Poor proprioception; our unconscious awareness of body movement and position; is a common underlying cause of injury to the ankle. Little sensors / receptors built into the tissues of our body (joints, muscles, and ligaments) detect movement and send information about its direction and speed to our brain which in turn uses this information to plan and coordinate movement. Injury to tissues with these built in receptors mean that the brain has ‘less information to work on’ and fails to activate muscles when appropriate, for example to ‘right’ the ankle when it is about to ‘roll’.
Subtle changes to foot shape and structure (‘skeletal drivers’) such as external tibial torsion, forefoot / rearfoot varus, and Hallux limitus drive excessive pronation of the foot disrupting the normal heel to toe mechanism. This is especially relevant with tendon injuries and ankle impingement problems.