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Ankle Sprain - Pulse Physiotherapy and Pilates

The ankle sprain is a rotation or a very rapid movement of the joint, it is the most frequent trauma in most sports. Almost everyone thinks that sprain means stretching of the ligaments and inflammation of the ankle.

In fact, the ligaments are very strong, a twist is more likely to Fracture of the lateral malleolus, ie the ligament remains intact but the violent impact could break the bone.

This is an uncontrolled tension of the foot that causes the stretch or rupture of: capsule, tendons and blood vessels.

In more severe cases it can also injure the muscles and nerves.

In case of mild sprain, with proper treatment most patients recover completely, but in some cases can be a condition of instability, pain or stiffness, which can also cause relapses.

The pain is felt on the outside of the foot and possibly in the medial (internal) region, in rare cases it is noticed at the level of the Achilles tendon.

How is ankle sprain classified?

The most frequent displacement is dorsiflexion (dorsiflexion) and supination (sprain in inversion) for anatomical reasons. The fibula reaches a level lower than that of the tibia, in fact when we try to do the pronation of the foot (movement of external rotation of the feet) we can reach a bone barrier earlier, instead, turning inwards (supination) the limit is only By the force of the ligaments.

In this case, the ligaments involved in the trauma are: the anterior talofibular that is always affected, the posterior talofibular that is elongated only in severe cases and the calcaneous-fibular only in severe cases.

Sprains are classified according to the magnitude of the injury:

1st degree: Stretching of the ligaments and tendons without lesions 2nd degree: Partial ligament injury 3rd degree: Total lesion of at least one ligament.

What are the causes of ankle sprain?

Sprain is caused by the lateral support of the part of the foot that causes violent external rotation and supination of the ankle (inversion). It is very rare to find a person who suffers from sprain in eversion, that is, the ankle rotates inward.

The predisposing factors to sprain are:

1. Instability from a previous sprain 2. A fall after a jump 3. A sports trauma (soccer) 4. Lack of training. 5. Tennis not suitable for the type of sport. 6. Start the exercise without proper muscle warming. 7. Support the foot improperly.

In severe sprains, tendons of the fibular muscles may be injured, those in the lateral region of the leg, or tendinitis may occur. The fibula can break in the classic sprain in ankle inversion. Generally ankle sprain occurs in children, young sportsmen and women wearing high shoes, but it can happen to everyone.

Symptoms of ankle sprain include:

  • Pain in the lateral region of the ankle , between the external malleolus and the last 3 fingers that may be mild but also unbearable

  • Instability in walking

  • Swollen foot and ankle

  • Reduction in foot function

  • It is not possible to support the weight of the body on the foot (in severe cases).

How is ankle sprain diagnosed?

The diagnosis is absolutely clinical, the health professional checks the patient's medical history, which in this case is very simple.

The patient should explain how the sprain or trauma occurred, this is sufficient in most cases. The only "special" can occur are patients who complain of foot pain but have suffered sprain at least 6 months before. In these cases, discomfort can have different causes.

During the physical examination, the health professional performs the palpation of the ankle, looking for the painful areas.

We can observe the swollen foot , also in the acute phase we can see purple spots that represent the hematoma caused by the rupture of the capillaries.

Then, the health professional performs the evaluation of the movements, in most cases there is a limitation of supination and dorsiflexion.

Generally, the patient is unable to walk on the toes, but is able to walk on the heels.

Only in more severe cases, the doctor prescribes a musculoskeletal ultrasound to check for broken tendon or ligament injuries.

How to cure ankle sprain?

Usually one the problem is the belief that sprains recover with immobilization and without carrying the weight on the foot for two weeks. Often see athletes who after 10/15 days of injury are still unable to support the foot and are unable to move. In addition, applying ice for many days is contraindicated and makes the joint even more rigid.

Each sprain is different from one another, make am appointment with a physiotherapist to give you the best recover program possible.

Physiotherapy for ankle sprain

The immobilization phase should not take too long, because it is not curative, makes the patient more fearful and causes joint stiffness.

Manipulating the anterior tibia, osteopathic technique

After this brief phase, the goals of rehabilitation are:

1. The reduction or disappearance of pain to resume daily activities: work, driving, sports, etc. 2. The improvement of muscular trophism, that is, the strength of the stabilizing muscles of the leg in order to favor a good control of the joint. 4. Recover the proprioceptive ability, that is, re-educate the foot for the perfect control of posture and movement.

In most cases, physical therapy consists of manual therapy or manipulations to unlock the joints, especially between the tibia, fibula and the talus, but in some cases to heal the patients had to manipulate from the knee to the heel. It could use tapping, exercises to get strength back and balancing exercises.

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