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Episode 153: Ankle Pains and Sprains Part 2

Video Highlights

- Frequent ankle sprains?
- Recurring achilles tendinitis or plantar fasciitis?
- Never go over 3 out of 10 intensity with this drill.

Today we are going to take a second look at ankle pain and recurrent ankle sprains and show you another option.

We’ve already looked at a neuro-mechanic drill for recurrent ankle sprains, Achilles tendinitis and occasionally plantar fasciitis, and if you haven’t watched that blog that’s a blog, it’s about a nerve called the sural nerve. The sural nerve is this interesting nerve, it goes down the outside of the leg and it’s a sensory nerve only. It doesn’t really deal with muscles and making stuff move, it’s just sensation.

Really great drill that we looked at before, again particularly for the stuff we’ve already mentioned which is ankle sprains and Achilles tendinitis. Today what I want to do is look at a different nerve for the lower leg. This one is also often implicated when people have recurrent ankle pain or recurrent ankle injuries, and this is also a motor nerve, so it helps us control the musculature of the foot and the ankle.

The nerve that we are going to look at is called the common peroneal nerve. The common peroneal nerve comes off the common sciatic nerve. Everyone knows about the sciatic nerve, big nerve that runs down the back of your leg. The sciatic nerve is here and you can see that it splits off, in the common peroneal nerve, and then the common peroneal nerve splits off into the superficial and deep.

We have a couple of different drills. One very specifically that I love, another neuro-mechanic drill that can help you once again floss this nerve through the surrounding tissues. If there is some type of restriction it can be very, very helpful in help getting rid of pain and also improving motor control, which is one of the reasons we wind up teaching it a lot.

The setup for this one is very similar to the sural nerve, which is the one we looked at previously. I’m going to use a chair again. I mentioned this in the previous blog that if you have balance issues, if you’re really tight through the lower extremity, have a lot of pain, perfectly fine to do these sitting down or even lying down. If you are just doing this even maybe prior to a run, for a warm up or something, doing it standing may work a little bit better.

What I’m going to do is I’m going to put my foot up on the chair. For this particular exercise, once again the big difference or the big thing we have to focus on is our foot and ankle position. What I’m going to do is I’m going to point my toes down toward the floor. I’m going to what’s called plantar flex. From here I need to pull my does toward the mid-line of my body, and now I need to curl my toes. All right?

A lot of people will cramp immediately, on the bottom of the foot as soon as you get that full position. If you cramp, stop, relax the foot and if you need to in the beginning you can avoid having the toes flexed. That often makes it a bit more comfortable.

What we’re going to do is we’re going to get in a nice, tall spine position, we’re going to lock the knee, we’re now going to point the toes, curl the toes in, and curl the toes. From here I’m going to start moving forward into a forward bend, also with some rounding of the spine, because we’re trying to traction the nerve at the beginning of the skull actually. What you will feel is a weird stretch, kind of nervy sensation that may run from the outside of your knee, across the top of your lower leg, and across the top of your foot. If that’s what you’re feeling you’re doing it correctly.

Please remember our basic rules. We do not want this to be super intense. It should be a level 3 out of 10 or less, not more. All that we’re doing with our body position, etc. is getting to a point where we’re at a 3 out of 10, and then we’re going to move a joint, take tension off, and then put the tension back on so that we can basically tension and relax the nerve.

Once again nice tall spine, lock the knees, point the toes, turn the foot in, curl the toes. Come forward, little spinal slump. I now have about a 3 out of 10 tension on the outside of my leg, so the first thing I’m going to do is take the tension off by bending my knee and then straightening my knee. I’m going to do that 5 to 10 times.

I come up, shake it out, I’m now going to repeat the same thing. Lock, point the toes, turn the toes in, curl the toes, come down, now I’m going to go to my lumbar spine. I’m going to rotate my body toward the straight leg. If my right leg is out I’m rotating to the right from my lower back. I’m going to do that until I feel that 3 out of 10 tension, which for me is right about there. So I’ll take the tension off, put the tension on. That’s another option.

A third option usually is the foot. Once again I’m going to get everything nice and relatively tight so I have that 3 out of 10 tension. Right there. Then I’ll relax my foot, and then go back into the position. Relax my foot, then back in.

Ideally you’re going to aim for 5 to 10 repetitions of that, 2 to 3 times a day. One of the things that you’ll typically notice if you want to pre and post test is you can always do a single leg balance test before you do the drill and then after you do the drill. Very often what you’ll find, because you’ve now facilitated hopefully some motor activity, some better muscle activity in that ankle, your balance typically will be better after the drill than before.

Hopefully this works out well for you. If you have any questions please let me know.

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