ANKLE SPRAINS

Contrary to popular beliefs, ankle sprains are not caused by weak muscles. The most common cause are previous sprains causing laxity to the ligament. The other cause is poor proprioception. Proprioception is your body's unconscious ability to sense movement, action and location.  I have found that supporting the loose ligaments with rigid strapping and some form of balance training to improve proprioception is effective for the rehabilitation of ankle sprains.

When the ankle is sprained by "rolling in" an inversion sprain can occur. This affects the ligaments of the outside of the ankle. There are three distinct ligaments on the outer ankle, Depending on the severity of the ligaments, one, two or all three ligaments can be partially or completely torn. If there is pain on the bone(lateral malleolus), a fracture should be suspected and an X-ray would be indicated. If there is pain and tenderness above the ankle into the lateral leg, a high sprain would be suspected. A high sprain is actually a strain of the peroneus muscle. For a high sprain we would strap the ankle higher.
 
Sprains to the inner ankle are less common caused by "rolling out" of the ankle or an eversion sprain. Sprains to the front of the ankle or hyperextension are sprains to the dorsiflexors tendons.

In addition to the strapping and balance exercises we also massage the affected ligaments, tendons and muscles to reduce adhesions and scar tissue. Many times there are subluxations to the joints of the ankle and foot and we can improve mobility with the appropriate manipulation.
 
Another common injury is a strain to achilles tendon. Achilles tendonopathy can be caused by poor footwear and a poor knee lift and putting too much effort on pushing off of the ankle. In deconditioned or novice athletes, weakness of the tendon can contribute to achilles tendonopathy. Supportive strapping and returning to activity with less stress  to the tendon with bicycle training, elliptical training and resistance training would be indicated.

As with any injury, a comprehensive consultation and examination are essential to evaluate the correct diagnosis, treatment and prognosis. I appreciate your positive response to these newsletters.