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Have you sprained your ankle?
If you have stretched your ankle ligaments, early intervention is key to a quick recovery, and to prevent re-injury further down the line. In the United States alone, there are an estimated 2 million ankle sprains every year. Most people are able to recover fully, especially with the right care. But, if an ankle sprain is not treated properly, it can lead to impaired mobility and fast-progressing arthritis in years to come. We will explore chronic ankle sprain and exercises that prevent future ankle injuries. There are a lot of bad news concerning ankle sprains but in my practice I have found there is good news too. The bad news is that many ankle sprains become chronic, and re-injury of the same ankle is very common (1).
What is a Sprain?
Very simply, sprain is an injury to the ligament. Ligaments are ropes of our body that connect one bone to the next. These sprains are microscopic, or partial tears in the ligament. It often happens when, instead of landing on the sole of the foot, the person steps and, as they land, the full body weight is concentrated on the side of their foot. This misstep pushes the ligaments beyond their normal range of motion causing the fibers of the ligaments to tear. I have treated ankles with a partial tear, complete tear and avulsion fractures.
How do I know if my ankle ligament was torn?
There are a number of range of motion and ankle loading tests that can determine if a tear is present. After the initial inflammation is treated (treatment described below), we are able to see if any instability or excess of movement is present. These findings point to a partial or a complete tear.
Why do I get sprain so easily?
We think that a sprain results from a simple misstep but many risk factors increase the chances of spraining an ankle. Balance, muscle strength, and previous injuries are all reasons why someone might roll the ankle. So preventing an ankle sprain is as important as early treatment if it happens. Furthermore, early treatment prevents re-injury.
Am I at risk for an ankle sprain? A Test...
Here is a test to see if you are likely to have an ankle sprain. It's a simple balance test. If you can stand on one foot while looking straight ahead for 30 seconds your ankles have some protection. Then, close your eyes and continue in the same position. If you can stand another 15 seconds your ankle is twice as protected.
Why see a chiropractor after an ankle injury versus another medical specialty?
Chiropractic is one of the only specialties that focuses on direct non-invasive treatment of the joints and ligaments. Surgeons treat these tissues with more invasive procedures and physical therapists treat these structures indirectly through exercise. Musculoskeletal system consists of our nerves, muscles, discs, bones, ligaments and tendons. A chiropractor is a specialist in all of these except for a broken bone.
How can chiropractic care help with ankle pain?
Your tibia (shinbone) and fibula (lower leg bone) meet at your ankle, forming a socket that your talus (ankle bone) fits into, which rests on the calcaneus (heel bone). These bones are connected together by ligaments and muscles. This means than an ankle injury can affect bones, muscles, ligaments and tendons.
Chiropractic Ankle Traction Adjustment as Initial Treatment for an Ankle Sprain
If there is a way to decrease the initial swelling after injury the ankle would heal better and faster. I have seen ankles swollen to twice its size and after one adjustment the ankle looked normal. The adjustment does not twist or bend the ankle and is well tolerated by young children to the elderly.
Stabilization Treatments
The standard R.I.C.E (rest, ice, compression, elevation) is indicated for an ankle sprain. Compression, neuromuscular stimulation and improved stability can be also enhanced by kinesiology taping. Immobilization is another important aspect and is achieved through a brace, or a boot.
Mobilization Treatment
Mobilization and stabilization are both equally important and we can overdo either one of these. There are multiple joint mobility techniques but we will explain one of them that helped many of our patients. Restoring anterior to posterior glide of the ankle joint has an instant pain relieving effect due to decreased joint swelling. A patient may be unable to step but able to perform resistance band strengthening with no pain. These exercises have been shown to improve recovery (2)
Manual Therapy Treatment
I had a patient that sustained a severe sprain that also resulted in an avulsion fracture. Some forces do not tear the ligament, but break and pull away a small chunk of bone where the ligament it is attached. Manual therapy improved healing of the nearby ligaments and the patient was able to walk without a limp after 3 visits and immobilization.
Extremity adjustment for Injuries
Chiropractic adjustment is a safe and highly effective method to speed up recovery after an injury. It is fascinating to watch severe swelling go down in seconds after a proper ankle adjustment. Sometimes after an injury the joints become “stuck”, and once the restriction is dealt the person can feel immediate improvement in pain and walking ability.
As the initial inflammation begins to subside, chiropractic adjustments can be introduced to strengthen, stabilize, and mobilize the ankle, with a focus on restoring full flexibility in the joint. In addition to working on the joint, regular chiropractic adjustments also promote increased blood flow to the area to speed up the healing process.
1. Mugno AT, Constant D. Recurrent Ankle Sprain. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560619/
2. Jones, Morgan H., and Annunziato S. Amendola. "Acute treatment of inversion ankle sprains: immobilization versus functional treatment." Clinical Orthopaedics and Related Research® 455 (2007): 169-172.
