Because sprained ankles are so common, every second person you talk to will have a different opinion on what is best and what you should do. So, to help you out we looked at the best research and summarized what is REALLY the best sprained ankle treatment so that there is no room for confusion.
Here is our infographic summary:
As you can see, almost all research papers that this systematic review looked at, agreed that physical therapy (physiotherapy) should be trialled before surgery. This is relevant for grade 1, 2 and 3 sprained ankles – so even the high-grade tears. Of course, every injury is different so there is always the exception to this but your physio can guide you better with that after a thorough assessment.
What we found interesting was that ankle braces are now being recommended for at least one-year post injury. They have also been shown over this time to effectively lower re-injury rates and should be a g-to sprained ankle treatment. It is also worth noting that certain treatments that are used very commonly such as ultrasound and manual therapy show little benefit – this isn’t to say that they offer no benefit, they just haven’t been proven to give statistically significant improvements – for some people that can really help and we find manual therapy is very effective for the sprains and fractures (when out of cast) that are particularly stiff.
You can check out one of our most popular posts on ankle rehab HERE. It details some great basic rehab exercises to help guide your ankle back to it’s best as this is far more beneficial than just resting the ankle. Resting won’t get your strength back, it won’t get movement back as effectively and can just lead to more dysfunction.
Takeaway point: Active rehab is the key to successful sprained ankle treatment.
Given the high frequency of ankle sprains in everyday life and dynamic sports such as basketball and volleyball, we decided to feature some summaries of research papers that show just how effective different sprained ankle treatments are.
Today we have a great infographic summarizing a systematic review (the highest level of evidence) that helps answer the question of how to how well do ankle braces really help prevent a sprained ankle:
This study effectively shows that ankle braces – lace-up braces specifically – are incredibly effective in reducing the number of sprains that occur in basketball and this can be translated quite well to assume that it has similar effectiveness to prevent a sprained ankle in other sports as well.
You can check out the abstract to the mentioned study here and if you need an example of a good lace-up ankle brace, here is a good example on Amazon of the DonJoy Ankle Brace
Knee cracking, popping and creaking are very common complaints but are actually nothing to worry about. Today’s post is an explanation of what causes the cracking in your knees, why it is no issue and what you can do to help it if it still gives you or a family member the heebie-jeebies…
What causes knee cracking?
Firstly, in the majority of cases, the cracking IS NOT FROM ARTHRITIS.
The most common cause of knee cracking or crackling are:
Gas bubbles within the main knee joint. We have a lubricating fluid within our joints called synovial fluid and within this can be gas bubbles. The change in joint pressures with movements of the knee causes these gas bubbles to move and pop – causing the cracking or popping noise
Fluid movement behind the kneecap causes more of a fine crackling noise when bending the knee back and forth
Another common cause of knee cracking is extra-articular (outside the joint) tendons or ligaments snapping back and forth over a knobbly bit of bone.(1)
Either way – these are not usually painful but if you are getting pain with you knee cracking then you should see a physio to get it assessed and treated.
The cracking can happen at any age but is more common as you get older and can be in one or both knees
Painful knee cracking
This is far less common but it can be caused by wear and tear (degeneration) of the cartilage and can be treated well with good treatment and rehab exercises – particularly if caught early, so if in doubt, go see your physio.
The video below gives a great explanation of crepitus and how it has no correlation to pain or pathology (Watch from 1 minute onwards)
How to decrease swelling and support your knee
For those that DO have painful knees, as well as seeing your physio, a compressive knee support can help a lot. There are two main types for you:
A slip on compression sleeve with patella support. Having support for the kneecap at the front helps maintain alignment and compression of the support is key for helping keep the knee warm and decrease fluid from swelling.
For those of you with large thighs, a wrap around knee support can be better fitting and more comfortable as the above braces and more cylindrical in shape and can slip or roll down.
Another great way to support the knee is to get the muscles around it stronger! A great place to start on that is some wall sits, which is a very safe way to lay a base of strength without aggravating any knee pain. Check out more on that here
Many people will suffer from back pain in their lifetime. A recent study found that over 80% of Americans will have back pain at one time in their lives. The costs related to back pain amount to over $100 billion annually. This is due to a decrease in wages and the financial measure of productivity. Our spines and all the supporting factors (muscles, tendons) can only take so much abuse. Yoga for back pain can be very effective in decreasing the need for medication and regaining function.
Lower back pain is caused by many things such as poor posture, constant motion in repetition, or even aging. It’s caused by the discs between vertebrae drying up. They can bulge or rupture as well which presses on the nerves. This is sometimes the pain you’ll experience. It’s been found that stretching daily can prevent this from occurring and relieve symptoms.
Yoga for back pain can help align your spine and pelvis, it allows the muscles to relax which makes your body more resilient. Yoga poses can ease the tension in your back. They also work on the system of muscles that affect posture and the lower spine. This includes easing tension in the hips, inner thighs, and hamstrings.
Yoga for back pain Instead of Medication
The Journal Archives of Internal Medicine found that those who do yoga are twice as likely to stop or cut back on pain medications. For those with severe back pain, yoga probably isn’t the right option unless you’re willing to go through yoga teacher training. You can cause yourself damage by doing poses incorrectly so getting educated on yoga is helpful if you want to take this route.
For those who suffer from everyday soreness due to sitting at a desk, there are postures that can lengthen the spine. This eases the pain while strengthening and stretching the muscle and will promote the alignment of the spine and pelvis.
FOR THE LOWER BACK
This gentle pose is great for beginners and quickly calms the mind. It opens up your back and stretches it out while relaxing the muscles.
How to Do Child’s Pose
Sitting on your heels, bend your body forward. Your arms should be stretched out in front of you and relaxed on the floor.
Bring your belly and head to the mat.
Breathe in deeply until you can feel the breath in your back. Stay in this pose for as long as you like.
Pigeon pose offers a deep stretch in the hips which could be causing your back pain. This hip tightness usually occurs from sitting at a desk for too long. When you deeply stretch the hip flexors, you effectively take pressure off your back.
How to do Pigeon Pose:
Start at table top (on your hands and knees)
Bring your right knee forward, behind your wrist.
Try to place your right ankle in front of your left hip. Where you place your ankle will dictate how deep the stretch is. Feel it out for yourself and adjust when needed.
Bring your left leg back so that it’s straight behind you, align your knee with your hip. Point your toes.
Another thing to be aware of is that your left knee might want to fall outwards. Make sure the heel is pointed up to the sky.
Focus now on keeping the hips square.
Bring your upper body down to the ground while keeping hips level. If you need a bolster to support this, go ahead and use it.
To get out of the pose, use your hands to push back. Lift your hips and move the legs back to table top.
FOR THE UPPER BACK
Snake pose helps stretch out your shoulder, upper back, glutes, ankles, and feet. As you open your chest, you counteract the slouching of sitting for long periods.
How to do Snake Pose
Lie on your belly with your feet hip-width distance. Your arms should be by your side with your palms towards the sky.
Interlace your hands behind your back and press your feet into the mat.
Lift your chest on the inhale.
Exhale and bring your shoulders back further.
Keep your neck long and gradually go deeper into the stretch with a few rounds of breathing. Hold the pose for 5-10 deep breaths through your nose.
FOR THE WHOLE BACK
Downward Facing Dog
The downward facing dog does a lot of stretching in one pose. It is a pose you can do for instant relief and it counteracts any hunching of the back. It also cleanses your organs and helps the upper and lower back. You get a good hamstring stretch which is connected to the lower back. You also give the heart a break because you’re somewhat upside down. When you do downward facing dog daily, you help improve your posture.
You get a good hamstring stretch which is connected to the lower back and is great for taking pressure off.
Steps to do Downward Facing Dog
Start at tabletop with palms wide. Your shoulders should be stacked over your wrists.
Curl your toes under and walk the palms so they’re slightly in front of your shoulders.
Put weight on your palms as you raise your knees off the ground. Focus on trying to bring your stomach to your thighs.
Lift your hips high up into the air and imagine that you’re pushing your tailbone to the ceiling.
As you slowly make your way into the full stretch of downward facing dog, try to get your heels on the ground. If you’re new to yoga, give it some time but do your best.
For maximum benefit, hold this pose for up to 30 seconds and breathe deeply into the areas that you feel.
How often do I do the yoga for back pain?
It’s important to do these poses daily to really experience the results. Ensure that you consult your doctor to see if your type of back pain will be positively affected by a yoga practice. There are plenty of gentle poses that will both relax your mind and your muscles.
This is a guest post by Meera Watts
About the author:
Meera Watts is a yoga teacher, entrepreneur, and mom. Her writing on yoga and holistic health has appeared in Elephant Journal, CureJoy, FunTimesGuide, OMtimes and others. She’s also the founder and owner of Siddhi Yoga International, a yoga teacher training school based in Singapore. Siddhi Yoga runs intensive, residential training in India (Rishikesh, Goa and Dharamshala), Indonesia (Bali). You can follow her here:
The Quadratus Lumborum can cause some real grief through your back, buttock, hip, and groin but with the right management, exercises and self-treatment, you can be pain free – long term.
Where is quadratus lumborum pain felt?
You can see the pain referral patterns below for the deep (closer to the spine) and superficial fibers of the QL muscle. Referral from the quadratus lumborum can vary a lot between people due to this varied referral pattern, in some, it can be a literal pain in the butt and others it is the side of the back, hip or the groin.
You can easily see from the video below that is the quadratus lumborum tightens up, it can pull at your bottom ribs, vertebrae or pelvis and if this happens one side more than the other, it can lead to some real asymmetry and not just cause back pain but a whole raft of other things.
How can a tight quadratus lumborum effect you?
Apart from being painful, it can also increase the load on quite a few other structures. Often when one side tightens up it can lift that side of your pelvis a little making you feel out of place or out of alignment (even though your back can’t go out of place,1). It can also pull at your ribs, tilting you to the side, limiting your reaching and restricting your breathing. And last but not least if the QL is tight on both sides, you get more compression on your spine.
The QL can also:
Cause a sharp stabbing pain in the low back
Cause pain and limitation when trying to turn in bed or stand from sitting
Make it look like you have a leg shorter than the other by holding one side of your pelvis higher
Contribute to a lot of other issues such as patellofemoral pain, trochanteric bursitis and scoliosis due to asymmetrical tension
So how do we fix it?
In three steps:
Ease the pain by decreasing tension by releasing the muscle (stretching often doesn’t help)
Get you back to normal by regaining full range of motion through your back and hips
And finally, treat the cause by improving strength of the QL so that it can handle everything you throw at it
1. Ease pain
For this, we need the muscle to relax so the most important thing is reducing aggravating activities and applying heat. Heat can be applied be a wheat bag, hot water bottle, heat rub or anything similar, it will make a big difference. Of course make sure you don’t make it too hot or hurt yourself, by following the instructions.
Also, you can directly release the quadratus lumborum, which is far more specific than stretching. Check out our past blog post to learn how to do a myofascial release for your Quadratus Lumborum.
2. Regain normal range
We need to now get everything back to normal – not just the quadratus lumborum but the muscles that have changed because of the asymmetry that the QL caused. The following stretch is perfect for this, just remember to relax into it and that it isn’t, no pain-no gain.
Gluteal stretch: This will help even you out and regain hip range
Now get you quadratus lumborum stronger so that it can handle what you want to be able to do. A stronger QL means less pain and you have more control and power, without having to avoid things constantly.
To load the QL, we need to load the side of your body and the best way to do this is the side planks and the one sided farmers carry:
Side plank Level 1
Hold for up to 1 minute. Once you can do that comfortably, progress to level 2 below.
Side plank Level 2:
In the side plank, raise your top leg up and down up to 10 times. Repeat 3 times each side.
One sided farmers carry:
Hold onto a dumbbell, kettlebell or anything with a bit of weight to it in one hand and do some laps (e.g. 10 x 10m laps on each side).
Carrying a weight on one side makes the QL and obliques on the opposite side work hard to keep you upright.
Note: Don’t do two sided carry like in the picture!
Tip: try to stay upright!
And that’s it.
Work at that most days and notice the results.
On a side note, once you are feeling improved, don’t slack off on the exercises, they are great to do just to maintain yourself in great condition, even if it is just three times per week.