Is going over on your ankle sending you over the edge?

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Nottingham

Is going over on your ankle sending you over the edge?

28th March 2014 12:40 PM

Author: Cahir Doherty

Have you ever had a sprained ankle, and then a few weeks later done it again?  Do you want to know why it is likely to re-occur?  And what osteopathy can offer this most common of injuries?  Read on ...

In this short blog article I will talk a little about what a sprained ankle is, why we are prone to the injury and finally, what osteopathy can offer this very common injury.  My name is Mr Cahir Doherty and I work as an osteopath and acupuncturist at The Bridge Centre for Natural Health.  In addition I am a medical student at the University of Nottingham.

Incidence of ankle sprain

In 2003 there were over 300,000 emergency department presentations with ankle sprains in the UK. It is a very common sports injury!  What is a sprained ankle?  It usually refers to a sprain on the ligaments on the outside of the ankle.  A sprain is damage to a ligament that is graded as I-IV by your osteopath after detailed assessment and diagnosis.  Inflammation of the ligaments after spraining them can result in the four cardinal signs of inflammation, which are pain, redness, heat and swelling.  Collectively these combine to give a fifth sign, which is loss of function.

Anatomy

Why are we so prone to spraining the ligaments on the outside of the ankle?  The answer lies in the balancing act that evolution has struck between two factors:  mobility and stability.  The excellent mobility found at the ankle joint means that stability has been compromised, particularly when the foot is about to land on the ground with the toes pointed.  If one "rolls over" the ankle at this stage the only tissues providing stability are a collection of ligaments known as the lateral collateral ligaments.  Please see a lovely picture of these ligaments by clicking here.

Proprioception and repeat injury

It is very common to hear from patients that they have a tendancy to sprain one of their ankles repeatedly; the reasons for this are fascinating and involve proprioception.  I hear someone from the back saying 'What's proprioception?'.  I'll tell you in a minute.  For now please stop reading, close your eyes and touch your nose.

Done it?  Good.  That's because your proprioceptive system is working smoothly.  Proprioception allows you to know where your body is without watching it.  Imagine it as a detailed tracking system following the movement of your limbs and trunk as you go about your daily business.  Ever got up in the night to go to the bathroom and not turned on the light to get there?  Proprioception (and a good knowledge of your home environment!) will help you navigate without falling over.  I hear another voice from the back saying; "Yeah, yeah.  But what does this have to do with ankle sprain?".  The answer, dear reader, is 'lots'.  You see, receptors for proprioception are found to be concentrated in ligaments. When you sprain ligaments, you damage these receptors.  This reduces the ability of your brain to work out where you foot is when you are running.  Which in turn makes you more likely to twist your ankle. And the cycle continues.  Amazing stuff, right? Right!

Where the Osteopaths come in and save the day (or an ankle).....

"So I'll have to grow the proprioceptive receptors if I don't want to repeatedly twist my ankle?" Unfortunately the proprioceptive receptors are damaged permanently.  However, you can rehabilitate the remaining proprioceptors to avoid recurrence, and your osteopath can guide you on the rate and intensity of rehabilitation according to the level of tissue damage.

Osteopaths are statutorily regulated pracitioners qualified to diagnose the level of your ankle injury, treat the pain of the immediate problem (any any haphazard scar tissue from old injuries) and secondly, to treat the remaining adaptations within your body that have arisen from the original injury. Have you ever twisted an ankle really badly? If so you may walk with a limp and have gait adaptations that, over time, cause other seemingly unrelated problems elsewhere like knee pain or low back pain.  Be careful though, a bad ankle sprain can sometimes result in fracture so you may need to be assessed properly by your osteopath before treatment begins.

Self-Help

"What can I do to help myself while I'm waiting for an appointment?"  The answer is lots, again!  Remember RICE?

Rest

Ice

Compression

Elevation

I'll come back to this in the next blog on managing acute musculoskeletel injuries.  If you have any questions please email me using cahir@cahirdoherty.com.  Stay active and thanks for reading!

Cahir

 

Tags: Ankle, Osteopath

Treatments: Osteopathy

Practitioners: Cahir Doherty

The views expressed in these blogs are those of the blog authors and do not necessarily reflect the views of The Bridge Centre for Natural Health.

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