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Ankle Sprain Prevention & Rehab (Key Brain Training Ideas!)

Video Highlights

-- About ankle sprain
-- Feedforward Control Training
-- Gait Termination Task

Hi, I’m Dr Eric Cobb of Z-Health Performance and today we’re going to talk about an injury prevention tool called, gait termination task. We are a brain-based education company and as a result we are always focused on current research about, “hey what’s going on in the real world?” What are we finding out about the nervous system, the brain and how it interacts with the body. What do we need to then do to turn that information into exercises that people can actually use day to day? So whenever we look at lower extremity injuries, ankle sprains, knee injuries, what we often see is that the injuries occur more rapidly than the nervous system can respond. If I’m out for a run I step on a rock, my ankle whips out to the side. There’s actually very clear research on this at this point that the sprain or the ligament injury can occur before the nervous system can actually notice what’s going on and then send signals to the musculature to correct for that position. So that then feeds into this idea that we need to train our brain and train our body in a way that prepares us for different eventualities. 
So in the world of Neurology we would call this feed forward control training. Feed forward basically means that my brain is going to prepare in advance for what is about to happen so the easiest way to get started with this type of training is doing what we call gait termination task. What that basically means is that, if I’m walking or running and I need to stop and catch myself I’m terminating my gait. I’m stopping my forward momentum. Now, what we see in people that have experienced ankle injuries and knee injuries is that when tested their ability to decelerate and stop their body is not as powerful or not as fast as what we would normally see in uninjured people. So a part now of Rehabilitation from our perspective is, we begin teaching people gait termination practices.

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You start very simply, you’re just going to take one step your goal is to take a relatively forceful step and stop and balance once without falling over. Now you notice I’m just staring at the camera as I do this so it’s just a step stop to catch myself super easy now most people should be able to do that comfortably. We then want to begin increasing the difficulty but that doesn’t mean that we’re going to have you run and jump and catch yourself yet. Instead we want to incorporate normal body movements with being like turning my head, to the left turning my head, to the right. do you do two different versions of this you begin you’re standing you turn your head you step and catch your balance a lot of people will find themselves falling over when they do that and then you would turn your head to the right step catch your balance and you would do eight head positions turn left turn, right ,look, up, look, down, up over the left shoulder up over the right down and left down and right. So just going through those is going to be challenging and if you’re doing five to ten reps of each one of them on each leg you’ll start to actually feel like you’re doing some exercise. Now the next version would be turning your head at the same time that you step. So imagine your down the street you’re taking your next step your friend over here on your left calls you hey and again we’re now making it more challenging by stepping stopping balancing while the head is turning and again you would go through those different head positions this may not seem like a super exciting activity but it is very very important because what we’re trying to train your brain to do is to have a control system that says if I need to step and stop with my head turned left, I already have a plan in place. So as you’re doing this try not to do it mindlessly so as you’re preparing think what am I going to do I’m going to step, stop while I’m turning my head because this is the essence of a feed forward control system. Your brain is planning in advance what needs to happen in terms of stabilizing your body what muscles need to be active and believe it or not this is a very powerful tool for preventing recurrent injuries in the ankle and knee as well as as we look further into literature even up into the low back and spine. Additionally, this is critical for fall prevention so if you work with a population of people maybe who are aging you’re starting to become more and more concerned about falling then feed forward work is incredibly important. Now once this is progressing and you’re feeling better and you’re going a little bit faster and you’re moving; you you then add in more spinal and arm movements to it so now instead of just stepping and turning my head to the left, I’m going to step, I’m going to reach to the left and maybe even Bend forward so I’m doing something like this and I’m still forcing myself to catch my balance so if we can add in spinal movements bending turning anything that would basically feel normal to you like I’m going to step forward reach, over grab this, pick it up and put it over. Here those are the movements when the brain lacks a consistent and appropriate map where we often see people fall or injure themselves. Do think outside the box a little bit. Be creative, make it challenging, make it progressive going forward it is an incredibly valuable skill;l an incredibly valuable tool to add to your arsenal balance training.
Alright, good luck with it, I hope you enjoyed!

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