Welcome back, hopefully we are all moving better or at least on the road to moving better. We have introduced information here some you may have been familiar with and some of it may have been new as long your learning and improving your life. This week we are looking at the ankle. A complex joint which is made up of three joints, four bones and two major ligaments. It is one of the more injury prone joints; Sprained ankles have been estimated to constitute up to 30% of injuries seen in sports medicine clinics, 41% of all sports related ankle sprains are basketball related, according to the Academy of Orthopedic Surgeons. Approximately 1 million people sprain their ankles in the U.S. (1 in 320) annually, the treatment of ankle sprains in the U.S. costs more than $2 billion each year. Injuries can also be costly. According to the study, each injury costs close to $12,000 dollars per athlete, in direct and indirect costs to treat. In addition, 30 percent of the athletes who sustain ankle injuries will experience long-term negative effects as an adult. Sports Health News, August 2011. Plantar fasciitis is the most common cause of heal pain that is treated in outpatient clinics, approximately 2 million patients are treated for this condition every year.. This should demonstrate the importance of ankle mobility and stability.
What is the ankle? The ankle consists of 4 distinct bones the tibia, fibula, talus and calcaneus. The interplay between these bones allows for movement of the joint. The ankle is made up of three different joints talocural joint, inferior tibiofubular joint, subtalar joint. The talocular joint is a hinge joint formed by the distal ends of the tibia and fibula enclosing the upper surface of the talus this allows for dorsiflexion and plantarflexion. On to the inferior tibiofubular joint this is a point of strength between the lower surfaces of the tibia and fibula, the is supported by the inferior tibiofibular ligament. The subtalar joint comprises the articulating surfaces of the talus and calcaneus, it provides shock absorption and movements of eversion and inversion of the foot (outward and inward movement of the ankle). The ankle ligaments are extremely important for the stability of the ankle, comprised of mainly the collateral ligaments, both medial and lateral. The lateral collateral ligament prevents excessive inversion it is made up of three bands, the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament. The other major ligament is medial collateral ligament its also known as the deltoid ligament its considerably longer than the lateral ligament and spreads out in a fan shape to cover the distal end of the tibia and the inner surfaces of the talus, navicular and calcaneus. The plantar fascia is thin connective tissue that runs from the calcaneus to the metatarsal bones (the bones in between each toe and the bones of the mid foot).
The dysfunctions we are going to speak about this week are ankle sprains and plantar fasciitis. First up ankle sprains there are two types sprains inversion sprain which is the most common accounting for 90% of ankle sprains. The inversion sprain occurs when the foot is inverted falling inward, this causes the lateral to be stretched to far. The other type of sprain is the eversion sprain, this occurs when the foot twists outward causing the deltoid ligament to be stretched too far. Now with ankle sprains you have three grades, Grade 1 is just stretching of the ligament with some pain. Most people can walk without crutches, but cannot jog or jump. A Grade 2 sprain is a partial tearing of the ligament, with noticeable swelling and bruising. People have pain with walking but can still take a few steps. This leaves us with the Grade 3 sprain which are complete tears of the ligaments, noted to be very painful with difficulty walking. Some of the notable symptoms are instability in the joint along with bruising swelling and pain. Plantar fasciitis is the inflammation of the plantar fascia in the feet, this occurs with tight calf muscles, increases in weight or activity, repetitive activities like running. The symptoms are pain on the bottom of the foot near the heel, pain with the first steps getting out of bed or after sitting for an extended period of time and greater pain after exercise.
Our solutions for this week, ankle sprains are usually treated with RICE Rest Ice Compression and Elevation, this along with NSAIDS is the initial treatment plan. If you have the ankle immobilized you want to limit immobilization, begin some range of motion exercises achilles stretches and alphabet writing. Then some strengthening toe raises, heel and toe walking, from there proprioceptive training which is where your body relearns to send proper feedback to the brain. This where you will get the most bang for your buck, a 1988 study by University Hospital in Linkoping Sweden showed that six weeks of balance training improved balance and stability with soccer players with ankle instability. This was followed up with a 1997 study by the Norwegian University of Sport and Physical Education which found a two fold reduction in the incidence of acute ankle sprains in volleyball players after introduction of an injury prevention program using proprioception. Now with Plantar fasciitis you will need to stretch your calves, look to see if you need to clear up either the hips or hamstrings as well. Upon waking in the morning lightly rolling either a golf or lacrosse ball may help to break up the adhesions, after you run your take a frozen bottle of water and roll that under your foot. The other things you can do are towel crunches, picking up marbles with your toes and putting them into cups as well as stretching your foot into dorsiflexion with a towel. Some people report having benefits with night splints. Remember assess before after and during otherwise how will we know we are making progress.
The next blog will be about shoulder mobility!!
Another good one thanks
ReplyDeleteThis is an awesome blog. The last few weeks have been very helpful.
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