these same compensations from overloading and re-injuring the knee and hip.

Why do the knee and hip compensate for recurrent ankle sprains?

The muscles around the knee adapt to make up for the weaker ankle. Often, the knee will straighten during high-impact activities, like running and jumping, to reduce the force in the ankle. While it does protect the ankle, this adaptation increases the overall pressures in the knee. These pressures overload the various knee structures, leading to several injuries (Xu et al., 2022).

Studies have shown that people with recurrent ankle sprains have poorer ankle stability and reduced calf muscle activity. To make up for these issues, these people rely more on their hips than ankles for balance in their movements (Lin et al., 2021). The reliance on the hip leads to more frequent activation of the hip muscles. Without proper conditioning, the hip muscles tend to fatigue quickly, increasing the risk of overload injuries (DeJong et al., 2020).

What kind of injuries can arise from these compensations?

The increased stress on the knee puts one at a higher risk of ligament injuries. These ligaments include the Anterior Cruciate Ligament (ACL) or Medial Collateral Ligament (MCL). The injuries can range from a minor sprain to a complete tear. Depending on the severity, ligament injuries can involve a lengthy rehabilitation programme and may need surgery.

Larger loads at the kneecap can result in Patellofemoral Pain Syndrome, more commonly known as Runner’s Knee. Contrary to its name, this injury can affect non-runners in simple tasks like walking. To effectively treat this injury, rehabilitation must target the source of the injury by targeting the knee and ankle.

Moving up the leg, the most common hip injury seen due to recurrent ankle sprains is Greater Trochanteric Pain Syndrome. This condition can affect your ability to walk, run, and even lie on your side. In severe situations, due to further compensations, this condition can also result in lower back pain. Treatment for this injury will only be successful by addressing the hip and underlying ankle injury.

What can we do to minimise the risk of injury?

Early intervention and physiotherapy rehabilitation can reduce the risk of recurrence of ankle sprains and injury to the knee and hip. Treating ankle sprains early significantly reduces the chances of an injury to the knee and hip. A trained physiotherapist, such as one from our team, will help assess the risk of knee and hip complications and develop a personalised, activity-based rehabilitation programme for you to address the ankle sprain and any impairments that arise because of it.