Win the sprain game

Lots of men worry about their back
going out—or their knees just going.

The lowly ankle sprain, however, is
viewed as the common cold of musculoskeletal injuries. It happens, and you get
over it. It’s hard to avoid.

But a growing number of
researchers, surgeons, and trainers believe it’s time to rethink this joint. A
sprained ankle is the most common injury in sports, and yet our understanding
of it is only now coming into focus. Sprains cause more damage than we once
thought they did, and we can do a lot more to prevent the fallout. In short,
“Walk it off” may not be the proper response.

A recent study using data from
National Basketball Association team doctors and trainers in the US found that
ankle sprains are the most common injury among pro basketball players, on and
off the court.

Treatment necessary

But opinions have changed:
Inadequate treatment could prime you for years of residual pain and re-sprains.
Some 30 per cent of sprain victims face chronic ankle instability.

The ligaments in your ankle, Jau
Hertel of the University of Virginia says, are laced with sensory receptors.
“These are responsible for telling the brain where the ankle is in space,” he
says. When a sprain occurs, some of these sensors are permanently damaged; as a
result, your ankle can’t communicate as well with your brain.

That’s where rehab comes in. The
secret to reclaiming your ankle’s recovery lies in the four steps below.

Assess

Beneath that bloated purple mass
are three groups of ligaments that hold (or used to hold) the joint in place.
Your immediate diagnosis is simple: “There’s mild or severe. You can either
walk or you can’t,” says John Kennedy, an orthopaedic surgeon in New York City.
If you aren’t able to bear weight on your foot, seek immediate medical
attention so a doctor can further diagnose the severity of your sprain.
Otherwise, proceed to the next step.

Rest

And add to this “ice,”
“compression,” and “elevation” for the textbook RICE treatment.

Once at rest, wrap a compression
bandage comfortably around the foot and ankle to minimize swelling. When an
ankle is swollen, “the fibres in the ligaments are pushed in different
directions, and they may not heal in their natural anatomic position,” says
orthopaedic surgeon Mark Drakos, the lead author of the NBA injury study.

Elevate your ankle above your heart
to prevent fluid accumulation, and apply an ice pack for 20 minutes. This
requires a couch or bed. For two days, ice the joint every two hours for 20
minutes at a time.

Of course, you still have to move
around. For a severe sprain, a compression bandage isn’t immobilizing enough.
Ask your doctor if you can use a walking boot so you can resume part of your
regular life.

Exercise

With your foot elevated and your
heel held still, write the alphabet in capital letters with your big toe.
Complete this 10-minute range-of-motion routine four times a day the first two
days after your injury, says Dr. Drakos.

After 48 hours, here’s your drill:
Set up two tubs, one with hot water and one with crushed ice and water. Take
off any wrap or boot you’re using, immerse your ankle in the hot water, and do
the alphabet exercise for 5 minutes. Then dunk your foot in the ice water, keeping
your heel on the bottom of the tub and lifting your toes so they touch the
side. Hold that position for 8 seconds, and relax for 2 seconds. Repeat for a
total of six times. Then alternate 30-second hot and cold dunks for the next 4
minutes.

Do this drill three more times
throughout the day, reducing the hot-water-alphabet step by a minute each time.
Keep wearing the compression wrap when you’re not dunking your ankle, or until
it is no longer swollen or painful.

Balance

The next step is crucial. It
encourages balance, stability, and a sense of where your ankle is in space.

Your first move: Lift your healthy
foot and stand on the other foot while you brush your teeth. Do this twice a
day for 3 minutes, and you’ve engaged in the most basic form of proprioceptive
training.

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Ankle sprain is viewed as the common cold of musculoskeletal injuries.
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