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Ankle, Core strengthening, Health

Level 3 Ankle Sprain Rehab – Heal strong and fast

November 16, 2014 • By

Anmle excursion exercise, balance rehabThese are the rehab exercises that you need to get your ankle 100% and to minimize chance of re-injury which is far too comon. This ankle sprain rehab is aimed at improving range, balance and strength with simple, effective home exercises.

Too many people simply sprain re-injure their ankle is the full rehab isn’t followed through with and actually 33% still have pain remaining after one year! And on top of this, a history of ankle sprain ( you have injured it before) is the single most predisposing factor for ankle injury.(2,4)

This means after you have an ankle sprain it is very important to rehab it right as you have a high chance of ongoing symptoms and re-injury. And remember the research shows that the majority of grades I, II and III lateral ankle ligament ruptures can be managed without surgery – so get started as soon as possible for best results.(3)

In earlier posts covering the Level 1 and Level 2 rehab stages I have outlined the best exercises and self-treatment to help you heal strong and fast.

Quick test:  here is a great little test to see if your ankle range is back to it’s best. The other easy test to see if you need to do the level three exercises is to balance on the balls of your foot, one leg at a time – you should be able to do this for at least 30 seconds and you should be even between legs.

 

Grade 3 ankle rehab has 3 main goals:

  • Achieve full range of motion
  • Have good ankle  and leg control through this range
  • Full strength of the ankle stabilizers

To get there, here are the exercises that you need to do:

1. Toe balance

ankle sprain balance exerciseankle sprain balance exerciseThis is a great balance exercise to strengthen your ankle in this vulnerable position and better yet, it is simple and you can do it anywhere.

Stand on the ball of your foot. You will most likely need to start with one finger on the wall for balance.

Goal: 1 minute each side

Make it harder: Do this on a rolled up towel, bosu ball, foam etc.

 

2. X excursion exercise – Balance re-training

This exercise has come about from a well used test within the health industry – the Star Excursion Balance Test. The great thing about the tests we use as physiotherapists is that they really do challenge you, which make them great as exercises also as if your body is challenged, it is going to adapt to improve.

 

3. Ankle stretch

Ankle stretch exercise

Along with the classic calf stretch, this one is great for getting full range in your ankle and making sure your you are even.

Hold for one minute.

 

 

 

 

 

4. Ankle self mobilization

 

 

Putting in the time to rehab your ankle fully is so important, not only will it decrease or get rid of any pain but it will improve your mobility and performance. Even just working on your balance retraining decreases chance or re-injury by 22-33% – nothing to scoff at right.(5)

So write the exercises down, favorite this post and make it a routine.

Yours in health,

Shaun


Ankle, Health

Quick Ankle Range Test – Must Know for any Athlete

September 22, 2014 • By

how to improve ankle flexibilityThere are very few tests which are proven predictors of injury AND are accurate on anyone. Whether you’re an amateur, weekend warrior or a pro, good ankle range is a must for many basic movement patterns – this post will benefit you all.

 

If you want to go straight to the ankle range test – skip down the page to The Test.

 

Limited ankle range – namely ankle dorsiflexion, which is where your foot bends up towards your shin, like at the bottom of a squat – affects many of our everyday movements and activities, such as squats, climbing down stairs, landing from and jump and even walking.

Having limited ankle ROM can and will lead to injury.

After a “battery” of musculoskeletal tests, this study found that only ankle dorsiflexion range of movement, measured using the weight-bearing lunge test (what I am showing you today), was significantly associated with sustaining a lower extremity injury. Just a few of these injuries are:

How does a stiff ankle contribute to so many problems? Having one part of the kinetic chain limited, means that other parts (e.g. plantar fascia, hip flexors) need to absorb this lack of flexibility OR you start doing things differently – compensatory patterns, to ignore this problem. It’s unlikely that you would even realize that this is occurring – which is why doing this test regularly is so important! Having limited ankle dorsiflexion has even been shown to be a real risk factor ankle sprains – Which, as we know, are VERY common.

Examples:

1. Compensatory movements

  • Early heel lift (1)
  • Excessive pronation
  • Knee hyperextension

2. Overloads other structures

  • Plantar fascia – Simply due to the heel coming off the ground early – putting earlier and greater stretch on the tissue on the bottom of the foot
  • Knees – Due to hyper-extension and over-pronation of the foot
  • Hips – The hips can actually really affect the ankle, so it works both ways

So what is this all-powerful test?

The Test

As mentioned above, this test is something special. It easily shows whether you are at risk of lower limb injury. It is very reliable and accurate, even when done by novices, AND it is one of the most common tests used in Physiotherapy. The standing lunge test – Also know as the knee-to-wall test – Is demonstrated in the image below: easy ankle range test - ankle stiffness can cause injury Now – If your range is LESS THAN 10cm, that is not good enough and needs to be worked on. Note: if you are naturally a very flexible person, you should be aiming for 15cm. In the next couple of weeks I will be posting on HOW TO IMPROVE your ankle range with three easy self-treatments – So keep in the know by subscribing to email or via social media.

You cannot go wrong with this test as it is very reliable, standardized and easy to test

– and then re-test down the track after you have been working on it!


Ankle, Health

Sprained Ankle Treatment – Rehab Exercises Level 2

September 30, 2013 • By

sprain strain self treatment ice rest compressSprained ankle treatment: How to get a stronger ankle, recover quicker and get back out there faster and better than ever!

Following on from the level 1 ankle sprains post about what to do in the first 72 hours, here we will cover a comprehensive rehab regime that will help you recover in weeks, not months.

Sprained ankle treatment needs to include:

  • Range of motion exercises
  • Proprioception exercises
  • strengthening exercises

And most importantly these need to be gradually progressed so that your body is challenged just enough! Your body adapts to the forces that go through it, so if you challenge that ankle sprain (or any other part of your body) it will adapt and be better for it!

Proprioception Retraining: Proprioception is the ability for you brain to know where you body is in space. If this is decreased, you have poor balance and increased chance of re-injury. Sprained ankles are the worst injury in the body for impaired proprioception and needs to be addressed. If you aren’t sure what proprioception is – extend one arm out to the side, close your eyes and mirror it exactly with the other arm – you could do this with your eyes closed because of your proprioception.

sprained ankle rehab exercises1. Single leg standing (SLS): Begin by standing on one leg on a solid surface (you can put one finger on the wall for balance if you need to start with) and aim for 1 minute.

When you can do this comfortably for 60 seconds, step it up by:

  • SLS on a folded up towel. A Folded towel is great to use as you can easy progress this by doubling it up again and again and then finally rolling it up to make it much harder. Progressing each time when you can easily do it for 60 seconds. NOTE: Have a bench in front or to the side to grab onto if need be – but only if you have to!
  • You can also use Wobble boards, Bosu balls and balance boards when towels become too easy (or boring!)

 

Restoring Full range of Motion:

calf stretch , soleus, gastroc - self treatment for shin splints2. Calf Stretch within a pain-free range – The best way to do this is by dropping your heel of a step and holding for 1 minute as shown in the picture to the right.

3. Lunge Stretches and accessory glides – See this video for great mobilization techniques. Remember not to push into too much pain!

 

Strengthening:

4. Heel Raises (calf raises) – Begin using both feet and progress to one foot as pain and strength allows. Perform 30 with one finger against a wall for balance.

Single leg Squat, hip stability and strength5. Single Leg Squat: As soon as you can, begin doing these to maintain and increase the strength in your entire lower limb! do 2 x 12 on each side and begin by only bending a small distance – Give it a go!

6. Ankle Eversion Training – See this video on how to do this important exercise with a Theraband or similar elastic band.

Stick to this Rehab program for the full 6 weeks for best results and make sure to keep challenging and progressing yourself!

For more rehab exercises and tips and to really fine tune your ankle, check out the Level 3 ankle rehabilitation. Research based and very easy, with great results.

 

Let me know how you get on with your sprained ankle treatment and please Like and Share!

 

 


Ankle, foot pain, Health, Lower limb

Sprained Ankle – Heal Fast and Strong with Self Treatment

September 30, 2013 • By

Treating a sprained ankle the RIGHT way early on means a stronger ankle, faster recovery and less chance of re-injury. In this series I will tell you what a sprained ankle involves, the most effective self treatment and the best rehab exercises to get you back out there!

This post is Level 1 but when you need to step it up after the first 48-72 hours, switch over to the Level 2 and Level 3 rehab exercsies.

First of all, a little information about what a sprained ankle involves, but if you are in the know about Sprains already, skip the info and scroll down to Self – Treatment

Sprained ankles are known by a few different names:

  • Twisted ankle
  • Rolled ankle
  • Lateral ankle sprain
  • Inversion ankle sprain
  • And of course “Oh no!”

The most common type of sprained ankle is the lateral ankle sprain (85%), and that is what we are going to discuss and sort out today.

Mechanism of injury: The plain and simple is that a sprained ankle is typically when your foot is forced inward (inversion) and down at the same time (often when changing direction, turning and/or on uneven surfaces). This puts the ligaments under too much stress too fast which causes a tear of one or more of your ankle ligaments.

sprained ankle - lateral ligaments

 

Quick anatomy: The lateral (outer) ankle has 3 ligaments supporting, with the weakest of these (and so most often injured) being the ATFL. The ATFL is the Ligament at the front of the ankle shown here and in most simple sprains, this is the one torn with or without the ligament below it.

 

Sprained ankle recovery time: The general recovery time is 2-6 weeks (if looked after properly) and keep in mind, even if it feels bad now, if you do all the right things you will be one of the 95% who return to sport and activity within 6 weeks.

 

Not taking ankle rehab seriously often leads to far too many chronic ankles, long-term disability and other injuries so YOU NEED TO TAKE THIS SERIOUSLY!

Note: it is important to rule out fractures early on. An accurate way of doing this is using the Ottawa ankle rules, or going to see your local Physio for a quick assessment – These rules are great for minimizing unnecessary X-rays.

 

Self – treatment

Initial management: In the first 72 hours it is very important to follow the RICE and HARM principles – This will take weeks off your recovery.

DoRICE injury treatment, heal strong and fast: RICE

  • Rest – From running etc.
  • Ice – 10 minutes at a time, no more, every hour you are awake.
  • Compression – Eg Tubigrip.
  • Elevation – Get your foot above your heart when possible.

Don’t: HARM

  • Heat
  • Alcohol
  • Running
  • Massage

HARM increases blood flow to the area, worsening inflammation and so causing more secondary damage and a longer healing time.

Keep moving (within reason of course) – It is important not to baby sprained ankles and start weight-bearing through them as soon as possible to normalize movement and decrease loss of muscle activity. If necessary you may need to be on crutches for the first 24 hours (if very painful and you really have tried to walk on it) then move to partial weight-bearing and then full weight-bearing.

Foot paddling is a great exercise to do in these early days – In sitting or lying, simply point your toes up then down repeatedly in a pain-free range. You can try doing small circles with your foot also, remembering not to push into pain. Do this every 1-2 hours (little and often)

Footwear: Wearing good supportive footwear with heel and arch support(such as your runners) is great as this takes the pressure off the injured ligaments and lets them heal well. DO NOT WEAR HIGH HEELS (Please!).

 

AND THEN: After the first 48-72 hours of doing this, click over to rehab exercises and get started rehabilitating your sprained ankle! And remember you still use ice after the first few days whenever it is sore or swollen.