Rehabilitation Of Ankle Sprains

By Dr. John A. Papa, DC, FCCPOR(C)

 

An ankle sprain is a very common injury that can happen to athletes, non-athletes, children and adults.  A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position.  This may occur while participating in sports and recreational activities, wearing inappropriate shoes, or running, walking or stepping on uneven surfaces.

 

Inversion ankle sprains constitute 90% of all ankle sprains.  This type of injury occurs when the foot is forced inward (inversion) and produces most of the pain on the outer side of the ankle.  Eversion ankle sprains are less common and occur when the foot is forced outward (eversion), causing the most pain on the inner side of the ankle.  A high ankle sprain is a unique and separate injury in which the ligaments around and above the ankle joint are injured.  This is known as a syndesmotic sprain.

 

Pain and swelling are the most common symptoms of an ankle sprain.  There may be bruising over the area of injury which may spread down into the foot towards the toes several days following the injury.  Individuals may also experience difficulty walking or weight bearing on their injured ankle.  Most ankle sprains can be managed conservatively.  However, obvious evidence or suspicion of a broken bone, fracture or joint dislocation necessitates the need for emergency medical care.

 

Initial conservative management of ankle sprains should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  The P.R.I.C.E. principle helps decrease pain and swelling and can be used during the rehabilitative process as needed.  Additional treatment options include electrotherapy, ultrasound, taping, bracing, soft tissue techniques, and manual mobilization to assist in returning to full functioning.  Rehabilitative strategies should progress to include active range of motion, stretching and strengthening exercises for the ankle joint and lower extremity.  Proprioceptive/balance training is crucial in minimizing the risk of ankle instability and re-injury.

 

Assuming that proper rehabilitative strategies are employed, successful recovery from an ankle sprain injury will depend upon the severity of ligament damage.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks.  Moderate injuries usually require 4 to 12 weeks to heal.  Severe injuries will take longer to heal.  In some circumstances, surgery may be required for severe ankle sprains.

 

An untreated ankle sprain may lead to chronic ankle instability.  This may also result in secondary foot, knee, hip, and back problems because of subtle changes in movement patterns.  If you are having difficulty with ankle pain, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Defining Common Muscle And Joint Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  Common mechanisms of injury include slip and fall or collision-impact type accidents, overstretching a body part, twisting awkwardly, or performing repetitive movements.  This can cause pain, stiffness, and swelling in a joint and/or muscle, leading to injuries such as sprains, strains, and contusions.

 

A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Common locations for sprains are the ankle, wrist, and knee joints.

 

A strain refers to a stretching or tearing of a muscle or tendon.  Muscles are responsible for producing force and causing motion, whereas tendons are the tough fibrous extensions of muscle that attach to bone.  A strain injury can occur when the muscle-tendon complex suddenly or powerfully contracts, or when it is overstretched.  This is called an acute strain.  Overuse of certain muscles over time can lead to a chronic repetitive strain.  Strains are commonly referred to as “pulled muscles” or "tendinitis".  The shoulders, forearms, low back, and leg regions are common locations for strains to occur.

 

Contusions are commonly called “bruises”, and occur when small blood vessels in the skin, muscles, or bones are subjected to trauma. 

 

Sprain, strain, and contusion injuries can exist on their own or in combination with each other.  Initial conservative management and first aid of these injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  This can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  With a mild injury you should experience progressive improvement within 2 to 3 days.  You should gradually begin using the injured area after this time.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks. Moderate injuries usually require 4 to 12 weeks to heal and may require basic rehabilitative treatment and exercises.  Severe injuries will take longer to heal.  Healing times may also vary depending on a persons age, physical condition and general health.

 

You should seek immediate medical care under the following circumstances:  a popping sound heard during the injury accompanied by a feeling of joint instability or inability to weight bear; obvious evidence or suspicion of a broken bone, fracture or joint dislocation; or injuries at risk for infection.  For less serious injuries that do not subside, you should contact a licensed health professional who deals in the diagnosis and treatment of muscle and joint pain.  They can determine the cause of your pain and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance. For more information on managing muscle and joint injuries, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Muscle And Joint Injury First Aid

By Dr. John A. Papa, DC, FCCPOR(C)

Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  This can cause pain, stiffness, and swelling in a joint or muscle, leading to injuries known as sprains, strains, and contusions.  Initial conservative management and first aid of such injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation) outlined below.

 

PROTECTION:  Immobilize the injured area to protect from further injury.  This can be accomplished with the use of an elastic wrap, brace, splint or sling.  Walking aids such as crutches or a cane can be useful to help you get around.

 

REST:  To ensure proper healing, rest the injured area and avoid activities that cause pain.  Do not restrict all activities completely.  Other regions of your body can still be used.  This will help prevent physical de-conditioning.  An attempt should be made to return to regular or modified activities as soon as possible provided it does not put you at risk for further injury.

 

ICE:  Ice cubes, frozen vegetable bags, or commercial ice/gel packs are examples of cold sources that can be molded or applied to an injury site immediately.  Icing will help to reduce pain, swelling, and inflammation in the injured tissues.  Ice application should not exceed 10 to 20 minutes at a time.  Allow for skin temperature to return to normal before ice is reapplied.  This cycle can be repeated as often as necessary within the first 24 to 72 hours.  Ice should never be applied directly over the skin for a prolonged period of time as this can damage the skin.  A wet towel can safely be used as a barrier between the ice and skin and acts as an excellent conductor of cold.  Do not apply ice to blisters, open cuts, or sores.  Individuals hypersensitive to cold and those who have circulation problems should avoid ice.

 

COMPRESSION:  Compress the injured area with an elastic tensor bandage.  This will help decrease swelling.  Do not wrap the bandage too tightly as to cut off circulation.  You should not feel an increase in pain with compression.

 

ELEVATION:  Elevate the injured area (whenever possible) above the level of the heart, especially at night.  Gravity helps reduce swelling by draining excess fluid.

 

You should seek immediate medical care under the following circumstances:  a popping sound heard during the injury accompanied by a feeling of joint instability or inability to weight bear; obvious evidence or suspicion of a broken bone, fracture or joint dislocation; or injuries at risk for infection.

 

By using the P.R.I.C.E. principle after an injury, you can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  In the event that you suffer from ongoing muscle and joint pain following an injury, you should contact a licensed health professional who can diagnose your condition and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Muscle & Joint Injury First Aid

By:  Dr. John A. Papa, DC, FCCPOR(C)

 

Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  This can cause pain, stiffness, and swelling in a joint or muscle, leading to injuries known as sprains, strains, and contusions.  Initial conservative management and first aid of such injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation) outlined below.

 

PROTECTION:  Immobilize the injured area to protect from further injury.  This can be accomplished with the use of an elastic wrap, brace, splint or sling.  Walking aids such as crutches or a cane can be useful to help you get around.

 

REST:  To ensure proper healing, rest the injured area and avoid activities that cause pain.  Do not restrict all activities completely.  Other regions of your body can still be used.  This will help prevent physical de-conditioning.  An attempt should be made to return to regular or modified activities as soon as possible provided it does not put you at risk for further injury.

 

ICE:  Crushed ice, ice cubes, or snow should be molded or applied to an injury site immediately.  Icing will help to reduce pain, swelling, and inflammation in the injured tissues.  Ice application should not exceed 10 to 30 minutes at a time.  Allow for skin temperature to return to normal before ice is reapplied.  This cycle can be repeated as often as necessary within the first 48 to 72 hours.  Ice should not be applied directly to the skin.  Instead, a damp towel should be used to serve as a barrier between the ice and skin and act as a conductor of cold.  Do not apply ice to blisters, open cuts or sores.  Individuals hypersensitive to cold and those who have a circulation problem should avoid ice.

 

COMPRESSION:  Compress the injured area with an elastic tensor bandage.  This will help decrease swelling.  Do not wrap the bandage too tightly as to cut off circulation.  You should not feel an increase in pain with compression.

 

ELEVATION:  Elevate the injured area (whenever possible) above the level of the heart, especially at night.  Gravity helps reduce swelling by draining excess fluid.  You should seek immediate medical care under the following circumstances:  a popping sound heard during the injury accompanied by a feeling of joint instability or inability to weight bear; obvious evidence or suspicion of a broken bone, fracture or joint dislocation; or injuries at risk for infection.

 

By using the P.R.I.C.E. principle after an injury, you can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  In the event that you suffer from ongoing muscle and joint pain following an injury, you should contact a licensed health professional who can diagnose your condition and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Rehabilitation Of Ankle Sprains

By Dr. John A. Papa, DC, FCCPOR(C)
 

An ankle sprain is a very common injury that can happen to athletes, non-athletes, children and adults.  A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position.  This may occur while participating in sports and recreational activities, wearing inappropriate shoes, or running, walking or stepping on uneven surfaces.

Inversion ankle sprains constitute 90% of all ankle sprains.  This type of injury occurs when the foot is forced inward (inversion) and produces most of the pain on the outer side of the ankle.  Eversion ankle sprains are less common and occur when the foot is forced outward (eversion), causing the most pain on the inner side of the ankle.  A high ankle sprain is a unique and separate injury in which the ligaments around and above the ankle joint are injured.  This is known as a syndesmotic sprain.

 

Pain and swelling are the most common symptoms of an ankle sprain.  There may be bruising over the area of injury which may spread down into the foot towards the toes several days following the injury.  Individuals may also experience difficulty walking or weight bearing on their injured ankle.  Most ankle sprains can be managed conservatively.  However, obvious evidence or suspicion of a broken bone, fracture or joint dislocation necessitates the need for emergency medical care.

 

Initial conservative management of ankle sprains should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  The P.R.I.C.E. principle helps decrease pain and swelling and can be used during the rehabilitative process as needed.  Additional treatment options include electrotherapy, ultrasound, taping, bracing, soft tissue techniques, and manual mobilization to assist in returning to full functioning.  Rehabilitative strategies should progress to include active range of motion, stretching and strengthening exercises for the ankle joint and lower extremity.  Proprioceptive/balance training is crucial in minimizing the risk of ankle instability and re-injury.

 

Assuming that proper rehabilitative strategies are employed, successful recovery from an ankle sprain injury will depend upon the severity of ligament damage.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks.  Moderate injuries usually require 4 to 12 weeks to heal.  Severe injuries will take longer to heal.  In some circumstances, surgery may be required for severe ankle sprains.

 

An untreated ankle sprain may lead to chronic ankle instability.  This may also result in secondary foot, knee, hip, and back problems because of subtle changes in movement patterns.  If you are having difficulty with ankle pain, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.