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ankle pain

Ankle, foot pain, Health, Lower limb

Sprained Ankle – Heal Fast and Strong with Self Treatment

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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 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.

 


Ankle

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

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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


Health

Ankle Pain Running? Improve Your Ankle Range, FAST.

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Limited ankle range can cause you a lot of problems, and not just at the ankle.

Can you spare 5 minutes to improve your ankles and in turn, your running?

Well then you are in the right place! As I discussed in last weeks post,  whether you’re an amateur, weekend warrior or a pro, good ankle range is a must for many basic movement patterns. If you don’t have it, you can’t squat right down, you can’t have a proper stride when walking or running AND it loads up other areas of your body causing pain and injury.

But luckily, there are three easy exercises that you can do to improve your ankle range.

wpid-wp-1411170423169.jpeg

 

First: Have a quick look at the post I mentioned above to take the ankle range test, so that you know your score (this way you can see how well you improve!)

 

 

 

 

These are the three things will improve your score in days:

calf stretch , soleus, gastroc - self treatment for shin splints1. Calf stretch

Lets get the basics right. The easiest way to do it is to, one foot at a time, drop a heel of a steps, as shown.

Hold this for 30 seconds

Swap over and do the other foot, and then you are done.

 

2. Self myofascial release – Plantar fascia and calf

For the second exercise, you need to work over some of your tight soft tissue (muscle and fascia etc)

  • First, get a nice firm ball (eg, tennis ball, lacrosse ball). While standing, place it under one foot and apply medium pressure. Now slowly roll it around the bottom of your foot, right through the arch for 30 seconds on each side.
  • MTSS shin splints self treatmentSecond, get your Foam Roller – if you don’t have one, either buy one (great investment) or use a ball. Get down on the ground and spend 1 minute on each side, nice and slowly really working in through  your calves.

I know that was really two exercise, but I’m sure you can handle it!

 

That’s four minutes so far, one to go…

3. Ankle mobilization exercise

Check out this video by Adam Kelly, that demonstrates this exercise well – All you need is a strong elastic band or a willing helper and do this for 30 seconds on each ankle.

 

Done. You have just decreased your chance of ankle pain running, walking and more.(1)

I challenge you to make this a daily routine for 10 days and re-test and see how much your score has improved!

 

Let me know how you get on and be sure to subscribe for more.

 

 


Ankle, Health

Quick Ankle Range Test – Must Know for any Athlete

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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!


Lower limb, running, Shin Pain

Shin Splints Treatment and Exercises

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runningShin splints is the most common lower limb injury in athletes and can lead to large blocks off training and serious injuries such as stress fractures if ignored. Here you will find out, what it is, what causes it and how to treat and rehab it YOURSELF with effective self treatment methods and exercises.

Shin splints is an Umbrella term that describes pain along the inside border of your tibia(shin) and covers a number of pathologies. The most common and Injury most often associated with Shin splints is Medial Tibial Stress Syndrome.

shin splint painMedail Tibial stress syndrome (MTSS) Is the most common Injury in runners (Lopes et al 2012) affecting 9.5 percent of all runners, coming in just ahead of achilles tendinopathy and plantar fasciitits.  In MTSS pain is felt along the inside border of your shin bone (tibia), it is tender to touch and the tender/ lumpy area is larger than 5cms.

MTSS is caused by repetitive contraction of the calf muscles causing excessive stress on the tibia. The calf muscles (namely the soleus, flexor digitorum longus and tibialis posterior) attach onto the inside border of the tibia, and the repeated pulling from any of these muscles at their attachment causes micro-tears which causes inflammation, pain and excess tissue build up.

Now this generally happens due to one or a number of the following reasons:

  • Sudden increase in training that your body isn’t used to.
  • Change on footwear or training surface, eg. going barefoot (minimalist running) or changing from flats to hill running.
  • Poor hip control causing excessive internal rotation.
  • Over pronated foot type.
  • Poor running form (See Ironing out your running).

 

Differentail Diagnosis:

Stress reaction and stress fracture

These also cause shin pain and can be causes by MTSS or occur by themselves due to over training so it is important to have these ruled out by your Local physio if there is pain when you: tap on your shin bone, jump on your heel or if the pain is localised to one spot on the shin.

 

MTSS is far too often ignored and put aside as calf tightness until it is far worse than is should have got, which means some serious time off training and a lot of money spent on rehab. Below we are going to run through exercises and self-treatment that will both help heal your MTSS/shin splints AND prevent them happening again.

 

Exercises: All of these need to be done 2 x daily if you have shin splints.

calf stretch1. Calf Stretch:  Drop your heel off a step and hold it for 1 minute.

 

 

 

 

 

 

MTSS shin splints self treatment

2. Foam roll your calf: Position as shown in the picture to get as much weight through the roller as you can. Spend 2-3 minutes slowly rolling your whole calf – ignore the pain!

 

Tip: You can also give yourself and self-massage, which is really effective at reducing tension and getting right to the point!

 

 

 

glut and Lat stretch - Hip flexibility

3. Sling stretch for hip range: Hold for 1 minute.

 

 

 

 

 

 

Bridge - increase leg strength, glute activation and decrease back pain.

4. Single leg bridge for hip stability: 

Hold for 5 seconds, 2 x 12 reps each side.

 

 

 

 

 

Single leg Squat, hip stability and strength

5. Single leg squat for lower limb strength and stability: To make it harder and better for lateral stability, keep your free leg out to the side.

Do 2 sets of 12reps each side.

 

 

 

 

 

Make the above exercises a routine even when pain-free!

Self treatment:

The main technique that will benefit you is self deep tissue massage. Check out this post for a easy video demo of this.

 

Tinker with your training:

– Decrease your training load to allow healing to take place

– decrease hill running and running or walking on hard surfaces

– Take a good look at your shoes and consult a Podiatrist of Physio re your foot mechanics.

– Once pain has gone, start SLOWLY building up your training again.

 

 

So there you have it, your guide to Shin Splints Treatment! Take some time to check out some other great posts that will help athletes and runners out a huge amount in preventing lower limb injuries as it is ALWAYS better to prehab!

Iron out your running – run faster, easier and injury free.

Quick balance and stability test.

Glute activation – the missing link

Please Share and like and let me know how you get on!


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