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Ankle, Health

The Ultimate Sprained Ankle Rehab: Heal Fast and Strong

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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 will take you through early, middle and late stage rehab exercises as well as self treatment advice for a lateral ankle sprain so that you can get on with life. Alternatively, you can skip the hassle and get all the extras in one document by downloading our comprehensive Sprained Ankle Recovery Guide


Stage 1: Acute Ankle Sprain, the First 72 Hours

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
  • Torn lateral ankle ligament

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. The other 15% is made up of high ankle sprains and medial ankle sprains and the advice below is quite effective for those injuries also.

As with everything on this website, the rehab regimen does not claim to replace or be better than the best practice of going and seeing a doctor or physical therapist.

Mechanism of injury:

The plain and simple is that a sprained ankle is typically when your foot is forced inwards (inversion) and down at the same time.

This often happens 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 Anterior Talofibular Ligament (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). 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.

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. If clear of fracture, conservative rehab is typically the way to go – surgery is rarely needed or the first port of call (1).

YouTube player

Sprained Ankle 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.

Summary:

  • Do POLICE
  • Don’t HARM
  • Protect
  • Keep Moving
  • Foot Paddling
  • Footwear

1. Do: POLICE

This has changed from the previous RICE recommendation, see more on this HERE.

POLICE acute ankle sprain treatment heal fast

Note: Don’t wear compression at night time

2. 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.

3. Protect:

Braces have been proven to reduce re-injury rate and improve recovery so check out your options here. Using a functional ankle brace at all times during the day is now a go-to treatment for sprained ankles for the first 6 weeks and then up to a year after injury as needed.

You can see an update on the Clinical Best Practice Guidelines from the British Journal of Sports Medicine HERE if you want more detail on that. Basically, Lace-up ankle braces are a brilliant way to protect the ligaments and reduce re-injury rate and preferred over moon boots or nothing.

4. Keep moving (within reason of course)

It is important not to baby sprained ankles and start weight-bearing through them as soon as possible. This helps to normalize movement and decrease the loss of muscle activity.

If necessary you may need to be on crutches for the first 24-72 hours then move to partial weight-bearing and then full weight-bearing.

5. Foot paddling

This 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, remember not to push into pain. Do this every 1-2 hours (little and often)

6. 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!).

Now that you have taken care of your sprained ankle in the first 48-72 hours by doing everything mentioned above. Let’s start on the next stage below.

You can download our comprehensive Sprained Ankle Recovery Guide, with all of this great information.


Stage 2: Early Rehab and Sprained Ankle Treatment

sprain strain self treatment ice rest compress

How to get a sprained ankle stronger, recover quicker and get back out there faster and better than ever!

Note: You still use ice after the first few days whenever it is sore or swollen.

Following on from the stage 1 rehab (above) about what to do in the first 72 hours, here we will cover a comprehensive rehab regime that will help the majority of you recover from an ankle sprain in weeks, not months.

Your body adapts to the forces that go through it. Progressively load your ankle, it will adapt and be better for it!

Sprained ankle treatment needs to include:

  • Proprioception exercises
  • Range of motion exercises
  • Strengthening exercises

1. Proprioception Exercises: Retraining for a sprained ankle

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.

Note: 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 exercises

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 performing 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!)

2. Range of motion Exercises

calf stretch , soleus, gastroc - self treatment for shin splints

Calf Stretch

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. Make sure this stretch is within the pain-free range.

Lunge Stretches and accessory glides

See this video for great mobilization techniques. Remember not to push into too much pain!

3. Strengthening Exercises

Heel 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. Also known as Calf Raises.

Single leg Squat, hip stability and strength

Single Leg Squat/Pistol Squats

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!

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!


Stage 3: End Stage rehab – “Bulletproofing” after an Ankle Sprain

Research-based and very easy, with great results

You can also head over to our rehab guides page to get all three levels and much, much more in an eBook!

Anmle excursion exercise, balance rehab

These are the rehab exercises that you need to get your ankle 100% and to minimize chance of re-injury which is far too common.

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!.

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)

Our bodies are great at healing by themselves but if you don’t push your ankle to regain strength and range – you leave yourself at high risk of re-injury

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. 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)

First, Some Quick Tests:

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.

Stage 3 ankle sprain 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:

Toe balance

ankle sprain balance exercise

This 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

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.

YouTube player

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. This only needs to be done if you can’t point your foot down evenly after 6 weeks – you don’t need to do it earlier.

Hold for one minute.

Ankle self-mobilization

YouTube player


In Conclusion

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 require a lot of jumping, twisting and hopping, or if you have sprained your ankle more than once, it is definitely worth your while looking into getting a good lace-up Ankle Brace.

Yours in health,

Shaun


Ankle, foot pain, Health, Lower limb

Sprained Ankle – Heal Fast and Strong with Self Treatment

• 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 exercises. Alternatively, you can skip the hassle and download our comprehensive Sprained Ankle Recovery Guide

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 inwards (inversion) and down at the same time. This often happens 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). 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.

 

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.

 

Sprained Ankle 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.

Do: POLICE

This has changed from the previous RICE recommendation, see more on this HERE.

POLICE acute ankle sprain treatment heal fast

Note: Don’t wear compression at night time

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.

Protect: Braces have been proven to reduce re-injury rate and improve recovery so check out your options here

Keep moving (within reason of course) – It is important not to baby sprained ankles and start weight-bearing through them as soon as possible. This helps to normalize movement and decrease the loss of muscle activity. If necessary you may need to be on crutches for the first 24-72 hours 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, remember 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 the next stage of rehab exercises to get started rehabilitating your sprained ankle or skip the hassle and download our comprehensive Sprained Ankle Recovery Guide.

 

And remember you still use ice after the first few days whenever it is sore or swollen.

 


Foot pain

Fasciitis Treatment: A Physios Guide to Fixing Heel Pain

• By

Do your heels hurt from a lot of walking or running? Or have you been told that you have plantar fasciitis or a heel spur? Well, you are certainly not alone!

We have developed this comprehensive guide to give you the what, why and how to help fix plantar fasciitis.

What does the plantar fascia do

The plantar fascia is a strong band of connective tissue that starts at the bottom of your heel and runs along the bottom of the foot, attaching into the toes.Think of it like a big strong rope that supports your foot and helps you move.

It is important for:

  • Maintaining your arch when walking and running
  • Stabilises your arch: As you push off your big toe, the fascia is put on more stretch, which lifts up the arch into a more stable position so you can propel yourself forward. This is called the windlass mechanism. You can see in the diagram below how when the big toe is pushed up, that pulls on and tightens the fascia, lifting the arch up. For more info on the windlass mechanism, you can see this previous post.

plantar fasciitis treatment exercises

What is plantar fasciitis

In a nutshell: It is a thickening of the plantar fascia due to overload.

A massive 4% of the population over 20 have plantar fasciitis and it is a massive cause of loss of function. It is essentially an overload injury where multiple factors combine to increase the load/pull on the fascia. This overload combined with not enough time for the tissue adapt leads to mal-adaption.

Essentially, it adapts wrong and ends up getting thicker and dysfunctional.

Other common names of Plantar Fasciitis

  • Plantar fasciopathy or fasciosis
  • Plantar heel pain

Is fasciitis inflammatory?

No. There has been shown to be some inflammation early on in the pathology but on the whole, it is not an inflammatory injury after the first 1-2 weeks.

This is why over the last ten years, a lot of the medical profession and research down around this condition have been leaning towards calling in plantar fasciopathy, not fasciitis. For now though and the purpose of this article, we will continue to call it fasciitis for continuity. (1)

Fasciitis symptoms

  • Pain upon waking and taking your first few steps –This startup pain” is because your plantar fascia and calves have been in a contracted, shortened position all night.
  • Sharp stab or a dull ache in your arch or at the heel.
  • Pain after long period sitting.
  • Pain that eases gradually in a walk or run as it warms up

Risk factors for Plantar Fasciitis

  • Limited ankle or big toe range of motion
  • High body mass index/Overweight
  • Older age,
  • Prolonged standing.

The best Plantar Fasciitis Treatment

Nplantar fasciitis treatmentow that you know the what, why and how of how fasciitis can happen, we can move on to the main thing. How you can help your plantar fasciitis get better, faster.

These are the main things that need to covered in a comprehensive treatment of plantar fasciitis

  1. De-load the fascia through alteration of exercise or load
  2. Support the foot and fascia
  3. Improve strength of the calf muscles for better control and shock absorption
  4. Reduce the pull on the plantar fascia by
    1. Improving flexibility in the calf and plantar fascia
    2. Improving ankle dorsiflexion range if needed
  5. And last but importantly, we gradually load the plantar fascia to re-align the fibres and get rid of the thickening

Here are those steps laid out in far more detail:

1. Reduce load

Plantar fasciitis happens from the repeated load on the plantar fascia without enough recovery. So, simply, to help give it a chance to recover, we need to reduce the weight bearing load to a degree. It isn’t about stopping completely, that is barely ever needed.

For Plantar Fasciitis, it is all about the relative rest

This means resting the fascia, compared to what it has been doing and what overloaded it. For example, if you were running 5 or 6 days a week, you could cut that down to 3 times per week, every second day. There isn’t a set exact guide for this but the big thing is to listen to your body. If you have more morning pain the next day then ease off a bit more and don’t do quite as much.

Not satisfied with decreasing your running or walking or too sore to keep going? Then on the rest days or as an alternative, try getting on a bike or rowing machine and get your exercise in another way.

2. Support the foot

Helping support under the plantar fascia and encouraging good foot motion can be great for relieving pain when you have plantar fasciitis. There are a few options to help here including:

  • Orthotics – These help support the medial arch and cushion the heel and are recommended for up to 1 year
  • Gel heel pads – Great to help reduce impact and give a soft surface for your heel
  • Fasciitis compression sleeves – These great socks can mimick arch taping really well and we have found they can give patients great relief

3. Improve strength

Studies have shown that people with plantar fasciitis have calf weakness, as well as ankle and calf tension2. This can increase load and contribute to fasciitis as the calf is then absorbing less impact and there is less control.

Strengthening the calf is important but often when the plantar fasciitis is irritated, it can be too sore to do. Never fear though, we have provided a couple of different levels of strengthening for you to work at daily:

level 1: Theraband Calf Strengthening

As per the picture below, push your foot down again a resistance band (TheraBand for example) and then control back up.

Repeat this for 3 sets of 12 repetitions and adjust the tension of the band to make it easier or harder

calf stengthening for plantar fasciitis

Level 2: Heel raises

Starting on two feet, and holding onto a wall if needed for support, raise up onto your forefoot as shown and then slowly control back down over three seconds.

Do this for 3 sets of 12 repetitions and when that is easy, start doing them on one leg at a time.

Note, if there is more than a little pain then start with level 1.

Calf raise, calf exercise, heel raise

4. Reduce the pull

Both the calf and the plantar fascia attach onto the heel and some fibres of the Achilles tendon actually wrap around and attach to the plantar fascia. So it makes sense that any tension in the calf, plantar fascia or ankle can increase the pull at the heel and worsen fasciitis.

Here is a quick test t see if you have enough ankle range:


easy test to measure your ankle range

If you can’t get your knee touching the wall when your foot is 10cm (4 inches) without your heel coming off the ground then you have some work to do! Here are the top three exercises to regain ankle range and reduce plantar fascia and calf tension:

1. Ankle mobilisation

Improve the dorsiflexion range in your ankle if you failed the ankle range test above. See the video demo below for an easy ankle self-mobilisation at home. Alternatively, if you don’t have a band (you can get one here if needed), you can lunge your knee back and forth towards the wall for about 3 sets of 20 reps.

YouTube player

2. Calf stretch: Hang one heel off a step at a time to stretch out your calf and hold this for 30 seconds each side.

calf stretch , soleus, gastroc - self treatment for shin splints

3. Plantar fasciitis deep massage: Use a hard ball or a massage ball to roll out the sole of your foot. Do this between the heel and balls of your foot, NOT under the heel. Do this slowly and firmly for 1-2 minutes to relieve the plantar fasciitis – You can also use a small frozen water bottle!

plantar fasciitis treatment

5. Gradually load

The final aspect of rehab is to load the plantar fascia. The idea behind this and in some recent, successful research is to treat it like a tendon injury. In tendon injuries such as Achilles tendinopathy, the tendon is thickened and the fibres and dysfunctional due to overload. The big part of tendon rehab thing that helps this a lot is putting gradually more load through the tendon. This causes the tendon to adapt and change for the better.

Looking at it like this and treating the plantar fascia like a tendon (even though it technically isn’t) looks to be gaining good results in research and the clinic and is becoming a mainstay or plantar fasciitis rehab over the last few years.

If you want to read further about this, you can check out the main research paper here, with their main conclusion being:

High-load strength training may aid in a quicker reduction in pain and improvements in function

Otherwise, if you don’t want to read a research paper:

This is the main exercise that is used to load and strengthen the plantar fascia to ultimately help fix plantar fasciitis

The high load strengthening exercise is done as per the image below. A small towel is rolled up to raise the toe up (hence, putting the plantar fascia on stretch) while doing a heel raise off a step. Go up and down slowly (count 3 seconds each) and hold at the top for 2 seconds.

This can be started two-legged and progressed to one-legged as it gets easier. You can then add a backpack with something heavy in it to add a little extra load. Keep doing this until you are pain-free.

plantar fasciitis strengthening exercise

Rathleff Et al. 2014

Conclusion:

And that’s it – all the information, treatments and tools that help fix plantar fasciitis.

Unload, Support and Gradually strengthen

Thanks for reading, you will most likely also enjoy our Comprehensive Plantar Fasciitis Rehab Guide


Ankle

The Top Sprained Ankle Treatment | Infographic

• 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.

OR check out our new, full and comprehensive Ankle Rehab Guide – it is downloadable, simple and step by step, not to mention being research-based which means it is proven.

Takeaway point: Active rehab is the key to successful sprained ankle treatment.


Ankle

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

• 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.

If you need an example of a good lace-up ankle brace, here is a good example on Amazon of the DonJoy Ankle Brace and if you want to make sure you rehab your ankle well, which reduces re-injury by 50%, follow our Sprained Ankle Rehab Guide


Ankle, Health

Ankle pain, The Best 3 Support Braces

• 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.


Health, running, Thigh

Hamstring Injury – Role Biceps Femoris plays

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Hamstring injury happens frequently in running-based sports such as athletics, football, rugby etc. Over 80% of these occur in the outer hamstring when the leg is swinging through.

It is often thought that hamstrings are injured from changes in direction, pushing off and explosive movements but in reality, most hamstring injury happens when the leg is swinging through, just before the foot touches down.

Which Muscles are the Hamstrings?

Here is a quick few stats and anatomy refresher to ground you:

Hamstring injury

The hamstrings are made up of three muscles

  • The Biceps Femoris, which has two parts to it. The long head which cross’ both the hip and then knee joint and the short head which only crosses one joint
  • Semitendinosus that helps with hip and knee rotation as well as knee flexion
  • And Semimembranosus at the inner thigh that helps with hip extension and knee flexion

What is the cause of Hamstring injury?

Hamstring injury happens when any of these muscles get injured. It usually happens during a sudden strenuous movements which impact one of the hamstring muscles or any of the tendons.

Most hamstring injuries are thought to happen in late swing phase of running, just before the foot lands.

Hamstrings’ Function:

Check out the video below to see how the hamstring works in walking:

YouTube player

As you can see in the video, the hamstrings fire into action before, during and after the foot lands. At this point when the knee is extended, the muscle is working while at it’s peak length and at maximal force development working hard eccentrically to slow leg swing down.

What is eccentric contraction?

An eccentric contraction is where the muscle controls lengthening out, which is far harder on the muscle than a concentric contraction where it contracts to push-off.

Biceps Femoris’ role in Hamstring Injury

The Biceps Femoris long head (BFlonghead) is involved in almost 80% hamstring injuries.(1). So what is the link between the mechanism of hamstring injury described above and BFlonghead taking the brunt of injuries?

Recent studies have shown that the Biceps Femoris is more active when the hip is extending, rather than when the knee is flexing. Which means that BFlonghead has to work harder with eccentrically slowing the leg down as compared to other hamstring muscles.

This also means that exercises performed using knee flexion do not often strengthen Biceps Femoris as much as say Semitendinosus, which is more active in knee flexion where it works to bend the knee

nordic curls - hamstring rehab and strengthening exerciseA lot of hamstring strengthening is done at the knee (nordic curls, hamstring curls etc) which has been shown to be more the work of the medial hamstrings than Biceps Femoris.

Conclusion:

Hamstring chair bridges

Credit irunfar.com

So there you have it, the BFlonghead of the hamstrings works harder eccentrically slowing down the momentum of the leg swinging forward and often gets missed in strengthening sessions – Stuck between a rock and a hard place!

This gives athletes and health professionals better guidance as to what rehab exercises to add in post injury and also in injury prevention programs depending on injury, leading to decreasing the nearly 30% re-injury rate.(1)

Click here to learn more about hamstring injury and find information about healing faster and stronger from it.


Foot pain

The Human foot – Amazing video of foot mechanics

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Foot mechanics the natural human footThe human foot is an amazing thing and something we rely so much on – It shouldn’t be taken for granted. This is a great video by the BBC that demonstrates and discusses our amazing natural foot mechanics of our feet and how it works to keep us moving efficiently.

There is some dissection in the video so be warned if you are a bit squeamish, but it is well worth it!

There is also a great explanation in here of the plantar fascia and windlass mechanism and how this natural spring mechanism helps us move – you will be surprised how complicated our feet are!

 

YouTube player

What do you think about our foot mechanics? Pretty bloody lucky aren’t we.


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