Doctor's Orders - July 2018

by Dr. Jason Han

One of the most common injuries we see on the mat are ankle injuries. The foot/ankle complex is your primary contact with the ground, making it a critical piece to all dynamic movements in your training.

You would be hard pressed to find a friend or student that has not suffered through at least one ankle sprain. And, chances are that if a person has had one, he/she has had multiple recurrences. It has been shown that an important predictor of an injury is a previous injury.

Ankle issues can keep students and teachers out of commission for weeks. So, what does this injury mean, and what can we do to prevent it?

The majority of ankle sprains happens when the foot “rolls inward” and stretches the ligaments on the outside of the foot. It’s important to realize that damage to the ligament and swelling in the area causes you more than just pain. It also shuts down your ankle’s ability to fire the surrounding muscles — potentially leading to other injuries. In addition, your balance and your joint’s ability to recognize where it is in space are both compromised.

There are four main things every program can institute in their curriculum to tackle this problem before it starts: 1) calf-stretching, 2) balance training, 3) glute-strengthening, and 4) trunk stability.

Calf-Stretching. Many martial arts disciplines require you to be light on your feet, and to explode at any moment to either attack or defend yourself. Strong calves are great, but a lack of flexibility can decrease their effectiveness and increase the risk of injury. The ability to push off your ankles is important, but being able to accept your weight requires great ankle flexibility.

Balance Training. Don’t be fooled by all of those YouTube videos of athletes balancing on crazy unstable surfaces. Before you even get to that point, don’t forget the basics!

First of all, balance training on stable ground should be done before moving on to any other challenging surfaces. Can your students balance barefoot, on one leg, for an extended period of time? And most importantly, can they do this while not allowing the hips and trunk to wobble?

Glute-Strengthening. The hips are the primary driving force behind all your lower-body movements. The muscles within the foot are important in creating a stable base. However, the muscles of the hip are equal contributors as well.

Here’s a simple test. Have all of your students balance on one foot with a slight bend in their knee. Time how long they can hold a stable position, then compare the left and right sides. Be sure to also notice if the knee and foot are collapsing inwards or outwards.

If you see a lot of excessive motion, chances are they may also have issues with hip weakness.

Trunk Stability. If the frame of your car is not strong and sturdy, it’s only a matter of time before your wheels fall off. The same goes for our bodies. Proper control of your trunk will also play its part in preventing future ankle injuries.

Imagine jumping off any surface with one leg. If you lean to that same side when you land, your center of gravity is no longer directly over your ankle. This not only makes the ankle work harder, but the simple law of physics increases your likelihood of spraining it.

One of the hallmarks of any successful program is longevity. Longevity forms the foundation for both lifelong learning on the students’ end, and a stable student population on the teacher’s end. Preventing injuries is part of that equation. Being able to program simple exercises that address these areas as part of your curriculum can be a great start.