Hi everyone, this is Dr.Takada from FuncPhysio Physical Therapy. I would like to talk about a twist/sprained ankle. Isn’t it a common injury?
A sprained ankle is an injury of the ligaments and tissue around the ankle. There are different types of sprained ankle cases but I want to focus on the most common case, which is sprained ankle to inward/inversion called anterior talofibular ligament injury.
I think a lot of people have an experience of inversion sprained ankle via sports when they are young or even now. It happens not only sports but also just walk around the city especially women who wear a high-heel.
A sprained ankle is common injury and happens easily.
BUT have you ever treated it correctly? Don’t you think it healed or fine when swollen went away or pain is gone?
Actually sprained ankle(no matter how severe is) may trigger secondary disease later on. Have you ever heard about the ankle becomes weak and sprains easily after a sprained ankle once? It is true(unfortunately), and I give you reasons why.
First, it is no guarantee that the ankle ligament heals naturally by itself. There are different degrees of a sprained ankle. The low degree would be pulled/stretched the ligament. A high degree would be a complete tear of the ligament.
Unfortunately, if the ligament is complete tear once, would not be able to recover. Even if it’s not a complete tear of the ligament and the case of a partial tear, it’s the same thing. For that reason, the ankle becomes looser than before and it makes happening easily/often.
Secondly, the ankle has sensors in the ligaments. They sense the position of the joint and control/make balance our body when our feet touch the ground. This sensor is very important especially for sports like football.
But these sensors are broken or affected by sprained ankle or surgery. Generally speaking, the function won’t be back if you don’t do rehabilitation correctly. Our body can cover with other parts of the body or functions so people feel no problem with that.
Our body can also handle it but in a different way as before, and also visual sense usually takes over the function. So in that case, It won’t be work in the dark.
Third reason which is not familiar but I’m the most concerned is the dislocation of the ankle joint due to a sprained ankle. The ankle area and foot are composed of small bones, and those bones are gathered by a ligament.
Let’s think about it!! Those small bones are pulled by powerful force when the complete tear happens. The dislocation doesn’t go back to the normal position itself. If it is not fixed, it stays with dislocated forever.
Third reason is the real problem of a sprained ankle and also it causes future sequelae.
Additionally the dislocation creates other issues. First of all, it is polyarthritis. It’s due to the unbalance of the pressure(usually inside of the ankle is more pressure) on the ankle.
Secondary, it’s plantar fasciitis or hallux valgus. The dislocation makes other ligaments and fascia dislocated. It affects a range of motion of dorsal flexion(move your toe toward you) less. That causes our leg to outward when we walk, it leads plantar fasciitis or hall us valgus.
Thirdly, the dislocation effects to hip joint, pelvis, low back and also shoulder sometimes. The ankle receives the weight of the body so if the dislocation happened, it is hard to spread out the weight evenly. Some people feel the different lengths of the legs.
In reality, I always check my patients’ ankle even the patients’ chief complaint is neck pain, shoulder pain or low back pain.
The majority of people have not only loose ligament but also the dislocation as well. I often treat the ankle to reduce low back pain.
What do you think about the sprained ankle right now? Some cases of dislocation are invisible with MRI. Some practitioners also still think that the sprained ankle is fine when swollen is gone.
What is the best way to treat the sprained ankle? The first thing that we have to do is icing and compression. The long period of inflammation damage the tissues. Additionally, my clinic has Class IV Cold lessor.
This machine has a benefit for anti-inflammation and tissue recovery. Next is exercising fibularis longus muscle. This muscle can support loose ligaments.
For the imbalance, the balancing exercise can help and recover the balance sensor function.
Let me explain how to do the balancing exercise. Please stand by one foot and close the eyes. It might be hard to keep the balance after the sprained ankle but I prefer you can keep the position at least 30 seconds.
You can try to close your eyes and see how it goes. Then if you could keep the balance for 30 seconds, try to stand by one foot next. After that, try, like, Tai Qi with one foot for 30 seconds.
Finally, try to keep the balance by one foot on the unbalance like pillows. Please challenge hard little by little. Even if we’re healthy, keeping balance would be harder by age but it’s able to keep it better and prevent the sprained ankle or fell down if we do training regularly.
Only for the dislocation, you need to see a practitioner who is well known about this injury. One of the signature techniques in our clinic is Functional Mobilization but our clinic physical therapists have special skills.
It doesn’t matter how long the ankle joint has been dislocated. The most important thing is WE CAN FIX the dislocation no matter what. Also highly recommend to fit it as soon as possible. People usually recognize their weight on the feet evenly and feel the ground more than before right after the treatment.