Ankle Injuries
The ankle joint is one of the most commonly injured joints in the body. There are ~ 1 million ankle injuries that occur every year in the United States and ~85% of them are ankle sprains. The ankle joint consists of 3 bones: the tibia (shinbone), the fibula, and the talus bone of the foot. Movement at this joint is plantarflexion or pointing of the foot down and dorsiflexion or bending the foot towards the body. This joint movement allows for energy absorption and transference allowing us to walk, run, and jump.
SPRAINS: An ankle sprain is an injury to the ligaments of the ankle. Ligaments connect bone to bone and provide stability to our joints. When an ankle sprain occurs, the ligaments are overstretched and sometimes torn. A sprain can involve one or more ligaments. The more ligaments involved, the more disability that can occur. The majority of sprains involve the outer portion of the joint when the foot rolls inwards, this is called an inversion/lateral ankle sprain. A sprain can also occur to the inside portion of the ankle joint, however this is not as common because the inside ligament is much stronger than the outer ligament. Sprains occur at varying degrees - Grade I to Grade III. You may experience minor pain and swelling that seems to go away quickly within 5-7 days (Grade I) or the injury could result in swelling, bruising, and difficulty placing weight on your foot while walking and standing (Grade III). Grade II sprains usually heal completely with treatment in 6-10 weeks. A Grade III sprain, with or without surgery takes about 3-4 months to fully heal. The weakened ankle ligaments, no matter the severity, decreases the stability of the ankle which can predispose the ankle to recurrent sprains. If you have had one sprain, no matter the severity, you are highly likely to endure recurrent sprains if you do not get the treatment that is needed to stabilize the ankle joint.
When the injury first occurs, the old saying “RICE” still stands true. This stands for rest, ice, compression, and elevation. Another important intervention is to protect the ankle while recovering from injury. This will decrease the swelling and pain allowing the ligament (s) to sufficiently heal. When the swelling and pain are well controlled, range of motion exercises, i.e.writing the ABC’s with your foot, should be initiated. Advanced strengthening, stretching, and proprioception exercises are then recommended to perform. An exercise program should be developed and progressed according to each person’s individual limitations and should be closely monitored by a professional. Balance and proprioception exercises are added to the program in order to retrain the joint to stabilize when performing activities such as jumping or walking/hiking on uneven ground. This will assist with returning to your normal activities, whether that is a sport, hiking, running, or doing yard work.
There are several strategies to prevent an ankle sprain. Wearing good shoes that provide support, stability, and grip to avoid slipping. Maintain or attain normal ankle, knee, and hip flexibility, muscle strength, and endurance. Improve your balance and proprioception. Improving your balance and your ability to stand and walk on uneven surfaces will help reduce the risk of injuring an ankle. Proper warm-up and stretching is always recommended before you participate in any activity.
Conservative management of this type of injury through Physical Therapy is important to ensure you regain your strength and range of motion and prevent further occurrences of the same injury. Leaving any degree of ankle sprain untreated, can lead to repeat sprains, chronic instability of the ankle, and/or anterior impingement syndrome of the ankle. Those who undergo a structured rehabilitation program are more likely to return to activity safely and in less time.
FRACTURES: If there are forces generated at the ankle joint that are higher than what the bones can withstand, a fracture occurs. A fracture can be a complete or incomplete break of either the tibia or fibula bone, or both. Fractures can occur from direct trauma to the ankle from an accident or a fall. They can also be from indirect stresses to the ankle through twisting, pivoting, or a volatile muscle contraction. In many cases, the severity of an ankle fracture may not be determined immediately. Reducing the swelling in the ankle allows for improved accuracy of the diagnostic imaging. Initially, the ankle is treated with rest, elevation, compression, ice and medication to reduce pain and swelling in the joint. The ankle may be immobilized by a boot, brace or cast allowing the bones to heal. Surgical fixation is another treatment option. The decision to need surgery is based upon the type of fracture sustained, the specific bone that is involved, if the bones are out of position, and the age and health of the patient.
To restore normal foot and ankle mobility, strength, and function, physical therapy treatments are recommended after surgical or non-surgical treatments of ankle fractures. Learning how to walk and run normally again, restoring normal balance reactions, and improving joint mechanics and mobility are the essential components of a skilled physical therapy program.
If you or someone you know has an ankle injury call AVORA Physical Therapy at (828) 505-2664 today!
SPRAINS: An ankle sprain is an injury to the ligaments of the ankle. Ligaments connect bone to bone and provide stability to our joints. When an ankle sprain occurs, the ligaments are overstretched and sometimes torn. A sprain can involve one or more ligaments. The more ligaments involved, the more disability that can occur. The majority of sprains involve the outer portion of the joint when the foot rolls inwards, this is called an inversion/lateral ankle sprain. A sprain can also occur to the inside portion of the ankle joint, however this is not as common because the inside ligament is much stronger than the outer ligament. Sprains occur at varying degrees - Grade I to Grade III. You may experience minor pain and swelling that seems to go away quickly within 5-7 days (Grade I) or the injury could result in swelling, bruising, and difficulty placing weight on your foot while walking and standing (Grade III). Grade II sprains usually heal completely with treatment in 6-10 weeks. A Grade III sprain, with or without surgery takes about 3-4 months to fully heal. The weakened ankle ligaments, no matter the severity, decreases the stability of the ankle which can predispose the ankle to recurrent sprains. If you have had one sprain, no matter the severity, you are highly likely to endure recurrent sprains if you do not get the treatment that is needed to stabilize the ankle joint.
When the injury first occurs, the old saying “RICE” still stands true. This stands for rest, ice, compression, and elevation. Another important intervention is to protect the ankle while recovering from injury. This will decrease the swelling and pain allowing the ligament (s) to sufficiently heal. When the swelling and pain are well controlled, range of motion exercises, i.e.writing the ABC’s with your foot, should be initiated. Advanced strengthening, stretching, and proprioception exercises are then recommended to perform. An exercise program should be developed and progressed according to each person’s individual limitations and should be closely monitored by a professional. Balance and proprioception exercises are added to the program in order to retrain the joint to stabilize when performing activities such as jumping or walking/hiking on uneven ground. This will assist with returning to your normal activities, whether that is a sport, hiking, running, or doing yard work.
There are several strategies to prevent an ankle sprain. Wearing good shoes that provide support, stability, and grip to avoid slipping. Maintain or attain normal ankle, knee, and hip flexibility, muscle strength, and endurance. Improve your balance and proprioception. Improving your balance and your ability to stand and walk on uneven surfaces will help reduce the risk of injuring an ankle. Proper warm-up and stretching is always recommended before you participate in any activity.
Conservative management of this type of injury through Physical Therapy is important to ensure you regain your strength and range of motion and prevent further occurrences of the same injury. Leaving any degree of ankle sprain untreated, can lead to repeat sprains, chronic instability of the ankle, and/or anterior impingement syndrome of the ankle. Those who undergo a structured rehabilitation program are more likely to return to activity safely and in less time.
FRACTURES: If there are forces generated at the ankle joint that are higher than what the bones can withstand, a fracture occurs. A fracture can be a complete or incomplete break of either the tibia or fibula bone, or both. Fractures can occur from direct trauma to the ankle from an accident or a fall. They can also be from indirect stresses to the ankle through twisting, pivoting, or a volatile muscle contraction. In many cases, the severity of an ankle fracture may not be determined immediately. Reducing the swelling in the ankle allows for improved accuracy of the diagnostic imaging. Initially, the ankle is treated with rest, elevation, compression, ice and medication to reduce pain and swelling in the joint. The ankle may be immobilized by a boot, brace or cast allowing the bones to heal. Surgical fixation is another treatment option. The decision to need surgery is based upon the type of fracture sustained, the specific bone that is involved, if the bones are out of position, and the age and health of the patient.
To restore normal foot and ankle mobility, strength, and function, physical therapy treatments are recommended after surgical or non-surgical treatments of ankle fractures. Learning how to walk and run normally again, restoring normal balance reactions, and improving joint mechanics and mobility are the essential components of a skilled physical therapy program.
If you or someone you know has an ankle injury call AVORA Physical Therapy at (828) 505-2664 today!