Understanding The Ankle Joint For A Better Rehabilitation Plan For Sports Physios

In this series we will be dealing with one of the most underappreciated joints in the body.

Throughout my 13 year career in private practice and professional sports ankle injuries have been a recurring theme.

The ankle joint is a key player in our physiology, so why do most people struggle to get the long-lasting results athletes need?

Today I’ll share some of the fundamental principles of an ankle joint injury.

Force Distribution

The key we need to understand from a whole body approach is that as that foot hits the floor we want the forces to be distributed each and every direction.

What you are going to see with a lot of patients who have had old ankle injuries is when motor adaptations kick in or stress they will avoid loading certain tissues.

Intent In The Midfoot

Good intent in the midfoot is critical for the tissues above it, the hamstring, glute and quad to all function efficiently. If you lose intent through the ankle joint then there are consequences in the chain.

The Knock-On Effect

The ankle is a far bigger player than most people think. Its ability to function effectively has far reaching effects.
Research shows that ankle instability can cause issues with the hip and other joints so when treating an ankle injury we have to be sure we restore range of movement, have good intent through the foot but we also need to give the body as many options for movement.

Be Aware of Fractures

If you have an ankle injury, we need to be careful there is no fracture. If you do pinpoint tenderness on the base of the fifth metatarsal or the distal tip of the fib then we may be suspicious there could be a chip or some kind of fracture that needs to be further investigated.


If an athlete reports an ankle injury medially, they feel pain at the front of the leg or perhaps the ankle was twisted when the injury occured I would suspect there could be a syndesmosis injury.

Recognising this injury is incredibly important. This is one of the most misdiagnosed and mismanaged injuries. If this is ignored and not handled correctly it can be hard to get the athlete back to where they used to be.

In This Series

There you have a brief overview of what we need to be thinking when looking at an ankle joint injury. In later parts we will go through making sense of your assessments, making sense of your patient’s symptoms and building a treatment plan on a solid foundation.

For more articles and resources on the ankle joint and how to get long-lasting results with your patient’s click here.

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