Ankle sprain treatment


Black and blue. Ouch!

(Keywords: ankle sprain treatment, chiropractic help, ankle exercises, plantar myofascitis, ankle joint pain)

Few of us will escape the need of treatment of a lower leg injury on one or another occasion. A soft-ball slide, standing unexpectedly on the edge of the pavement or uneven ground, can and does from time to time cause awesome injuries to the ankle. Note the swelling, and the bruising from torn tissues.

It could be from a fracture within the ankle, but more likely it is due to torn ligaments or tendons.

Like all sportsmen and women, I have had my shares of sprains and strains. Of the three major events I have experienced, sprained ankle, a calf muscle strain and a slipped disk ... the ankle was by far the worst. Perhaps only by a small margin, on second thoughts. That ankle sprain troubled me for six months in my pre-chiropractic days. Ouch!

Update: I wrote this page some five years ago. My recent run in with a femoral nerve damage must surely compete with that ankle injury, only it lasted two months under chiropractic care.

Worse, it disabled me. I had to give up squash for six months. And what cured it? This is dinkum, latent heat fusion ...


Chronic foot pain - plantar myofascitis

Treatment of a sprained ankle will include careful chiropractic management of any subluxation of the talus bone in the ankle mortise joint. Other joints in the foot, leg and even pelvis too, of course. During such a sudden sprain, a chain events often shakes up the whole spine. Thereafter ankle exercises are vital to prevent reoccurence and a future plantar myofascitis ...

Whilst sprained ankle often happens in sport, or stepping unexpectedly on the edge of the curb, never forget our CHIROPRACTIC HELP safety on the stairs page. In your own home it's paramount.

CHIROPRACTIC HELP Safety on the stairs ...



On a personal note...

I was playing an important squash match when, at full stretch, I put my foot clumsily into the crack between the floor and the wall. The stab of pain as my ankle turned was one of the most painful things I have ever experienced. Sadly, I had to concede, as there was absolutely no possibility of continuing the match.

Within half an hour the ankle was very swollen and the next day there was bruising spreading down into the toes. Those were pre-chiropractic days, and I had no idea what to do.

The only suggestion of the school nurse for ankle sprain treatment was to use ice. Placing weight on the foot caused sharp stabs of pain within the ankle, and I had to use crutches for a week.

The ankle was extremely unstable, and for about six months, it would turn suddenly and unexpectedly, with sharp pain, and swell just whilst walking on level ground. After a few months the side of my knee started to ache.

It's a myth that, if you can walk on the walk on the ankle, that nothing is broken.  Fortunately mine was not broken, though it should have been x-rayed.

What occurs in a sprained ankle?

  • First and foremost the talus bone, which connects the foot to the lower leg, subluxates. This is the cause of the incredibly sharp, stabbing pain.
  • Secondly, the ankle ligaments are frequently sprained , and may very occasionally completely rupture. Fortunately this is very exceptional. This sprain is the most likely cause of the bruising frequently associated with a sprained ankle.
  • Thirdly, the muscles or a tendon may be strained.
  • Fourthly, a fracture may occur, usually the lateral malleolus or the head of the fifth metatarsal (called a Jones fracture). The ligaments and tendons are so strong that the bone fractures before the ligament or tendon ruptures. This is called an avulsion fracture . Can you spot the fractures on these x-rays? Occasionally they may need to be pinned.

TIP: Every day is a good day to quit smoking, but particularly today - avulsion fractures in smokers usually need to be pinned. The bone doesn't get enough oxygen, so after 6 weeks when the cast comes off, if it's still not healed, you have an operation and another two months in a cast to look forward to. Your call.

Can you spot the Jones fracture (below) on the side of the foot? There is a little white marker. This has to be cast, or it won't heal. The first priority in the treatment of a sprained ankle is the management of any fractures obviously. There are very few chiropractors equipped to do this, though the introduction of the post-graduate FICS programme is changing that. (see below)

CHIROPRACTIC HELP FOR ANKLE SPRAIN TREATMENT

An x-ray is important before chiropractic ankle sprain treatment if there is any suggestion of possible fracture, as adjusting the ankle would obviously aggravate the condition.

  1. To facillate normal quick healing, the first treatment is to adjust the subluxated talus bone. This is not usually particularly painful, and can be done with a standard chiropractic technique. Restoring the normal biomechanics enhances the normal healing time.
  2. If there is fracture, usually of the large bony bump on the side of the ankle (called the lateral malleolus) or a bone on the very side of the foot (head of the fifth metatarsal), then casting of the ankle by an orthopaedist is recommended.
  3. Sprain and strain of ligaments and tendons is done using the standard RICE ankle sprain treatment method: Rest, Ice, Compression bandage, Elevate.

Usually more than one tissue is injured and unfortunately the treatment of one (eg a fracture) may contra-indicate the treatment of another (eg ice on the sprain, or adjusting the talus). Fracture will always take precedence. The talus can always be adjusted once the fracture has healed.

Sports chiropractic is now an integral part of the profession since the establishment of Federation International Chiropractic Sports ( FICS online ), a training course for chiropractors interested in treating sportsmen and women.

Rehab.

Ankle sprain treatment should ALWAYS include rehabilitation. Ankle exercises plus stretches plus ankle muscle strengthening. Otherwise another sprain is just around the corner and the likelihood of a nasty chronic plantar myofascitis!

A good ankle exercise stretch is simply to kneel on a carpet, with your toes pointed out behind you. Sit back on your heels, pressing them gently down towards the carpet. You should feel the stretch in the front and sides of the lower leg (not the calf).

Another essential stretch is for the Achilles / calf muscle complex. Stand about one metre from a wall, with one foot forward,knee slightly bent, and the other straight with the heel firmly on the ground. Stretch forwards, first with the leg straight, and then slightly bent.

Strengthening weak muscles and stretching damaged ligaments so they remain flexible, mobilising the subluxated joint, and finally re-establishing what is called "proprioception" are all important parts of ankle sprain treatment. Do it! Wobble boards are important aspect of chiropractic ankle exercises ... are easily available, and really make a difference. Ask your chiropractor where you can buy one locally, or very easy to turn on a lathe if your are at all handy. 

Whilst not every sprained ankle necessarily needs professional care, I am finding more and more patients complaining of foot and ankle pain, such as plantar myofascitis, that has its origins in a long forgotten sprain sprain (years ago). When in doubt, treatment of a sprained ankle should include a chiropractic examination. If a subluxated Talus bone or a subtalar joint dysfunction, for example, is not corrected, it will alter your gait and inevitably leads to changes in the foot.

This is particularly true if you are a sportsman and woman - footflare occurs and your performance will drop off. Plantar myofascitis often has its origin in a long forgotten injury that really should have had ankle sprain treatment.

An aside: A report in a geriatric medicine research journal reveals that older persons who do balance exercises every day (such as a wobble board, though just standing on one foot makes a good start) are much less likely to fall and break a hip or crack their head on the floor, the most common cause of death. When you're done with your wobble board, give it to mum for a birthday present. She will bless you in time. Tell her to be careful, or she may be needing ankle sprain treatment!

For more interesting cases from the Chiropractic Coalface, click here: CHIROPRACTIC COALFACE ...

Arthritis

Severe disabling arthritis of the ankle is less common than in the knee and hip, however it remains a regular challenge in every chiropractic clinic periodically. Invariably, it's an old sprain or fracture that was not well managed with the proper ankle sprain treatment; the hyaline cartilage degeneration is often accompanied by obesity, perhaps in part the cause, often the result of the disabling arthritis from the original injury.

If you can't walk regularly because your ankle hurts, you're likely to put on weight, further aggravating the problem. Worse, how fast you can and do walk, research proves, will directly affect your longevity.

Joint distraction is one excellent option for advanced arthritis in the knee or ankle.


Useful links

Choosing the right shoes is vital if you plan to walk or jog safely after your Chiropractic Ankle Sprain treatment. A firm strap around the heel helps to prevent pronation, and a solid rubber heel reduces shock to the cushioning under the foot. If you have a tendency towards flat feet, make sure there is good arch support to prevent pronation.

At this site you will get some straight forward advice in what is really quite a difficult topic. Ankle sprain treatment begins with the best walking shoes ...


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What Other Visitors Have Said

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Interesting challenges of the day

1. Mr B  came initially for a painful and stiff neck and then asked whether chiropractic could help the cold numb feeling running down the side of his thigh for six months. Meralgia paresthetica is a double crush syndrome with the nerve affected in the back and groin. He's 80% improved after five treatments.

2. Mrs C has a long history of severe, disabling migraine headaches since having her wisdom teeth removed. She clenches her teeth at night. After six treatments she has no migraines but some jaw joint discomfort remains; a bite plate is in the offing.

3. Mrs U has the trophy for the worst back this year. After major surgery with plates and screws two years later she still had paresis in the lower leg and severe disabling back pain. She's doing far better than expected, in no little part due to a lift in her shoe for a very short leg.

4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.

5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.

6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of her foot. It started after a long drive in the car. After six treatments she is 60 percent better, but it's slow and is going to take the full 6 weeks to heal.

And now a setback, after lifting her child she now has leg pain. It's going to the be difficult.

7. This lady is a 70 year old woman, is on maintenance care for a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection after a total shoulder replacement. After four operations he is incapacitated.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. This man is a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. I reassured him it's not hip arthritis.

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mr C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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