Ankle sprains: do not underestimate them so that the sprained ankle does not become unstable
A sprained ankle is an injury that we often do not pay much attention to and consider it a banal injury. Some suffer from it very often, reducing the duration of treatment to a minimum. Unfortunately, we have no idea that even this common injury can have a big impact on our way of moving in the future. We will look at this problem in more detail. What actually happens with this injury?
Professionally, spraining the ankle is called ankle distortion. Most often it is an excessive deviation of the outer ankle outwards. On the outside of the ankle, the ligaments are weaker than on the inner. Excessive movement beyond physiological boundaries leads to a certain stretching or injury of these ligaments. This injury can be divided according to the weight into 3 degrees:
1st degree – minimal stretching of ligaments – ligaments have stretched more than physiological, but they have not been torn, in this case the ankle slightly swollen, the swelling disappears in 2-3 days.
Stage 2 – stretching of a larger number of fibers to their minor ruptures – there has already been a tearing of a smaller number of fibers, swelling persists longer, a significant hematoma is formed and the mobility of the foot is partially limited
Stage 3 – complete rupture – the ligament is largely torn, the leg is significantly swollen, the hematoma is large, on both sides and above the ankle and persists for more than a week, the hock is unstable
What are the consequences?
The greatest consequences arise in the case of severe sprain, despite the fact that if the therapy was conducted, that is, the ankle was fixed with gypsum or orthosis for a sufficiently long time. However, very frequent slight sprains can also have great consequences. You may not even feel the effects of an injury until many years later. The classic case is that of a man who played football or volleyball in his youth and ankle sprains were the order of the day. Then he didn’t do much sports for a long time and at the age of fifty he decided to start running. Repeated vertical load on the foot, however, will make visible the problem that the athlete carries with him from his youth.
The ankle becomes chronically unstable and is more prone to further injury. The work of the muscles in the leg area changes significantly, which is very noticeably reflected on other areas of the body.
First, by injuring part of the ligaments, the mechanical strength of the hock decreased. Secondly, the ligaments of the hock contain a large number of receptors that inform the brain, which thanks to this information controls the involvement of the muscles of the foot. The rupture of the ligaments reduced the number of receptors and the fixation of the hock also reduced the activity of functional receptors, so that the overall information of the brain was reduced and slowed down. Therefore, the activity of the muscles has changed. The muscles are less responsive and are unable to react quickly and keep the leg firm when stepped on the bump. And thirdly, by injury, swelling and irritation of the painful receptors of the foot, there was a malfunction of the function of the foot in its joints. The resulting blockages with subsequent stiffening of the ankle limit its mobility and this must be replaced elsewhere.
So how to properly treat a sprain?
After the injury, it is best to immediately ice the foot, immobilize it with a bandage fixation and put it in an elevated position. It is necessary to lighten the leg. If the swelling and hematoma are mild, you can heal the ankle at home. It is important to catch the first stage and strictly follow the recommendations above. After the most acute phase subsides, i.e. after about three days, it will greatly help to remove the swelling of the lymphatic drainage, relax the soft tissues of the foot and mobilize the joints of the foot. Very pleasant and very helpful is kineziotejp. The latter can help both to improve lymphatic drainage and to mechanically strengthen the ankle. Taping is advisable for quite a long time until you feel that the ankle is fully functional.
In the case of the second degree, it is necessary to lighten the leg longer and fix the foot with an orthosis. Lymphatic massage and joint mobilization will also help a lot. It is advisable to start practicing with the foot after three days – to pull and stretch the toe, move the toes, make pinches, lift objects with the help of fingers from the ground. All these exercises will help to remove swelling. Mainly, however, they keep the foot active, i.e. information is sent from it to the brain, which prevents functional depression of the foot.
In the case of the third degree of damage, it will be necessary to have a fixed fixation of three to six weeks with the need for full lightening. However, it is not good to overdo it on the other hand with fixation and lightening. It was found that the load helps to form the correct setting of regenerating collagen fibers. If you save the foot too much, the collagen fibers will not have a stimulus to properly arrange and so the resulting scar will not be strong and the ankle will not be strong enough.Therefore, it is good to fix the foot, but gradually begin to load it.
When to start to load fully, depends on the degree of damage to the ligaments. It can be in a light case immediately or only after the fixation is removed. However, you must not burden it so that it will swell. Slowly test what the foot can do without overloading. Exercise is a necessary component. Walking alone will definitely not break up and warm up your foot! It is necessary to restore the full function of the foot. Exercise with your fingers, practice toe straps, stretch your instep and ankle. It will help to practice various modifications of walking – walking on tiptoes, on heels, walking sideways by crossing the legs.
It is only during these actions that one discovers how stiff the leg is, how clumsy it is and how you have lost control over it. The foot also needs to restore its equilibrium functions. So start with lunges and weight transfers over the affected leg, gradually it is good to try on some unstable surface, lens or line. Balance exercises are important to stimulate the activity of receptors that are stored in the ligaments and ankle joint. The foot will then be able to react quickly to a sudden deflection. Do not rush with running too much, first restore the full function of the foot. Then slowly test what the leg can run without pain and subsequent swelling.
Dagmar Lisá (Mostecká)
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