Statistics reveal that every day, over 25,000 Americans sprain an ankle. The foot and ankle are made up of almost thirty bones that are held together with elastic Connective Tissues such as LIGAMENTS, TENDONS, MUSCLES, and even FASCIA. Looking at the pictures below gives you an idea of what the ankle looks like on the inside.
Although a vast array of ankle injuries are possible, there are essentially two ways that you sprain your ankle. It can roll to the outside (Inversion Sprain or Lateral Sprain) or to the inside (Eversion Sprain or Medial Sprain). The inversions are incredibly common, while I rarely see an eversion. Below are the grades of Ankle Sprains
- GRADE I: Minor. Tissues are stretched but not torn. Prognosis 100%.
- GRADE II: A bit worse. Some tearing of the ligaments and tissues, and some degree of the standard features of an ankle sprain; swelling, heat, pain, a diminished ability to bear weight, etc… Prognosis is good if proper rehab is done (a few weeks to a couple of months). Fail to rehab means a heightened chance of re-injury, SCAR TISSUE, and degeneration.
- GRADE III: Severe. All of the symptoms of a Grade II, only worse. You will likely spend some time on crutches, and the healing time will be measured in months instead of weeks. Your ankle will never be the same after a Grade III sprain. Proper rehab is critical.
- AVULSION FRACTURE: Although it’s called a “fracture,” an of the ankle is not a different sort of fracture. The Ligaments or Tendons anchor themselves into bones via microscopic Velcro-like hooks called Sharpey’s Fibers can be stretched hard enough to pull ligaments and tendons off of bones — right along with a small chunk of bone. Sometimes these are big enough to show up on x-ray, sometimes they are not. Sometimes these require a cast, sometimes they do not.
REHABBING AN ANKLE SPRAIN
Because spraining an ankle is virtually inevitable, the way you handle it could be the difference between a normal life, and a lifetime of Chronic Pain. Even before you visit a doctor, think R.I.C.E.R.
- REST: Rest does not mean that you do nothing. Firstly, after you sprain sprain it, get off of it right away to prevent further damage. It may mean you need to lay off of sports for awhile or use crutches for a day or two. Studies have shown that injured athletes who get off their sprained ankle immediately, heal in half the time as those who don’t.
- COMPRESSION: An ACE bandage or ankle sleeve helps keep swelling down.
- ELEVATION: Elevation is only elevation if your ankle is above the level of your heart! Kicking back in a recliner is not good enough.
- REHABILITATION: There are tons of fantastic ways to rehab an ankle. Just cruise on over to YouTube. Because I have decimated my ankles in the past (several avulsions) I discovered that once you can tolerate it, a TRAMPOLINE is great ankle rehab.
After going through the initial pain and dysfunction of an ankle sprain, what can be done to speed the healing process and make sure it doesn’t become a chronic problem?
- PROPER NUTRITION: If you want to really help your cause, eat a diet that controls inflammation. HERE is how. I would also recommend our BEST NUTRITION for Connective Tissue Injuries page.
- CHIROPRACTIC ADJUSTMENTS: Not only will adjustments aid tremendously in realigning the pelvis (abnormal gaits such as those seen after an ankle sprain) always create pelvic distortion of some degree — often times (at least initially) without pain. Because the ankle / foot contains nearly thirty small bones that all have to move and articulate perfectly with one another, you need to get your ankle adjusted as well. I use a drop table to work through the various small bones and joints of the ankle.
- PROPRIOCEPTIVE TRAINING: Proprioception is your body’s ability to sense where it is at in space. Ligaments, tendons, muscles, and fascia, contain large amounts of mechanoreceptors (nerve endings that sense stretch or movement) that are responsible for proprioception. See our webpage PROPRIOCEPTION & DEGENERATIVE ARTHRITIS.
- STRENGTHENING AND STRETCHING EXERCISES: Increasing both the ROM and strength of injured ligaments, muscles, and tendons, is critical for preventing re-injury. There are a host of strengthening and stretching exercises that can be done without buying any equipment other than a five dollar piece of theraband rubber tubing. Again, YouTube is your friend.
- TISSUE REMODELING: Injuries to the ELASTIC, COLLAGEN-BASED CONNECTIVE TISSUES (i.e. Ankle Sprains) frequently cause microscopic scarring that the medical community refers to as Fibrosis. The worse the sprain, the more FIBROSIS will be present.
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