How To Prevent Ankle Injuries If You Have Hypermobility

How To Prevent Ankle Injuries If You Have Hypermobility

Hypermobility, EDS, and HSD are all conditions that can result in ankle hyper-mobility. Hypermobility in any joint means an increased risk of injury due to excess movement in the joint. In the ankles this can look like repetitively rolling your ankles, dislocating your ankle, or just ankle pain and aching in general. If you want to learn how to treat ankle hypermobility and what you can do to stabilize your ankles then this blog is for you!

What Causes Ankle Hypermobility 

Hyper-mobility can be associated with a range of conditions such as:

  • Ehlers-Danlos Syndrome
  • Hypermobility Spectrum Disorder
  • Mast Cell Activation Syndrome

For a more in-depth look at what can cause ankle hyper-mobility I suggest you read my blog, “ Treatment options for Ankle Pain from Hypermobility”.

Hypermobile Ankle Injuries

Hypermobile does not mean flexible, it actually means unstable. When it comes to the ankle joints instability can result in ankle injuries doing something as simple as walking. These injuries include:

  • Sprain
  • Strain
  • Fracture
  • Stress Fracture

Because a hype- mobile ankle can go beyond a normal range of motion there is more room for error when you trip, roll your ankle, or miss a step. This is why it’s important for someone with hyper-mobile ankles to provide extra stability to their ankles. Now, before you go buy a pricey ankle brace you may want to keep reading. 

Best Exercises for Ankle Stability and Injury Prevention 

The best way to strengthen your ankle and increase stability is with functional movement exercises. Exercises where you have a band around your foot and pull against it are not going to do anything for your stability in movement like walking, hiking, or working out which is where you need it the most! 

The most important thing to keep in mind when picking and choosing which ankle-strengthening exercises are best for you and which are simply not worth your time is that your feet should be connected to the floor! Anything else is not going to address how your ankle stabilizes when you’re on your feet. Here are some ankle stability exercises we use with our patients which can range from beginner to advanced. 

  • Single-Leg Stand 

This exercise is the perfect beginner exercise! If you have hypermobile ankles then your balance is certainly impacted! After all, our feet are our connection to  the ground, so if the connection is faulty, then all the structures above will be impacted. It would be like building a house on an unstable surface.

Now we are not just balancing for the sake of balancing, but to functionally stand on one leg requires a neutral spine, biological breathing, and keeping the heel, ball of the foot, and all toes on the floor. Watch the video below to learn how. 

  • Standing Ankle Hinge (ankle mobility) 

Ankle mobility is important, even for someone who is hyper-mobile! Note that mobility exercises are not the same as stretching! The point of stretching is to increase range of motion, but with a hyper-mobile person, we already have an excess range of motion! Instead, mobility exercises work on the strength and integrity of a joint through a range of motion. Which is exactly what is practiced in the exercise below.

For this ankle hinge exercise, you are controlling the amount of dorsi flexion and plantar flexion that occurs while the whole body is working to stabilize you. Focus on keeping your toes connected to the ground and not letting the arch of your foot collapse for the best results. 

  • Runners Bear 

What I have found to be the most effective form of functional exercise to improve stability in a hyper-mobile person is Dynamic Neuromuscular Stabilization (DNS). DNS is a type of rehabilitative exercise that follows the path that every baby goes through to go from a helpless infant to a running toddler. 

The exercise shown in the video below is a variation of the 11-month baby move, Bear, to include ankle stability and foot activation. 

Are Ankle Braces Good for Hypermobility 

The simple answer is, no! Putting an ankle brace on a hyper-mobile ankle is like putting a bandaid on a wound that needs stitches! Now with that said, if you are playing sports, that ankle brace may give you a bit more resistance before the joint has gone beyond its ‘stopping’ point.

If you’re a very active person with hypermobility, during the non-practice or game times, I prefer taping vs bracing in conjunction with the stabilizing exercises. We are not talking about immobilizing the joint but more of a kinesiology tape that has a stretch to it. My go-to is RockTape because they seem to last longer and not come off the body as fast. This kind of taping stimulates the sensory input to the brain for better stabilization and proprioception.

Where To Start If You Are Hyper-Mobile?

Hyper-mobility (EDS, HSD, MCAS) is not a death sentence and you are not doomed to just deal with pain. Do know that there are many steps you can take to start decreasing symptoms and you are not alone. It is best to seek care from clinicians that are familiar with hypermobility and treating patients with hyper-mobility. Search for hyper-mobile doctors and clinicians near you and interview them. Treating hypermobile bodies is not the same as the rest of the population and a clinician being in practice for even a long-time does not qualify them to know how to treat a hypermobile person. If you are hyper-mobile and are ready to provide your body with the stability it needs, contact me and ask whom I refer my hypermobile patients to for their health needs.

Dr Shakib

What Are The Treatment Options for Ankle Pain Caused by Hypermobility?

What Are The Treatment Options for Ankle Pain Caused by Hypermobility?

Hypermobility is an excessive range of motion in joints. It is different from being flexibile and can cause discomfort, injury, and pain in the affected joints, including the ankle. Ankle pain is a common complaint amongst hypermobile individuals and the instability leads to falls and further injuries. In this blog, we will explore the causes, symptoms, treatment, and best exercises for hypermobility and ankle pain.

What Causes Hypermobility In The Ankles?

Hypermobility can be caused by a genetic predisposition or an underlying medical condition such as Ehlers-Danlos Syndrome(EDS). In cases of EDS or Hypermobile Spectrum Disorders (HDS), excess activation of mast cells cause looseness of the ligaments. This looseness results in joint instability.

Now, certain activities that require repetitive ankle movements in extreme ranges, such as ballet, gymnastics, dance, and cheer certainly feed the problem. These activities over-encourage the ligaments to be pushed to the extreme. This causes injuries that linger for a long time if not, a lifetime.

Whether you have EDS or another hypermobile condition, instability in the feet and ankles is something that should be addressed sooner rather than later. Our feet and ankles are our base and are what connect us to the ground. If that connection is unstable then everything above is going to be impacted.

Symptoms Of Hypermobility In Ankles

Symptoms of hypermobility include joint pain, fatigue, and frequent dislocations which can vary from person to person. Depending on the severity of the hypermobility and the joints affected symptoms may vary. In the case of ankle hypermobility, some of the common symptoms include:

  • Ankle pain
  • Swelling
  • Instability
  • Foot pain
  • Repetitive rolling of the ankle and
  • Feeling of the ankle giving way or buckling

As mentioned above, issues in the feet and ankles impact the structures above which can also result in overall poor posture, dysfunctional movement, knee issues, hip pain, lower back problems, and more.

Treatment Options for Hypermobile Ankles

The best treatment for hypermobility and ankle pain must focus on stabilizing the ankle joint and strengthening the deep muscles of the feet. And that’s not accomplished with ankle braces! Also, in treatment, it is important to not disregard the structures above the ankles but should include functional movement of the whole body.

Let’s talk about braces here! No brace is going to provide support to fix a problem. The only brace that provides value, in my opinion, is worn in bed to support the degree of extension at the foot and ankle which is accentuated by the weight of the blanket over the feet while sleeping. This brace simply limits how far extended and outwardly rotated the foot can get both movements being excess in hypermobile persons.

Now, regardless of the physical rehabilitation provider (Chiropractor or physical therapist) the following needs to happen when it comes to the treatment of hypermobile ankles and feet:

  1. Functional Movement such as Dynamic Neuromuscular Stabilization (DNS). This is movement according to the natural design and addresses the ankles, not in isolation, but in full body movements. Remember, the feet and ankles serve as the base for the rest of the body and are not an isolated issue.
  2. Postural Neurology: The brain controls every function in the body! With lack of function, certain parts of the brain, in regards to movement and posture can actually shrink. The good news is we can activate weak parts of the brain with specific exercises including proprioception, balance, and stability.
  3. Biological Breathing: Would you believe that almost every patient that walks into my office is not breathing correctly? This dysfunction directly affects movement and posture resulting in compensatory patterns and negatively impacting stabilization.

Exercises for Ankle Hypermobility

The best exercises for ankle hypermobility are those that include how the ankle functions with the rest of the body, not just in isolation. Here are some specific exercises that may help:

Ankle Hinge:

 Single-Leg Stand:

This is exactly what it sounds like! You practice standing on one leg at a time focusing on the whole foot and toes being engaged into the floor. The entire spine must be neutral and done with proper breathing. This is going to work on your balance and ankle stability while the rest of the body plays its part. This is a great exercise to work into your daily routine with an activity like brushing your teeth.

Bear Advanced Ankle Stability:

What To Do If You Have Hypermobility and Ankle Pain

If you know you are hyper-mobile, or suspect this, and want to find pain relief, full body stabilization, and postural correction all in one office, contact me.  Remember, you don’t have to be in pain to address the problem now.

Dr. Shakib