Back pain and no use of ankle

Hi there

I would love to help you! In order to do so may I please have some more information? I would like to know more about your back condition and what is wrong with your ankle. How each one affects your practice. Why are you wearing a back brace? Seems to be periodic use – what is happening? Is someone ‘grooming’ you for surgery or trying to help you avoid it? Why do you need to stay off your ankle? I would really appreciate hearing whatever you are willing to share. Feel free to use my email or this forum.

Namaste
Gabrielle 🙂

Hi everyone

Here is a selected quote from jerz280’s private emails to me… copied of course with permission:

I can walk on my ankle, it is just in a brace (aircast) to “stabalize” it before embarking on physical therapy. For years I have had problems with my right ankle spraining on a pretty regular basis (about once a year for a number of years now). Around the age of 21 I was diagnosed with plantar fasciitis in the same foot. That is when I started spraining it frequently I am now 32.

I went to the doctor after being in yoga class doing a sitting position where you hold the leg (kind of like holding a baby) and my ankle started to get this rolling sensation which I had been getting for a while when sitting in a cross legged position for too long.

The back pain is on same side as the ankle brace and it almost seems like a sciatic condition. It started about a week after the brace went on and I hadn’t been to my regular Saturday yoga class for two sessions. I can’t seem to find a comfortable way to sit, stand, or lean without feeling a bit more pain in the area. The pain is not very bad (at least not yet) but it extends down into my hamstring, especially when sitting. I just can’t seem to find a comfortable place to sit no matter what I do with my feet.

It is not as bad when standing, but there is a little soreness when walking around. I do not want surgery so this measure is the first to see if we can strengthen the joint. The doctor has allowed me to continue with water aerobics, and biking, but has told me to stay away from yoga because of the “weird” poses that can put stress on the ankle. (His words, not mine).

My saturday morning yoga class is full of sun salutations, downward dog and other common poses as it is a beginner class. I used to practice more often (and had less sprains then) but some major life changes caused me to stop exercising and practicing. I only began taking off the weight, getting back into shape and taking up yoga again in January of this year.

Here are some of my thoughts:

That pose you did in class cradling your foot is quite strong on the ankle – so I am not surprised it bothered you.

It is no wonder that your back hurts on the same side. There is no doubt in my mind that you (whether consciously or unconsciously) compensate for your weaker ankle by walking more heavily or relying on your left side to support you. A change from the ground level (in the way you use your feet) is going to affect your ankles(!) your knees, your hips and YOUR SPINE and your shoulders etc.

Fundamentally I have a problem with full time use of a brace. It bothers me because they cause the patient to rely on the brace as a crutch. When the brace is removed there is no support so the ankle is in fact weaker. Now I have no idea as to the exact instructions you have been given for brace use so feel free to enlighten me.

For example if you have pronated ankles then you would use an orthotic device in your shoe. If you use them all the time when you take out the orthotic the ankle collapses. What is really required is some work to stabilize and strengthen the ankle. This is what I envisage for you. And I plan to suggest some stuff below.

The good thing about the exercises below is that they are GREAT for plantar fasciitis. I have given them to several yoga students with excellent results.

I have written an reply to someone else asking about exercises for an ankle problem: Ankle injury, painful. What exercises and poses help?. There is a section right down the end of my post that recommends strengthening the ankles when sitting on the toilet or on a chair. Take a look at that please, and if it doesn’t make sense please ask for another explanation.

The other exercise I would recommend is standing next to a kitchen bench or table and totally supporting your weight with your hands on the bench. Raise up a little on your toes 10-20 times a few times a day. As you feel a little stronger, raise your heels even higher. Over a very short time you will be able to build very good strength. This is a controlled exercise so support yourself as much as you need to. You will be able to rely less and less on the bench (although use it all the time). As I said: combine this with the exercises in the other post. In time you may even be able to walk around just on your tip toes and feel safe.

What you want to do is strengthen your ankles. I too have sprained my ankle badly in the past (and who hasn’t?) and noticed how the same one gets and can stay weak. I continued to sprain the same one: the inflammation would stay for months to a year as I babied it. Then one day I decided to use the ‘counter intuitive’ approach and give my ankle some work to do (controlled).

So do your best to load both legs evenly. I am not saying to NOT use the brace. I cannot be the one to decide that.

You have noticed that I have not yet mentioned your back! Huhh? Because the way you are using your body seems to be the problem. But you do need some relief. I would be less inclined to do the vinyasa flow yoga for a little while. It just seems a little too harsh on your vulnerable ankle and although you can step up instead of jump through there are a lot of other movements that I would be discouraging AT THIS STAGE.

This post is getting very long, so please allow me to hear your response to the above and let me know how long you are supposed to wear this brace every day. In the meantime I will get back to you here with back specific content.

Namaste
Gabrielle 🙂

Hi Ziporah

I just thought I would clarify a few things that I said to you above:

1) When I suggest to raise up on your toes (supporting yourself either sitting or with your hands while standing) I wasn’t saying to move your feet in circles (well not yet anyway). Try the simple up down movement pushing through your ankles.

2) This exercise is particularly fantastic for those with plantar fasciitis.

3) I mentioned the orthotics not because I thought you had used them but because they serve as a parallel example of how we can rely on a crutch to ‘support’ the body (and if used too long) how they can actually make the body weaker.

4) I forgot to mention that a very nice and extremely restorative pose for the ankles and knees (because it is likely while favoring your left leg you have caused some imbalances on the right side) is to sit kneeling on the floor, knees and feet and heels together body upright – maybe while watching TV or reading a book. Great to recreate some symmetry. Use whatever cushioning in and around the knees and ankles you need.

Will love to hear from you with your progress.

I will also be interested to hear if you can actually do those heel raises/ankle openers adequately with your brace on.

Namaste
Gabrielle 🙂