Ankle sprains are the most common significant injury to occur among tennis players.¹ Tennis involves frequent multi-directional movement, predisposing players to endure a potential ankle injury. For someone who plays tennis frequently, a minor ankle sprain may not be seen as an immediate issue that requires specialist attention. It is essential to recognize that even minor ankle sprains can lead to instability or deficits that may negatively affect tennis performance.
Understanding when the appropriate time is to see a healthcare provider is valuable. There is a lack of understanding regarding ankle injuries, including management, prevention, and acute and chronic treatment, which may lead to ongoing issues with playing tennis. A tennis player that has sustained an ankle sprain is twice as likely to sustain another ankle sprain injury.²
Whether you are a recreational or competitive tennis player, it is crucial to understand better management, prevention, and risk reduction of ankle injuries to take the appropriate steps to maximize your tennis playing performance.
From this article, we will look at the following:
- What is an ankle sprain, and how do I know if I have it?
- How Physical Therapy can help treat ankle sprains
- Three Things Tennis Players Can Do For Ankle Sprains And Chronic Ankle Instability
- Two Exercises to improve dynamic ankle stability and lower extremity strength
- Prevention strategies for avoiding future ankle sprains
What Is An Ankle Sprain And How Do I Know If I Have It?
Ankle sprains are a ligamentous injury that includes over-stretching soft tissue, typically with a quick movement, rotation, or pivot motion playing tennis. Ligaments connect bones to provide stability in the foot and ankle, and sprains can cause instability or weakening of this connection. Over time if left untreated or if multiple ankle sprains have occurred, this can lead to a condition called chronic ankle instability (CAI).
CAI leads to a loss of balance, weakness, an increased likelihood of encountering more ankle sprains, and can lead to decreased performance playing tennis. CAI may feel like the ankle is going to “give way” and feels unstable, particularly while playing tennis. Having a single ankle sprain can increase the chances of attaining chronic ankle instability. It’s important to address this early on to prevent the further worsening of this condition.
How Physical Therapy Can Help Treat Ankle Sprains
Physical Therapy is beneficial for restoring strength, range of motion, balance, and stability lost due to acute or chronic injury. Following acute management of lingering swelling and pain, exercises will be implemented to help to improve these deficits. It is vital to challenge the body effectively with appropriate exercise to achieve the desired results and improve strength, balance, and ankle stability.
Initial examination of an ankle injury will include a full lower extremity assessment to see if additional deficits may contribute to an increased likelihood of sustaining an ankle injury. An assessment may include:
- Examining lower extremity strength.
- Walking and running gait.
- Hip and knee mobility.
A functional assessment may additionally be performed to further assess deficits related specifically to tennis, such as observing squatting, jumping and lateral movement which may help to optimize performance when returning to tennis.
Shoe wear may additionally be assessed to help reduce the incidence of injury. Supportive shoes are necessary to reduce the incidence of injury due to the frequency of multi-directional movement playing tennis.
Three Things Tennis Players Can Do For Ankle Sprains And Chronic Ankle Instability
1. Immediate management of symptoms following an ankle sprain
Following an acute ankle sprain, it is important to apply ice and compression while elevating the ankle to reduce swelling and limit excessive activity. You can remember this strategy by the acronym RICE for Rest, Ice, Compression, and Elevation.
The immediate goal is to protect the ankle from further damage and promote the healing of the injured soft tissue. If you are a competitive tennis player and cannot take a break from tennis, then an ankle brace or taping to maintain stability and reduce pain may be warranted to assist with continued activity.
Depending on the extent of the injury, an assistive device such as crutches or a knee scooter may be utilized to limit weight-bearing on the affected ankle if pain is severe enough.
A follow-up visit and possibly treatment from a Physical Therapist may be warranted to determine the extent of the injury, the appropriate diagnosis, and treatment.
2. Functional Movement Analysis
A Physical Therapist will perform a functional assessment to assess deficits related specifically to tennis, such as observing squatting, jumping, and lateral movement, which may help to optimize performance when returning to tennis.
Footwear will be assessed, and suggestions will be made to decrease re-injury risk. Supportive shoes are necessary to reduce the incidence of injury due to the frequency of multi-directional movement playing tennis.
3. Two Exercises To Improve Dynamic Ankle Stability And Lower Extremity Strength
Following acute management of lingering swelling and pain, exercises are given to help to improve strength, stability, and balance deficits following an ankle injury. It is important to challenge the body effectively with appropriate exercise to achieve the desired results and improve strength, balance, and ankle stability. Exercises may include but not be limited to:
1. Y-Balance Exercise
- Begin by standing on one leg (position 1)
- With your raised leg, reach out as far as you can in front of you (position 2) without losing balance or taking another step keeping your toes close to the ground without making contact.
- You will repeat this to the side and also in a diagonal direction behind your stance leg (positions 3 and 4)
- Perform three sets of 10 repetitions. Do this twice a day.
2. Single-Leg Romanian Deadlifts (SL RDLs)
- Begin by standing on one leg (1)
- Without significantly bending your stance knee, lean forward and hinge from your stance hip keeping your back leg and knee straight until you are parallel to the ground (2)
- Try to keep your foot pointed towards the floor and avoid rotating your body
- Return to an upright position keeping your back leg straight and in line with your torso
- Perform three sets of 10 repetitions. Do this twice a day.
Preventing Future Of Ankle Sprains
Are ankle injuries preventable? It may be difficult to completely avoid initial or subsequent ankle sprains and injuries with tennis, but performing specific, consistent exercise and bracing have been found to significantly decrease the recurrence of ankle sprains.³
Even if you have not had an ankle injury before, it is possible to reduce the likelihood of injury by incorporating specific exercise that targets stability and strength of the lower extremity and ankle.
A Physical Therapist may help to prescribe specific and appropriate exercises that may assist with injury prevention. Suppose you are someone that has consistently been enduring subsequent ankle sprains or injuries. In that case, bracing may be effective in helping to prevent recurrence as well. If you haven’t been able to return to playing tennis after an ankle sprain, then give your Physical Therapist a call today!
Thank you for reading Three Things Tennis Players Can Do For Ankle Sprains And Chronic Ankle Instability. We hope it has helped you understand more about acute and chronic ankle injuries. Please visit our Sports Injuries page to learn more about other conditions and how we treat different types of common sports injuries.
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- Kaiser, P., Stock, K., Benedikt, S., Ellenbecker, T., Kastenberger, T., Schmidle, G., & Arora, R. (2021). Acute tennis injuries in the recreational tennis player. Orthopaedic Journal of Sports Medicine, 9(1), 232596712097367. https://doi.org/10.1177/2325967120973672
- Delahunt, E., & Remus, A. (2019). Risk factors for lateral ankle sprains and chronic ankle instability. Journal of Athletic Training, 54(6), 611–616. https://doi.org/10.4085/1062-6050-44-18
- Doherty, C., Bleakley, C., Delahunt, E., & Holden, S. (2016). Treatment and prevention of acute and recurrent ankle sprain: An overview of systematic reviews with meta-analysis. British Journal of Sports Medicine, 51(2), 113–125. https://doi.org/10.1136/bjsports-2016-096178