Sprain injuries can occur to any joint in the body. The most common is an ankle sprain, but they can occur in the fingers, the spine, the hips…anywhere there is a joint. Sprain injuries involve damage to various joint structures, primarily the ligaments. Ligaments are non-contractile, meaning they don’t shorten and lengthen like our muscles do. They basically just hold our joints together. Some people have laxity in their joints while others have tight joints; much of this depends on the individual characteristics of that person’s joints / ligaments.
So sprain injuries involve tears in ligaments and ligaments are designed to hold our joints snug together. As you can guess then, our joints become less stable after a sprain injury. A common description is that the joint feels like it will “give way” or feels “unstable”. After most sprain injuries, there is pain, swelling, weakness and generalized joint dysfunction. After a period of time, most sprain injuries recover and a person can resume a normal amount of function. Of course, this depends on the joint and the level of injury! Perhaps one of the most overlooked aspects of recovery from sprain injuries is proprioception. Although your sprained ankle may not be swollen or painful any longer, it may be far from back to normal without you even knowing it. If this is a case, we often hear of repeated sprains in an area since the person never completely fixed the area!
Generally speaking, proprioception refers to a person’s ability to control a joint and know where the joint is at any given time. For example, our brain can figure out that our elbow is positioned bent or straight without even looking at it. Some of this awareness is attributed to proprioception. Our ligaments (among other structures) have tiny receptors that monitor the movement of a joint and tell our brain where that joint is when moving. So when we jump to block volleyball, our ligaments tell our brain to activate certain muscles so that we land flat on our foot and don’t roll over on our ankle. Unfortunately for some, they don’t “recalibrate” this function after a previous sprain and they roll their ankle again. Proprioceptive training is important for any joint injury. It involves slowly and carefully retraining the injured joint to somewhat understand where it is in space during movement, so that the joint structures can provide continual feedback to the brain during movements, ensuring the optimal activation of muscles around the joint.
Proprioceptive training is best performed under the guidance of a professional. If you’re curious though, a common and typical progression of proprioceptive training for a common sprain like an ankle involves various progressions of standing on one leg. For example, the patient would be advised to compare the ability to balance bare foot on each leg. Once the sprained ankle can perform equal to the uninjured side, attempt the same barefoot balancing with the eyes closed. This takes the visual cues out of the equation and solely challenges the joint feedback. From there, some movement can be introduced, where the patient balances on one foot while catching a ball or performing a slight lunge. Again, this is all best supervised and prescribed by a professional…but it gives you an idea of what proprioception training is. Good luck!