This is because the ankle doesn’t work in isolation and is connected to a web of connective tissue throughout the body. We need to remember that the whole body can be affected, even if you didn’t fall.

Some ankle sprains involve a sudden direct roll of the ankle which may reverberate up the side of the body through the foot, leg, thigh, hip, trunk and neck. This is known as the Lateral line.

An ankle sprain that involves a twist of the body creating a rotational pattern around the foot that extends from the foot, ankle, leg, thigh and hip, then crosses the to the opposite side of the trunk to the shoulder and neck, then back down the body to the foot. This is called the Spiral line.

Some sprains involve both the Lateral line and Spiral line.

The effect on the body can cause chronic swelling, chronic pain, and ongoing instability in various regions of the body. While the ankle might be the focus of treatment, the foot and the muscular patterns occurring above the foot are critical to the outcome.

A balancing act

We may struggle to regain balance after an injury and wonder why this goal remains unmet. We tend to think of balance as the ankle’s job to keep us stable. The reason is that balance is a whole-body activity. So, let’s unpack what we need to balance.

Balance from top to toe

Any of these areas can sabotage our balance:

1. The vestibular system in our ears controls where are in space so our neck position is important.
2. The bulk of our weight is in the trunk. Keeping our shoulders and hips aligned impacts our balance.
3. Pelvic imbalances inform our hip stability. If one side of pelvis is fixed in a forward rotation after an incident, stability at the hips is lost.
4. Our hips need to be aligned with hips over heels for whole body alignment.
5. Standing with one knee bent affects the ability to stabilise the knee joint.
6. Ankle stability requires structural integrity of the ankle ligaments and control of the muscular system.
7. The foot needs to be self-supporting and adaptable.