A sprain is the strain or overstretching of the ligamentous fibers that join two proximal bone ends, usually at a joint. This strain can lead to rupture, and this is what leads to a classification of the severity of the sprain.
In the foot there are many ligaments that are responsible for providing stability and joining the multitude of bones that form it, but the most characteristic and frequent sprains are those of the internal and external lateral ligaments, which are those that hold the foot to the leg ( fibula and tibia) and prevent it from moving excessively to the outside and inside respectively. It is common for the sprain to occur when stepping badly and bending the foot so that it is with the sole facing inwards and resting on the outer edge.
Symptoms of ankle sprain
Depending on the severity of the ankle sprain, we will have different symptoms; thus we can distinguish several types of sprains:
- Grade I: In which there is a slight elongation of the ligament. Here we will see a certain inflammation under the malleolus or relief of the ankle (either internal or external) and the patient will feel pain in the area and will not be able to move or support the foot safely.
- Grade II: In this type, small tears of the ligamentous fibers already occur. Externally, inflammation, pain and a hematoma will appear in the area that can extend to peripheral areas (such as the fingers, parts of the leg …) You will not be able to support the foot, or move it, since it will cause a lot of pain.
- Grade III: The elongation is such that the ligament breaks completely (a part of it). The signs are as in the previous case but more exacerbated. The instability of the joint is very marked.
How to prevent it
Being accidental, we cannot prevent it in a specific way.
In a person who has had successive sprains and his ligamentous stability is insufficient, mobility is excessive or painful, we can indicate special attention to that ankle when we know that we are going to practice an activity that requires overexertion or an added risk to the joint ( training, match, walking on unstable terrain…).
We will hold that joint with suitable footwear, or even bandage it if that is not enough. If you can count on the hands of a physiotherapist, a functional bandage would be optimal in these cases, since it allows the movement of the joint but especially prevents the one that caused the injury and the one that would affect the damaged ligament)
Treatment of ankle sprainEmergency treatment for an ankle sprain:
- Ice application for 10 minutes intermittently every half hour.
- Do not use heat, in this initial period, as a means to avoid pain, as it would promote inflammation.
- Maintenance of the raised limb for as long as possible to avoid edema.
- More or less rigid immobilization depending on the type of sprain that has occurred.
- Prohibition of supporting the affected foot, at least during the first 2 or 3 days.
- Go to the medical center to make sure there are no more serious injuries.
The duration of immobilization depends on the degree of the ankle sprain. For grade 1 the time will be 4 or 5 days, for grade 11 10 days, while for grade III it will be up to 20. This always under the supervision of a doctor or a physiotherapist who will supervise almost every day day the state of the sprain and after the treatment of the same the first days, will continue bandaging the ankle to protect the joint during some week later.
The goal of prompt removal of the bandage is because some of the most common problems associated with sprains are muscle atrophy, joint stiffness, and osteoporosis that result from not supporting or moving the ankle for as long as it is. usually immobilize.
The movements that will be carried out during this first stage will always be very cautious. The benefit of not having the foot immobilized is detrimental to the safety of the ankle, since there is a risk that the mechanism that caused the ankle sprain will reoccur. That is why monitoring its condition is important on the part of the physiotherapist.
Properly physiotherapeutic treatment
Physiotherapy treatment during the initial period of sprains is to avoid edema and pain by:
- Contrast baths (in hot and cold water)
- Foot massage. Starting from the fingers, an ascending massage will be performed towards the leg, trying to relax the plantar fascia and foot muscles at the same time.
- Special currents, which facilitate the drainage of the edema and even some such as distortion currents that reduce the painful sensation.
- Cryotherapy (application of ice)
As the inflammation and the hematoma, if any, subside, the ligament itself is treated with:
- To be
- Evacuatory massage.
- Cyriax type massage, with anti-inflammatory action and above all to help the correct structuring and realignment of the ligament. When the ankle sprain occurs and as a consequence these ligamentous micro-tears, the healing of the ankle is carried out by means of fibrous tissue, which does not have the elasticity or directionality of the anterior ligament. There remains a tangled area, a fibrous mass that through this type of massage we try to orient properly so that the ligament remains strong thus avoiding new injuries.
Relieve pressure on the joint through manipulations and tractions. Any type of joint manipulation or decompression (always well done) relaxes the joint itself and the adjacent muscles. After a trauma, the injured joint remains in a state of over-tension due to pain, stiffness and the modification of its use (we will tread differently so as not to support the area that bothers us, which ends up harming the patient). Through these techniques an attempt is made to soften and relax this state.
The last phase and one of the most important is to strengthen the ankle and re-educate the balance and proprioception of the joint to avoid new injuries that are often very common in poorly treated sprains. For this we will:
- Exercises of proprioception of the ankle and the entire lower limb posteriorly. With exercises on the limp, on unstable plates, trampolines … so that the ankles are able to react and stabilize before any type of stimulus that unbalances it.
- Strengthening of the muscles in the area (tibialis, calves …) The physiotherapist will resist all movements of the foot, with the intention of strengthening the muscles.
- Reeducation of gait that is usually affected by pain and immobilization time
- Beginning of physical activity: light running and then increasing the intensity, performing series of multi-jumps, sudden changes of direction …
Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.