Recurrent ankle sprains

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The foot is a complex part of the body. It has joints and muscles and is directly influenced by the movement and balance of the body above. More complex problems of the foot and ankle to treat are; Recurrent ankle sprains occur when ligaments are stretched and when joints are stiff. Ligaments when they are sprained […]
The foot is a complex part of the body. It has joints and muscles and is directly influenced by the movement and balance of the body above.

More complex problems of the foot and ankle to treat are;

Recurrent ankle sprains occur when ligaments are stretched and when joints are stiff.

Ligaments when they are sprained do not return to A grade. We need to strengthen muscles to provide dynamic support where once the ligaments provided support. Otherwise a brace, tapping or surgery is an option.

The subtalar joint below the heel may be stiff, it requires movement in order for the ankle to adapt to uneven surfaces. This is what I term a ‘rocker bottom’ joint. If left stiff after an ankle sprain you may not have the ability to adapt so quickly to an uneven surface and you may go over on your ankle… again!

In addition our nerves get a bit scrambled. The messages may not be getting to the brain in quite the same way they used to. Practicing your balance helps this.

Sprained ankles can get better on their own depending on the severity and if treated properly with RICE; rest, ice, compression and elevation. BUT usually they require at least one treatment.

If you have more than one sprain, things get more difficult to rehabilitate . Loose ligaments may cause ankle instability. The surrounding muscles may be retrained to support the ligament(s). Or there may be a more complex twist in the body from your fall (original sprain) causing you to lose your balance. These can all be treated by a qualified foot and ankle physio.

Balance problems can occur because of unstable ankles but often there is usually more than one cause. Often the body has adapted above the ankle sprain with a twist or torsion and that is what is putting your body out of balance. A physio trained in postural analysis and gait re-education will be able to fully assess your body, release tight muscles and retrain your body to move correctly again.

The thoracic rings (ribs + spine + sternum) or pelvis are common areas for the body to be torsioned, and require treatment.

Fractures: After immobilisation for a period of time it feels strange to just ‘get up and walk’. Muscles are severely detrained and it is easy to pick up bad walking habits. It is always best to be guided into the correct exercises to restore good gait and function again after immobility. A physio with experience in lower limb biomechanics is an expert at gait re-education.

Some fractures are extremely small and get missed on early X-Rays. These are called occult fractures. If your foot or ankle remain hot and swollen and you cannot put your foot to the ground after 7 days (despite applying the RICE regime), you should see your doctor for further investigation.

Extremely Flat Feet may be the result of a weak Tibialis Posterior muscle (blog coming). It is important this is assessed and very specific strengthening exercises given.

In modern life we have added footwear and hard surfaces. These change how the foot works and often result in pain either walking or running.

It is good practice to assess the whole body with recurrent foot and ankle problems for muscular balance of the body in relation to the foot. Everything in the body is interrelated.

A-J is a Foot and Ankle  Physio in North Sydney who assesses the local problem and the whole body in relation to the feet, to help prevent reocurrence.

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