Proprioception needs to be retrained during ankle sprain rehabilitation to reduce the risk of recurrence.
Nonoperative management of ankle sprains involves rest, ice, elevation and compressive wrapping to mitigate swelling. Physical therapy is an important component of treatment to reduce risk of recurrence. This includes proprioceptive exercises, peroneal strengthening and use of functional bracing.
Lephart et al. review the role of proprioception during rehabilitation. They note that the neuromuscular feedback system that is critical to proprioceptive function is disrupted with injury. They recommend that physical therapy include a proprioceptive component to enhance dynamic and functional joint stability.
Figure A shows a clinical photo of the anterior drawer test. A positive test is indicative of an ankle sprain (namely, injury to the ATFL). Illustration A shows a schematic of proprioceptive exercises being completed on a “wobble” board to help retrain neuromuscular feedback.
Answers 1, 2, 4, 5: Rehabilitation of these components of the neuromuscular pathway is not as important as proprioception training in reducing recurrence of ankle sprains.
Let's start by looking at how tendons work. Tendons are tough, fibrous tissues that connect muscles to bones. The extensor tendons join the muscles on the front of the lower leg to the toes. They pull the toes upwards away from the ground. The two main extensor tendons come from extensor hallucis longus, which lifts up the big toe, and extensor digitorum, which lifts the other four toes. Both tendons run down across the front of the ankle, across the top of the foot and then fan out attaching to the tips of the toes.