23 April, 2013 23 April, 2013

Dry Docked – Three Steps to Avoiding Ankle Injuries

Chris Frolich gets twisted and rad at New Pier.

Surfing as we all know is richly rewarding, but we also know it can be a demanding activity – Demanding on your petrol budget, demanding on your patience while waiting out a flat spell, and of course demanding on your body.

Some surfers pay a heavy price with surf-related injuries, especially those who are always trying to push their limits – their next air a little higher and more tweaked, their next layback more contorted than the previous, or like Durban local Chris Frolich (above), their next re-entry a little more twisted.

None of us like time out of the water to recover from an injury, so it’s a good idea to plan ahead and exercise those parts of our body that are more at risk. Boland local Phil Nel has seen his fair share of surf-related injuries. Being a frothing surfer as well as a biokineticist at Le Roux & Nel Biokenetics, Phil knows a thing or two about avoiding an injury that will keep you dry docked.

With the help of Kommetjie fitness guru Neil Zietsman of 3S Training, Phil talks us through three easy steps to reducing surf-related ankle injuries.

* If you missed it, check out Phil and Neil’s guide to avoiding knee injuries>>

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3 SIMPLE WAYS TO REDUCE SURF-RELATED ANKLE INJURIES – by Phil Nel

The feet and ankles form the base to our surfboard, which our bodies are dynamically balanced on.

Ankle_Diagram

A complex array of bones, with surrounding ligaments, nerves and muscles form the ankle and foot joints. All these work in synergy to co-ordinate precisely in order to maintain balance and to exert force. With the evolution of surfing rising steadily towards high risk manoeuvres, so has the risk of ankle injuries grown.

In this year alone, WCT professional surfers such as John John Florence and Gabriel Medina have all suffered debilitating ankle injuries, which have resulted in sustained time out of the water.

One of the most common ankle injuries is when the foot ‘rolls’ over during a weight-bearing action. The direction in which the foot rolled over, force, angle of force, will determine which structures get injured. The severity of the injury can be as simple as a grade 1 tear of the ligaments, or as complex as a bi-malleolar fracture of the anklebones.

John John Florence doesn't hold back.

John John Florence doesn’t hold back.

I often get approached by surfers on the beach, asking about old ankle injuries. Usually they’ll complain of recent swelling, weakness or other more painful symptoms. Upon examination, their affected foot mostly test positive for joint instability. Ligaments attach bones to bones, forming joints. Injuries to the surrounding ligaments of the ankle causes joint instability. Basically put: there is now too much movement in the foot. Ligaments can’t just ‘grow’ back. The only hope is to strengthen the surrounding muscles to ensure stability and thus a successful return to surfing.

A weak, unstable ankle joint (because of the lack of primary ligament support in the foot) can lead to severe injuries if the foot gets put under force. This increases the risk of re-injury. A season-ender at best, or career-ender at worst. Weak ankle and foot muscles also lead to knee instability, and less support for your core muscles, which can lead to other injuries in these joints.

We often find in our practice that even uninjured surfers can do with much more dynamic strengthening. The following surf-specific exercises could help reduce the risk of ankle injuries and improve performance. These exercises are more suited for uninjured surfers. Injured surfers should first get past the initial stages of rehabilitation before attempting these. It’s important to get a proper diagnosis from a healthcare practitioner regarding new or old injuries!

SURF-SPECIFIC ANKLE CROSS TRAINING SHOULD FOCUS ON:

• Individual specific physical and psychological needs.

• Strengthening your ankle in all plains of movement with different forms of resistance.

• Stimulating the neuromuscular control (balance and postural stability).

• Having functional flexibility.

STEP 1: PROPRIOCEPTION EXERCISES

BOSU CALF RAISE: Balance on the bosu ball and lift your heels as high as possible while maintaining balance. The unstable surface adds an element of surprise that you would often find in surfing.

BOSU CALF RAISE: Balance on the bosu ball and lift your heels as high as possible while maintaining balance. The unstable surface adds an element of surprise that you would often find in surfing.

Proprioception is the body’s ability to realize its place in space. This is done by nerves in the muscles sending data back and forth to the brain. If a surfer moves into a position that could sprain the ankle, increased proprioception will decrease the risk by alerting the surfer to the danger.

Proprioception can also increase a surfers performance. A surfer with superior balance and awareness will be able to control his or her body more effectively.

Proprioceptive training is done with balance exercises. A simple way of stimulating this neuromuscular control is by doing balancing exercises on a wobble board, indo-board, bozo ball [see above], foam pads etc. All these apparatus provide an unstable support similar to surfing.

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STEP 2: PLYOMETRIC EXERCISES

Skipping: To warm up do at least five min of skipping. As you get better build up to 10 min. The best technique is to jump from one foot to the other.

SKIPPING: To warm up do at least five minutes of skipping. As you get better build up to 10 minutes. The best technique is to jump from one foot to the other.

Plyometrics (landing and jumping exercises) also provide good simulation on the ankles to launch and land surfing manoeuvres. Practice plyometric jumping and landing techniques on softer surfaces, and try using good trainers to help absorb the shock on your joints.

Focus on landing with your knees flexed (bent), your shoulders slightly forward and your glutes and hips back. Land on the balls of your feet with your heels slightly off the ground. Also try to land as ‘light’ as possible. A good simple example would be doing skipping, and a more advanced exercise would be Bodyweight Squat jumps. Incorporate these into your exercise routine and don’t do more than 25 advanced exercise landings in a session.

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STEP 3: ELASTIC RESISTANCE EXERCISES

Elastic resistance also offer a simple way of improving ankle strength. Bands are available in a variety of resistance levels. The American College of Sports Medicine suggests selecting an exercise band that allows you to perform a given exercise with a smooth motion while still challenging your targeted ankle muscles. Make sure to exercise in all four ankle movement planes. (Plantar/Dorsi and Inversion/Eversion)

Ankle Dorsiflexion: Tie a resistance band into a loop. Secure one end and put your foot into the loop. Point your toes down, then pull back against the band. Do two sets of ten on each foot. Remember different bands have different resistance so find one that is challenging but wont strain you.

ANKLE DORSIFLEXION: Tie a resistance band into a loop. Secure one end and put your foot into the loop. Point your toes down, then pull back against the band. Do two sets of ten on each foot. Remember different bands have different resistance so find one that is challenging but wont strain you.

INTERNAL ANKLE ROTATION: As demonstrated, place the band around your foot and rotate your ankle internally with the band providing resistance. Do two sets of ten on each foot.

INTERNAL ANKLE ROTATION: As demonstrated, place the band around your foot and rotate your ankle internally with the band providing resistance. Do two sets of ten on each foot.

EXTERNAL ANKLE ROTATION: Again using the elastic band, loop it around your foot and turn your ankle to the outside against the band. Do two sets of ten on each foot

EXTERNAL ANKLE ROTATION: Again using the elastic band, loop it around your foot and turn your ankle to the outside against the band. Do two sets of ten on each foot

For surf-specific training and workouts contact Neil Zietsman on neilziets@gmail.com or check out 3S training on Facebook here>>

For re-hab of a fresh or lingering surf injury contact Phil at Le Roux & Nel Biokinetics

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REFERENCES:
Delabier.F (2010), Strength Training Anatomy.
Kenney. W.L  (2004), ACSM’s Guidelines for Exercise testing and prescription.
Magee.D.J. (2006), Orthopaedic Physical Assessment.

5 Comments

  1. francois
    23 April, 2013 at 11:46 am · Reply

    Can you please give us some info on the old knee as they are the “Gabriels” of surfing and with all that shock absorbsion a lot can go wrong as I was sidelined during a J bay trip with my bro.

  2. Fleur Gwendoline Occhilupo
    23 April, 2013 at 11:49 am · Reply

    ok but always consult a good dr

  3. billabonga
    25 April, 2013 at 8:23 am · Reply

    shoulder,rotator cuff stuff?
    where

    • Philip L. Nel
      25 April, 2013 at 4:21 pm · Reply

      Yes. Rotator Cuff injuries (a.k.a Surfers Shoulder) will definately feature in our series 😉

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