By Anthony Pribila, PT, DSc, CMPT, CMP, CEAS
Ankle sprains can be a nasty and debilitating injury causing you to miss work, your sport or leisure activities. They can happen suddenly when stepping wrong, jumping and when running or walking on an uneven surface. Ankle sprains can happen in less than a second when the ankle rolls inward such as with an inversion sprain, or outward with an eversion sprain. Swelling can occur within seconds which often leads to lack of mobility, weakness and the inability to bear weight on that extremity. There are three areas that are often affected with ankle sprains: They are the lateral (most common), medial and high, or the tib-fib joint. In severe ankle sprains all three areas and even the foot can be affected at times.
Of the 206 bones in the body, the ankle/foot complex makes up a total of 28 bones on each side with 25 component joints. It is important to undergo a thorough assessment of the ankle and foot to properly address the true areas of injury and dysfunction. An accurate assessment and treatment can make a profound difference in a rapid return to function.
What does a proper evaluation consist of?
At Therapeutic Rehab Specialists (TRS) we look at the entire body’s overall functioning. This examination may include determining if there is a spinal component causing muscular inhibition or neural dysfunction. This can be accomplished by a palpation, strength testing, combined motion pattern testing, and a functional movement screen. An example of this is the discovery of someone with frequent ankle sprains having weak hip abductors or the side hip muscle responsible for raising the thigh to the side as well as helping to stabilize the lower leg. Movements such as twisting, squatting, toe and heel raising are assessed for dysfunctional movement patterns. This can be due to problems with functioning of the spine, hip, knee and ankle. Typically, a person will need good mobility of the ankle and hip with good stability of the spine, knee and foot. Often forgotten components of a proper ankle assessment include the foot and the distal and proximal tibiofibular joints.
A proper functioning ankle is also dependent on an individual having good active foot stability for which coordination exercises and at times orthotics may be recommended.
Are there overlooked areas in ankle sprains?
Although it is common medical knowledge that individuals who sustain inversion ankle sprains typically injure the lateral ankle ligament complex consisting of three main ligaments: the anterior talofibular, post talofibular and calcaneofibular ligament. We also find a disruption of the inferior tibio-fibular ligament from the ball of the ankle or talus rolling inward and causing a quick separation of the inferior tibio-fibular joint often resulting in an anterior or forward positioning of the joint.
Rapid resolution of ankle sprains
Ankle inversion sprain patients often present with lateral ankle swelling, trouble weight bearing on the affected leg, problems with ankle inversion and plantarflexion, as well as ankle weakness. We have witnessed remarkable results from a specialized distal fibula mobilization technique that was created by New Zealand physiotherapist Brian Mulligan. After performing this technique on our recent patient Pat: we witnessed pain free ankle inversion with improved ability to weight bear and a rapid resolution of swelling. Pat shouted out: “I’m healed, simply amazing!” Although quite flattered, we explained to Pat that we did not actually heal him, we only helped facilitate his body’s healing process by removing barriers. TRS therapists are trained and certified in this specialized fibular repositioning technique along with taping, which does not restrict but reinforce and encourage proper joint mechanics. There is not a week that goes by where we don’t have another miracle success story utilizing this technique in our treatment of ankle sprains.
Show me the research!
A 2006 study measured the effects of prophylactic ankle mobilization with taping on 443 measured basketball exposures resulting in 11 ankle injuries. All injuries occurred in subjects with a history of a previous ankle sprain. Significantly less ankle injuries were sustained by members of the ankle taping group (2), compared to members of the control condition without taping (9).
This study provides preliminary data regarding the prophylactic effects of fibula taping on ankle injury in male basketball players. Other previous studies on football as well as soccer players show similar results.
Once joint mobility is restored, range of motion is improved and pain is reduced, functional strengthening will be of importance with the incorporation of balance and coordination exercises. Our goal is for you to achieve excellent motor control with little to no effort. When you achieve good balance and motor control you are less likely to suffer reoccurring ankle sprains.
If you are one of the nearly million individuals who suffer an ankle sprain each year, call us at 813-876-8771 or check our website out at
www.therapeuticrehabspecialists.com to get back on your feet and back to what you love doing.
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1129 Professional Park Drive
Brandon, FL 33511
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