Friday Q&A: Yoga for a Sprained Ankle

Q: Nina—how bout yoga for a sprained ankle...got some ideas?

A: Why, yes, thank you so much for asking! Last year Baxter did a three-part series on the ankle that is worth revisiting or visiting for the first time if you’ve never read these posts. So check out Getting to Know Your Ankles, Ankle Sprains, and Recovering from Ankle Injuries.

In part 2, Baxter says that a typical recommendation from your doc is to elevate your foot and leg above the level of your heart, and because there are lots of yoga poses that are done lying on your back with the legs elevated, these poses could assist in the healing process. So in the acute phase of injury, try supported inverted poses such as Legs Up the Wall pose, Chair Shoulderstand, and Easy Inverted pose. See All About Supported Inversions for some other possibilities, and links to instructions for them.

Naturally, while you are recovering and need to keep the weight off your ankle, you will need to avoid standing poses. But there are so many other poses you can still do, including seated and reclined poses. If I were in your situation, I’d continue to practice what I could to maintain my flexibility while my ankle was healing. So try some seated poses, such as hip openers, twists, and forward bends, while keeping your ankle in a neutral, pain-free position. Of course, you’ll want to avoid poses that put pressure on the ankle, such as any variation of Hero pose (Virasana) or Half Lotus (Arda Padmasana). Also, many of our office yoga poses, which you can do seated in a chair, will be suitable for you. Reclined poses, including passive backbends as well as restorative poses, can be very effective at opening your body without putting any stress on your ankle. Again, just be sure to keep your ankle in a neutral, pain-free position. It’s kind of an interesting to challenge to figure out how to practice when you need to avoid aggravating an injury (right now I have a plain old skinned knee, so I need to avoid kneeling—it turns out that comes up more frequently in practice that you might imagine).

If the pain and inconvenience of having a sprained ankle is causing you to stress out—which I imagine it would—add in some stress reduction practices, such as meditation, yoga nidra (see the Relaxation Tracks tab at the top of our page), breath awareness or pranayama, or even just a nice long Savasana. Check the index on the right side of our blog for posts on all these topics.

Once the acute phase symptoms have diminished, Baxter says that you can turn your attention to a more typical asana practice, adding in his seated ankle rolls and alphabet spelling exercises (see Ankle Circles). At this point, you can focus on the strengthening aspects of the poses for the ankle and foot area, so add special attention to activating as many of the muscles surrounding your ankles and feet as you do your standing poses.

—Nina

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Ankle Sprains

by Baxter

Yesterday, I provided you with a basic overview of the anatomy of the ankle joint (see Getting to Know Your Ankles). Now let’s turn our attention to the most common injury to ankles, the ankle sprain. Suffering one sprain to an ankle, if mild, is usually no big deal. But many times, there will be several sprains over the course of time, often on the same ankle. This can lead to looser ligaments from repeated micro tears and stretching, resulting in overall less stability in the affected joint, and the tendency to have more twists down the road. Yikes! The vast majority of ankle sprains involve the action described about as “inversion” (which I defined yesterday), so are known as inversion sprains. Due to the foot rolling under and the ankle bowing outward in this case, the ligaments on the outer ankle and foot area are stretched and/or torn a bit, resulting in local swelling and pain in that area around the lateral malleolus. A small but important ligament in this area known as the anterior talofibular ligament is almost always the victim of the trauma. The case of the ankle rolling in is much rarer due to the longer fibula bone as the lateral malleolus tending to prevent that, so I won’t address this specific situation here.

On a practical level, when we suffer an acute ankle sprain, we get local swelling, tenderness over the area to touch and discomfort when we stand or walk, to varying degrees. The typical recommendations from your doc areto elevate your foot and leg above the level of your heart and to use ice can help to diminish the swelling associated with the trauma, so are a good idea to try. And since there are lots of yoga poses that are done lying on your back with the legs elevated, your asana practice could assist in the healing process.  In the acute phase of injury, poses such as Legs Up the Wall pose, Chair Shoulderstand, Easy Inverted pose, and similar poses may be all you want to try. All of these poses are also helpful if you suffer intermittent or chronic swelling of the feet and ankles, another common condition.

Legs Up the Wall pose (Viparita Karani)

Easy Inverted Pose

Once the acute phase symptoms have diminished, you can turn your attention to a more typical asana practice, as well as adding in last week’s seated ankle rolls and alphabet spelling exercises (see Ankle Circles).  At this point, you are ready to focus on the strengthening aspects of the poses for the ankle and foot area, so add special attention to activating as many of the muscles surrounding your ankles and feet as you do your standing poses. A modified Mountain pose Tadasana) sequence I learned at the Krishnamacharya Center in India years back also comes in handy for strengthening the ankles after injury. You begin in a good Mountain pose, and on an inhale, lift your heels up and balance evenly on the balls of your feet, taking your arms up and overhead. As you exhale, lower your arms and heels to the starting position. Do this slowly and mindfully six times. Don’t be surprised if you find that you roll in or out onto the ball of the foot, but work to even this out.

As always, cultivate patience with your body to gently guide it back to a healthier place and listen deeply to its requests to honor its limitations.

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