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Sprained ankle

Knowing the symptoms that can be


experienced with a sprain is important in
determining that the injury is not really a break in
the bone.
When a sprain occurs, blood vessels will leak
fluid into the tissue that surrounds the joint.
White blood cells responsible for inflammation
migrate to the area, and blood flow increases as
well.
Along with this inflammation, swelling from
the fluid and pain is experienced. The nerves in
the area become more sensitive when the injury
is suffered, so pain is felt as throbbing and will
worsen if there is pressure placed on the area.
Warmth and redness are also seen as blood
flow is increased. Also present is a decreased
ability to move the joint, and difficulty using the
affected leg .

Cause
Movements - especially twisting, turning, and
rolling of the foot - are the primary cause of an ankle
sprain.
The risk of a sprain is greatest during activities
that involve explosive side-to-side motion, such as
tennis or basketball. Sprained ankles can also occur
during normal daily activities such as stepping off a
curb or slipping on ice.
Returning to activity before the ligaments have
fully healed may cause them to heal in a stretched
position, resulting in less stability at the ankle joint.
This can lead to a condition known as Chronic Ankle
Instability (CAI), and an increased risk of ankle
sprains

The following factors can contribute to an increased risk of ankle sprains:


-Weak muscles/tendons that cross the ankle joint, especially the muscles of the lower leg
that cross the outside, or lateral aspect of the ankle joint (i.e. peroneal or fibular muscles);
-Weak or lax ligaments that join together the bones of the ankle joint this can be
hereditary or due to overstretching of ligaments as a result of repetitive ankle sprains;
-Poor ankle flexibility;
-Lack of warm-up and/or stretching before activity;
-Inadequate joint proprioception (i.e. sense of joint position);
-Slow neuron muscular response to an off-balance position;
-Running on uneven surfaces;
-Shoes with inadequate heel support;
- Wearing high-heeled shoes due to the weak position of the ankle joint with an elevated
heel, and a small base of support.

Eversion (medial) ankle sprain


A less common type of ankle sprain is called an eversion injury,
affecting the medial side of the foot. When this occurs,
the medial, or deltoid, ligament is stretched too much.

High ankle sprain


A high ankle sprain is an injury to the large ligaments above the
ankle that join together the two long bones of the lower leg,
called the tibia and fibula. High ankle sprains commonly occur
from a sudden and forceful outward twisting of the foot, which
commonly occurs in contact and cutting sports such as football,
rugby, ice hockey, roller derby, basketball, volleyball, lacrosse,
softball, baseball, track, ultimate frisbee, gridiron, tennis and
badminton.

Mobilization
A short period of immobilization in a belowknee cast or in an Aircast leads to a faster
recovery at 3 months compared to a tubular
compression bandage.Yet, a randomized
controlled trial has concluded that appropriate
exercise immediately after a sprain improves
function and recovery. The exercises were
focused on increasing ankle range of
movement, activation and strengthening of
ankle musculature, and restoring normal
sensorimotor control, and were carried out for
20 minutes, three times a day.

After the injury its probably best to not to walk for a couple of days
complete bed rest will increase the healing process and will also
eliminate the chance of mishandling of the affected part,if right ankle is
injured do not drive at all.
The amount of therapy that a person can handle will depend on their
level of pain and the grade of sprain they experienced. It is not
recommended to return to sports or extreme physical activities until
hopping on the ankle is achieved without pain.
Wearing high-top tennis shoes may also help prevent ankle sprains if
the shoes used are laced snugly and if the ankle is taped with a wide,
nonelastic adhesive tape.

Ankle exercises
To prevent sprains or re-injury from occurring, strengthening and
stretching exercises should be done through a full range of ankle motion.
To improve ankle mobility, ankle circles can be performed by extending
the legs in front of the body and then moving the foot up and down, side to
side, or rotating the foot in a circle. Another common exercise to improve
mobility as well as proprioception is to use the toes to draw the letters of
the alphabet in the air. Most importantly, the lateral aspect of the ankle
joint should be strengthened with eversion exercises (i.e. underside of the
foot is turned outward against resistance) to improve lateral ankle
stability. Stretching is also an important component of a strengthening
program, to help maintain joint flexibility.

Balance and stability training are especially important to retrain the ankle
muscles to work together to support the joint. This includes exercises that
are performed by standing on one foot and using the injured ankle to lift the
body onto its toes. To further enhance balance and stability, exercise
devices such as the wobble board can be used, progressing from double-leg
to single-leg stance, first with eyes open and then with eyes closed, for
enhanced effectiveness.

Flexibility exercises
Example of a flexibility exercise is a towel stratch and
writing the alphabet with toes which will increase the range
of motion.

Balance exercises
Balance exercises include the use of
a wobble board which help the whole body
function together. The use of wobble boards
have shown to produce significantly positive
results in gaining proper balance compared to
not using it