ANKLE JOINT

The ankle joint is formed where the foot and the leg meet. The ankle, or talocrural joint, is a hinge joint where 3 bones are connected to each other. They are the tibia and fibula of the leg and talus bone of the foot. The articulation between the tibia and talus bears more weight than between the smaller fibula and the talus.
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ANKLE JOINT LIGAMENTS

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 The ankle joint is responsible for moving the toes up as when standing only on the heels (dorsiflexion) and moving the toes down, as when standing on the toes (plantarflexion), and allows for the greatest movement of all the joints in the foot. The ankle does not allow rotation. When the foot is dorsiflexed, the wider part of the superior talus moves into the articulating surfaces of the tibia and fibula, creating a more stable joint than when the foot is plantar flexed.
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 The joint is most stable in dorsiflexion and a sprained ankle is more likely to occur when the foot is plantar flexed. This type of injury more frequently occurs at the anterior talofibular ligament.

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LATERAL ANKLE SPRAIN

Lateral ankle sprain is the most common injury to the ankle and the long term consequences of an ankle sprain is a common cause of chronic ankle pain. The most common type is the inversion ankle sprain, in which the ankle rolls over on the outside. An ankle sprain is the stretching and tearing of ligaments - in the sprained ankle the most common damage is done to the talo-fibula ligament (if the ankle sprain is worse, the calcaneo-fibula ligament can also be damaged) sometimes the tendons also get damaged.

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CAUSES OF ANKLE SPRAIN

Anything that makes the ankle 'tip over' increases the chance of an ankle sprainthis can occur in sport (eg jumping and landing on someone else's foot), walking on uneven surface, twisting motions etc. A number of factors predispose to ankle sprains: 1. Poor rehabilitation of a previous sprained ankle 2. Poor proprioception (proprioception is the ability to sense where a joint is. If you don't know where your ankle is, the muscles will not be able to prevent the ankle sprain) 3. Some feet are very easy to 'tip over' - this is common in those who frequently 'roll the ankle', without actually doing any damage and spraining the ankle 4. Weak muscles (they are just not strong enough to prevent the sprain occurring)

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TYPES OF ANKLE SPRAIN

The sprained ankle is often classified as to how severe it is: Grade 1 ankle sprain:

Some stretching or mild tearing of the ligament. Little or no functional loss - the joint can still function and bear some weight Mild pain Some swelling Some joint stiffness.
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TYPES OF ANKLE SPRAIN

Grade 2 ankle sprain: Some more severe tearing of the ligaments Moderate instability of the joint Moderate to severe pain - weightbearing is very painful Swelling and stiffness

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TYPES OF ANKLE SPRAIN

Grade 3 ankle sprain: Total rupture of a ligament - there is a loss of motion Gross instability of the joint - joint function is lost Severe pain initially followed by no pain Severe swelling

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TREATMENT
The sooner treatment starts for a sprained ankle, the greater chance to prevent chronic pain and long term instability. For all grades of ankle sprain follow the R.I.C.E. principles as soon as possible:

Rest your ankle - do not walk on it. Ice - this helps to keep the swelling down. Use ice on the injury several times a day for 15-20 minutes (more than 20 minutes is not advised) Compressive bandages are needed to immobilize the ankle sprain and to support the injury. Elevate the ankle above your heart level for as much as you can for 48 hours.
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TREATMENT
Blood Flow Stimulation Therapy If you are still experiencing some inflammation in your injured ankle, and the area is no longer swollen you may want to explore the healing benefits of Blood Flow Stimulation Therapy (BFST). BFST decreases inflammation and increases blood circulation. Blood is the transport mechanism for oxygen, nutrients, water and antibodies, thus proper blood flow is essential when healing any type of ankle sprain. BFST is provided through the use of heat therapy which can be found in heating wrap products.Use of an Inferno Wrap will send oxygen, nutrient and antibody rich blood to the treatment area.

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THERAPEUTIC ULTRASOUND

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THERAPEUTIC ULTRASOUND
Therapeutic ultrasound is a method of stimulating tissue beneath the skin's surface using sound waves. It is like a high frequency massage that can penetrate up to 4" below the surface of the skin. o The heating and massaging effects of therapeutic ultrasound have 3 primary benefits: it can speed the healing process, reduce swelling, and heal damaged tissue softening scar tissue. o Essentially, the nutrient absorption rate and blood flow within the injured ankle area will be greatly enhanced through the use of an ultrasound device. o Portable ultrasound therapy is recommended by many doctors and physical therapists, and is also often administered by physicians and massage therapists.

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THERAPEUTIC ULTRASOUND
When applied directly to the skin, the transducer head of an ultrasound unit cannot effectively transfer sound waves into the body. A conductive medium (ultrasound gel) is required to facilitate therapeutic ultrasound. Ultrasound can also be used to administer therapeutic medicines into the body which provides the added benefit of delivering soothing medicated gel to the site of the pain. This is a process known as Phonophoresis.

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ANKLE SPRAIN PREVENTION

Ankle sprain prevention can be as simple as wearing the right shoes or as complicated as balance training for athletes. Wear proper shoes for the activity. Always wear stable shoes that give your ankle proper support. High-top basketball shoes are a good choice. (High heels or platform shoes are not the best choice if you're trying to prevent an ankle sprain.)

Keep the ankles strong and flexible. Consult with the doctor or phsiotherapist for strengthening exercises.
When participating in a sport, consider having a weak ankle taped, as taping offers extra support. If you have repeated sprains, wearing an ankle brace while playing may help. Make sure a playing field (or home environment) is clear of any holes or obstacles to help avoid injury. If you have flat feet or bunions, consult a podiatrist as these conditions could lead to balance problems or instability of the ankle. Page 15