Last night I was playing basketball at the local college where we play every Monday night and having just spent some time trying to assess the injury of another guy who had hurt his heel bone, I went up to block a shot and came down dragging my toes under my foot and twisted the small bone on the outside of the ankle (fibula). This is the first time in over 8 years that this has happened to me and I felt instant pain and decided my ability to walk and train was more important than playing through. I was done for the night; 1st rule of thumb is knowing when to stop playing (right).
Anyway, what about injury prevention and restoration of an injured part? Well the best way we know to limit injury and I say limit rather than completely prevent because accidents occur at any stage and cannot always be avoided. Though you can't always avoid the injury, you can help yourself to limit the injuries severity by simply staying active, participating in an effective strength training workout and continuing to increase range of motion in your joints. In the case of an ankle such is my issue is maintaining strength, flexibility and muscle balance. In my case I strength train at least 4 days per week, I run sprints and do ground-based exercises on a regular basis but even those of us who do this for a living can still get hurt. We are not above the possibility of a accident or losing focus for a split second while playing a sport. It happens and then we too have to take care of the injury and go through the rehabilitation process.
What if I sprain my ankle?
Ankle sprains are very common, in fact according to statistics about 25,000 people experience it every day. By the way it's not only athletes but non-athletes who turn, twist or sprain their ankle in many different ways or causes throughout the day (i.e. walking on uneven surfaces, steeping off the curb at an angle, playing sports or being physically active in other ways).
There are different grades of sprains and the following information was taken from the American Academy of Orthopaedic Surgeons where they show a glimpse of how to determine or a medical professional determine this grade.
Mechanism of Injury
If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear. You may lose your balance when your foot is placed unevenly on the ground. You may fall and be unable to stand on that foot. When excessive force is applied to the ankle's soft tissue structures, you may even hear a "pop". Pain and swelling result.
The amount of force determines the grade of the sprain. A mild sprain is a Grade 1. A moderate sprain is a Grade 2. A severe strain is a Grade 3 (see Table below).
- Grade 1 sprain: Slight stretching and some damage to the fibers (fibrils) of the ligament.
- Grade 2 sprain: Partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.
- Grade 3 sprain: Complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs.
Classification of Ankle Sprains
| Severity | Physical Examination Findings | Impairment | Pathophysiology | Typical Treatment* |
|---|---|---|---|---|
| Grade 1 | Minimal tenderness and swelling | Minimal | Microscopic tearing of collagen fibers | Weight bearing as tolerated No splinting/casting Isometric exercises Full range-of-motion and stretching/ strengthening exercises as tolerated |
| Grade 2 | Moderated tenderness and swelling Decreased range of motion Possible instability | Moderated | Complete tears of some but not all collagen fibers in the ligament | Immobilization with air splint Physical therapy with range-of-motion and stretching/ strengthening exercises |
| Grade 3 | Significant swelling and tenderness Instability | Severe | Complete tear/ rupture of ligament | Immobilization Physical therapy similar to that for grade 2 sprains but over a longer period Possible surgical reconstruction |
I have spent some time since last night elevating, icing, resting and compressing my ankle I have been trying to assess the Grade of sprain for myself (though I would be the first to go in for an x-ray if needed) I believe we are dealing with a Grade 2 which includes moderate controlled swelling around the point of injury and some minor (yet dark) bruising has shown up.
As a result, instead of my normal daily activities and training, today I will be implementing the RICE treatment for my sprain
Rest- The first 24-48 hours after the injury is considered a critical treatment period and activities need to be limited and pretty much put on hold.
Ice- 24-48 hours post injury, ice the sprain for 20 minutes every 3-4 hours. Never ice for more than 15-20 minutes at a time due to the fact that you can cause damage to the tissue by over treating the area. Let the injured area warm again for a least 45 minutes to an hour before reapplication.
Compression- recommended especially in the early stages of the injury (first 48 hours) to help control swelling of the injured area. Using an ace bandage wrap the injured area snug but not cutting off blood flow; if you toes, fingers etc start to get cold, turn blue or tingle take it off and re wrap
Elevate- Keep the ankle or other injured part elevated. Some would say above the heart, but at least keep it from hanging down and stabilize the joint as much as possible.
By all means if the swelling persist and doesn't start to subside within a day or so (bringing some even limited mobility back to the joint) see a medical professional for an X-ray or MRI. It's not worth prolonging the injury and in many cases worsening the injury by reinforcing improper healing to take place.
Remember, our body has been created to care for itself and the healing that takes place is extraordinary; however we must use wisdom when it comes to injuries.
I will be signing off now and settling in to read through my new homework (The Seven Steps of Personal Safety) which is a book written by my friend, mentor and colleague Tim Powers. We are starting to implement this topic into our training in order to conduct seminars on How to avoid, deal with and survive the aftermath of violence and terrorism. You can check it out by clicking on the highlighted name and it will direct your to his site.
We are available to conduct these seminars, as well as our fitness seminars in your church, business, medical office etc so give me a call or email.
I hope this article will be of assistance to you and that you will continue or begin a life of movement and activity.
Keep moving and be blessed!
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