A sprain occurs when a ligament is injured or torn. The American Academy of Orthopaedic Surgeons states that up to 25,000 ankle sprains happen daily. A sprain can involve part or all of the ligament. There are different grades of sprains to designate how much of the ligament has been injured. In the case of chronic ankle sprains, the same injury is repeated over and over again, afflicting the same area. There are different ways to treat chronic ankle sprains.
Protection
Every time the ankle is sprained, the body will form new scar tissue, or a patch, to help the fibers reconnect. Overtime, movement will help align the scar tissue, but it is never as strong as the original tissue, which can lead to re-aggravation and re-injury. It is important to protect the ankle joint any time the irritating movement or activity is engaged in. The Mayo Clinic recommends protecting the joint with a brace or splint. This is done by purchasing an ankle brace at any grocery store. The brace should be large enough not to cut off circulation to the toes and high enough to cover the rounded ankle bones on either side of the leg. The brace should not be worn all the time for that can lead to further weakening of all of the ankle ligaments and muscles.
Proprioception
Proprioception is a fancy term for the brain knowing where the body is in space. There are receptors in every joint that help send information to the brain. In an injury such as an ankle sprain, these receptors can start giving false information to no information at all. The American Academy of Orthopaedic Surgeons notes that, if proprioception is not working properly, it will lead to further injury, especially in activities that require rapid changes in direction. Testing proprioception function is done easily by standing barefoot on one leg at a time. Starting with the uninjured ankle will give a better idea of baseline. Standing near a corner or sink when testing this is helpful in case of loss of balance. The one-legged stand should be tested on both sides with eyes open and eyes closed. An inability to stand without wobbling for 30 seconds is an indication that proprioception is off. If proprioception is not working properly, simply standing on one leg at a time will help strengthen the intrinsic muscles, ligaments and proprioception receptors.
Exercise and Stretching
The ankle will need to be strengthened to help prevent re-injury. Basic exercises include pain-free range of motion, isometric and tubing exercises. Stretching will include stretching all of the lower leg and food muscles. A popular range of motion exercise that also helps stretch the lower leg is tracing the alphabet in the air with the foot. This will get the ankle and foot moving in all possible directions and help relax any tense areas in the lower leg. Isometric and tubing exercises will strengthen the basic directions of the ankle such as turning in and out, tilting in and out and pointing and flexing the toes. Isometric exercises are performed first until the ankle is strong enough to add resistance from tubing.
Medical Care
Seeing a chiropractor or physical therapist will help as both of these professions have in-office tools such as ultrasound and cold laser to help with healing. Additionally, having the ankle joint mobilized or adjusted will help keep the joint functioning properly, thus reducing stress on the ligaments and muscles around the ankle. Advanced nutrition, proprioception and tubing exercises can also be done under supervision to really accelerate the healing process.
References
- "Quick Reference Conditions Manual;" Nikita Vizniak and Michael Carnes; 2004
- American Academy of Orthopaedic Surgeons: Ankle Sprain
- Mayo Clinic: Sprain
