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Smart ankles are important for anyone, in any season, but they are particularly important for runners. Ankles are "smart" when they adapt to uneven terrain. In New York City, there's plenty of this: cracks in the pavement, unexpectedly higher sections of pavement, sudden undulations in asphalt-covered streets. And, of course, in rural areas pedestrians have to react quickly to instantly changing conditions: bicyclists, the swerving baby carriage, the dog stuff.
Smart ankles can bend, but not break. Literally. A smart ankle can turn over, sometimes quite far, without the person suffering an ankle sprain or fracture. In general, your body is quite smart. But lack of regular fitness training can degrade some of these feedback mechanisms. Also, any ankle injury that hasn't been properly rehabilitated will result in an ankle that was less smart than before.
What to do? Taking on a fitness program is the number one solution. All aerobics and weight-training activities make your body much smarter than it was before. The smartness comes from refined function and more efficient activity of a particular neurological system known as proprioception. Proprioception is your body's awareness of its positioning in three-dimensional space.
With reference to ankles, diminished proprioception makes them floppy: the foot doesn't quite know where it is, adaptations to variations in ground surface aren't as instantaneous, and the actions of placing the foot on the ground and lifting it off are less than perfect.
The lack of rehabilitation of proprioception explains why one ankle sprain is frequently followed by others; it explains why people develop "weak" ankles after an ankle sprain. The ankles are weak because they're "dumber" than they were before the initial injury. Computing power has been lost and there are glitches in the instantaneous calculations necessary to maintain smooth, effortless function. These ankles turn over and twist easily, and the person suffers repeated low-grade injuries or worse. The key to successful rehabilitation is to establish new and better proprioceptive linkages. This is easily done by utilizing a few simple techniques.
To make ankles smarter, do a simple "stork" exercise. Stand a little less than arm's length from a wall, with your right arm perpendicular to the wall, and lightly touch the wall with the fingers of your right hand. This will prevent you from toppling over if you lose your balance. Stand on the right leg and place the left foot beside the right knee, so that the left knee is bent and facing directly front. Maintain this position for about twenty seconds, balancing on the right leg. Your right ankle will wobble a little as it readjusts to stabilize your weight.
These oscillations will continue for the duration of the exercise; they represent your proprioceptive system in a dynamic, learning state. Early on, you might lose your balance every so often; that's part of the training. You're re-establishing a connection between your brain and the structures of the ankle joint. You're relearning how to achieve and maintain balance so that walking, running, and jumping become smooth, coordinated activities. Now do the other side.
Do this routine a few times each day. It only takes a couple of minutes. Another exercise is toe gripping. In a seated position, place both bare feet flat on the floor. Grip the toes, clenching them hard so the arch of your foot comes off the floor, hold for a few seconds, and relax. Do this ten times. In a third exercise, place the injured ankle in a bucket of warm water, and "write" the letters of the alphabet with your foot. This is more difficult than it sounds and provides great practice in ankle coordination. You could "write" capital letters one day and lower case letters the next.
The result will be ankles that are strong and do not re-injure. Your ankle will still turn over occasionally--there are drastically uneven surfaces out there. You might even stumble and twist an ankle. But owing to the increased "smartness" of your ankles, the ligaments and muscle-tendon units will adapt to possible extreme stresses without tearing of fibers.
Dr. David Lemberg, the author of Commitment to Fitness: Real Fitness for Real People, is a board-certified chiropractic orthopedist in his twentieth year of private practice on Manhattan's Upper East Side. He has been published in national trade magazines such as Muscle & Fitness and Dancemagazine, the peer-reviewed Topics in Clinical Chiropractic, the Florida Chiropractic Society Review, and The Chiropractic Journal. Dr. Lemberg is a member of the postgraduate faculty of Los Angeles College of Chiropractic, and for the last ten years has taught orthopedics to chiropractors in venues across the United States and in Canada. He was Clinical Editor of the quarterly journal, Spinal Manipulation, published by the Foundation for Chiropractic Education and Research, from 1990 through 1995.
Commitment to Fitness: Real Fitness for Real People may be ordered through Dr. Lemberg's web site. His office is accepting new patients: 212-535-7429.
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