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Ankle

The Top Sprained Ankle Treatment | Infographic

December 8, 2017 • By

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:

Ankle sprain treatment

Explanation:

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.


Ankle

Do Ankle Braces Prevent a Sprained Ankle? | Research Round-up

December 6, 2017 • By

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:

ankle brace for sprained ankle running

 

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


Ankle, Health

Ankle pain, The Best 3 Support Braces

August 2, 2017 • By

Our ankles get little reprieve and time to rest so when we get ankle pain we need a way of looking after them while keeping going. We have outlined the best supports and given a guide so that you can find the perfect support for your ankle pain.

Recent research has proven beyond a doubt what the best thing is for ankle pain and it isn’t what everyone would think. In the past, the need for rehab and strengthening ankles up has been pushed as the most important. But actually, what has been shown to be even more effective in recent research, is wearing an ankle brace.(1

Here is a quick summary of the study from YLM Sports Science

Ankle pain support

Why do braces work so well for ankle pain?

They support you, allowing you to keep moving. That is the key.

Often when we have ankle pain, we aren’t as active, we start walking differently and avoid certain activities. But, with the right support, we avoid the muscle dysfunction and stiffness that comes from this. That is why ankle braces and the most popular item in most physical therapy clinics and that is why you have nothing to lose and everything to gain in getting one for yourself.

We have put together a guide for you below of the different types of ankle support to help you decide on what is best for you:

TypeLevel of supportUsed forLink to example product
Compression sleeveMild support- Ankle pain
- Compression in early stage rehab
- Reduction of swelling
- Mild ankle sprains
- mild instability
Support with strapsModerate support- Ankle pain
- Maintaining warmth
- Moderate support
- Mild instability
- Mild and moderate ankle sprains
Lace-up ankle braceComprehensive ankle support- Moderate and severe (grad 2 and 3) ankle sprains
- Moderate to severe ankle instability
- Dynamic sports

For those of you that don’t have a lot of room in your footwear, there are types of low-cut and low profile ankle braces like THIS Mueller brace that are also a great option.

Further information on ankle pain

For those of you that are information orientated, we have decided to go more in-depth into the many causes of ankle pain, why it can hang around and the many more things that you can do to help it as the more we can do to get rid of ankle pain faster, the better right?

Causes of ankle pain:

  • Tendinopathies: Overload injuries to the tendons around your ankle is common, including peroneal tendons, Achilles tendinopathy and more. Note tendonitis is a common term that is still used a lot but research over the last 10 years has shown that the majority of tendon overuse injuries are not inflammatory after the first 1-2 weeks.
  • Broken ankle: Following ankle fractures and subsequent casting you can be left with stiffness and pain for up to a year. An ankle support can really help with this as well as stretching if you don’t have the full range. You can test your range with an easy test in our past blog post here
  • Arthritis: The top two braces above can help a lot with this as they maintain warmth of the joint
  • Plantar fasciitis

The majority of ankle pain can be helped with decreasing the aggravating activity, supporting the area well and strengthening the ankle back again and there are a lot of great exercises in our past blog posts like THIS one that is great for not just ankle sprains but all sorts of issues down below!

Information on ankle sprains

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 ligamentsQuick 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 returns to sport and activity within 6 weeks.


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 some one leg standing and toe balance on one of my favorite rehab equipment: a BOSU Ball

 

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 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 retraining your balance decreases your chance of re-injury by 22-33% – nothing to scoff at right!(5)

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

 

Return to Sport:

As a simple rule, once both sides are even, you can get back to training and playing. So to test yourself out, see how far you can single leg jump and make sure both legs are within 5cm of each other and then do the X-excursion exercise as above and again, make sure both sides are within 5cm of each other. If they aren’t even, keep working at it.

Also if you are returning to sports such as basketball or volleyball etc that reuqire a lot of jumping, twisitng and hopping, or if you have sprained your ankle more than once, it is definately worth yor while looking into getting a good lace-up Ankle Brace.

 

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!