Every basketball player and fan knows the sickening feeling of an ankle giving way, your foot twisting underneath it. It could be a momentary pain, or it could be a severe ankle sprain that takes you out of the game for weeks.
There's a reason the distinctive feature of basketball footwear is their ankle-supporting high tops. The bones and muscles where foot meets leg are the most at-risk for a basketball injury.
We talked to Sheila Klausner, a physical therapist for AdventHealth Sports Med and Rehab, about how to give your ankles the attention they need.
Ankle Enemy No. 1
It happens in a fraction of a second.
"The body's center of gravity can be off to a very small degree, which causes the body to lean and the ankle to roll," Klausner says.
Most commonly, this injury is an "inversion sprain," where the tissue on the outside of the ankle (it connects bones in your ankle and leg) tears. The foot then bows inward, toward the center of the body.
The muscles you'll want to strengthen to prevent ankle injury probably aren't the ones you think about that often.
"The best form of activity strengthens the muscles on the sides of the lower leg and those that wrap around the bottom of the foot, like a sling," she says. Yes, the bottom of your feet.
Never had a bottom-of-the-foot workout before?
"You can use resistive bands to target certain motions, or do standing heel raises with your feet curved," Klausner says. She also recommends taping and bracing.
"Many athletes prevent ankle injuries by using taping and bracing to create external support," she says. "This is especially important once the body becomes fatigued."
Furthermore, the act of applying braces and tape can have an invisible side effect. It can make you more aware and thoughtful in taking care of your ankle, Klausner says.
High Tops, High Protection?
But what about those high top shoes? Yes, your ankle feels more protected, but does that translate into actual protection from injury?
Well, this is one of those areas without totally settled science.
In one study, high-tech cameras recorded recreational basketball players in different footwear while they performed quick cutting maneuvers. The analysis found wearing low-cut shoes did not significantly reduce ankle stability.
Klausner says there's "no substantial evidence that shows these shoes are going to absolutely prevent injuries."
That said, certain people with ankle weakness may benefit from the extra support. Something similar can be said for the practice of taping or bracing your ankle.
It's a reminder of the principle that there are few hard-and-fast, universal rules.
"I always tell people to consider their asymmetries," Klausner says. For example, do you have a strong upper body, but skip your legs at the gym?
"You have to work to build a balanced symmetry."
But how to figure out what asymmetries are quietly sabotaging your game or putting you at risk for injuries? It's tough to observe your own movements and identify imbalances.
That's where a professional comes in. Just as you'd see a cardiologist for a heart problem, a physical therapist is a specialist in movement.
"Our skillset is the analysis of human motion," Klausner says.
A physical therapist can help you interpret your body's messages through what's called a biomechanical evaluation.
Klausner has another way of looking at our bodies: "It's about how we fight the forces of gravity."
During her work on the campus of the University of Central Florida, she talks to students all day about how gravity's pull can ruin posture. Think about how you're sitting right now - is your back curved, your shoulders slumped forward? This is gravity winning and, over the long term, your body losing.
Then there are the phones.
"As soon as our head drops forward to look at that smartphone, gravity's winning," Klausner says.
A biomechanical evaluation can identify these imbalances and teach you to counteract them. Typically, a physical therapist will guide a patient through each joint's range of motion and pinpoint any muscles that could use some loosening.
"People can look at physical therapy as a form of preventive medicine and injury correction," she says, that's tailored to your specific body.
"Am I a stiff, tight body that needs to stretch or am I a hyper-mobile body that needs strength?" Klausner says.
Seeing a physical therapist can give you the big picture, one that includes your mind, body and spirit. They can teach you how your diet, habits and your body can either conspire to trip you up or put you on the road safe running.
The team at AdventHealth Sports Med and Rehab spans medical disciplines that support you physically, emotionally and spiritually to help you live a full life, off the court and on.