How many sprained ankles have you had? With 25,000 people per day spraining their ankles, chances are you’ve had a few sprains.
Every sprained ankle you have increases your chances of having another. Your connective tissue (fascia, tendons and ligaments) and muscles become either weaker or more brittle depending on how you sprained your ankle. Let’s assume your pattern is the most common one, where you twist your ankle to the outside of your foot. By landing on the outer edge of your foot or ankle, you stretch all the lateral or outside soft tissue of your foot, ankle, and lower leg.
With a severe sprain you more than strain the soft tissue, you actually tear your ligaments. The ligaments are the deeperthat hold your joints together. When severely sprained they can tear, and occasionally they completely tear off their attachment to the bone.
Most of us are familiar with the preferred immediate treatment to help reduce swelling and pain: RICE – Rest, Ice, Compression, and Elevation. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be recommended to reduce pain and inflammation. Because of the dangers of repeated use of these drugs and the increased effectiveness of systemic enzymes, more people are using proteolytic enzymes (scar tissue dissolving enzymes) to reduce the pain and swelling while aiding in the healing.
The chronic condition
Repetitive sprains increase the formation of scar tissue. Your body uses scar tissue to immobilize the joint as it lays down the infrastructure to mend connective tissue. All that is good, but as the sprains build up, so does the residue of the remnants of previous sprains. You body is unable to dissolve all the old scar tissue. What was your ankle’s natural Ace Bandage evolves into your ankle’s ski boot.
The chronic ankle instability, a condition marked by persistent discomfort and a “giving way” of the ankle, occurs because of the ankle’s tightness and weakness. Your ankle will not move freely in certain directions while being hyper-mobile in other directions. Rather than having a natural give, you now have an unstable ankle that is vulnerable to more sprains. What would have been a minor strain becomes a major sprain because the tight connective tissue doesn’t stretch like Spandex– it tears like a sheet.
Treatment and prevention of chronic sprains
Rehab exercises are important for the acute injury. They keep the joint from tightening up further while strengthening the weaken muscles. Unfortunately, rehab alone won’t prevent future injures.
To get the full benefit of rehab, you need to develop the strength in your core or intrinsic (deep) muscles of your body. Standing on one of those soft half balls requires your body to balance with these muscles. If your joint or your entire body is tight, this kind of balancing will be difficult.
The key to prevention is to release the scar tissue. Unfortunately stretching usually won’t do it for an ankle. You need someone with skilled hands to release it for you. The more that person understands the inter-connections of the entire body structure, the better the results. For example, I have seen that the tendency of many ankle sprains comes from a rotation of the femur; that is, walking pigeon-toed, or duck-footed (which is more common) rotate the femur unnaturally, and can cause instability that leads to sprains. For the greatest prevention you need to address all the primary and secondary causes.
A common secondary cause is improper movement patterns often caused by the body compensating from previous injuries. As you heal from an injury and/or protect that injured part, you develop movement patterns that become structural patterns that are inefficient and set you up for more injuries.
Owen Marcus, MA Certified Advance Rolfer, 30 yrs experience, www.align.org, call if you have questions – 265.8440. This article and many more health and wellness articles are at the blog: www.sandpointwellnesscouncil.com. Go to the blog to ask questions or add your comments on any article.