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Types of Ankle Sprain

 

 

What is the Connection Between Ankle Sprains and Trigger Points?

 

Foot pain, ankle pain, and ankle instability are often associated with trigger points 

Anyone involved in athletics is particularly susceptible to an ankle sprain - an acute injury to any or all of the ligaments that support the ankle structure.

Tearing or stretching of the ligaments can occur when the foot is rolled or twisted forcefully.

High-impact sports involving jumping, sprinting or running on changing or uneven surfaces often lead to ankle sprains.

Basketball, football, cross country and hockey are a few of the sports commonly associated with ankle sprains.

Lateral ankle or inversion sprains commonly occur when stress is applied to the ankle during plantar flexion.

The anterior talofibular ligament is most commonly injured. The medial malleolus may act as a fulcrum to further injure the calcaneofibular ligament if the strain continues.

The peroneal tendons may absorb some of this strain. Medial ankle sprains are less common because of the strong deltoid ligament and bony structure of the ankle.

When ligaments are stretched beyond their normal range some tearing of the fibres may occur.

 

Ankle Anatomy Trigger Points

 

Cause of Injury

Sudden twisting of the foot. Rolling or force to the foot, most commonly laterally.

Signs and Symptoms

First-degree sprains: Little or no swelling; mild pain and stiffness in the joint.
Second-degree sprains: Moderate swelling and stiffness; moderate to severe pain; difficulty weight bearing and some instability in the joint.

Third-degree sprains: Severe swelling and pain; inability to weight bear; instability and loss of function in the joint.

Complications if Left Unattended

Chronic pain and instability in the ankle joint may result if left unattended. Loss of strength and flexibility and possible loss of function may also result. Increased risk of re-injury.

Immediate Treatment

RICER. Second- and third-degree sprains may require immobilization and immediate medical attention should be sought.

Rehabilitation and Prevention

Strengthening the muscles of the lower leg is important to prevent future sprains. Balance training will help to improve proprioception (the body’s awareness of movement and joint position sense) and strengthen the weakened ligaments.

Flexibility exercises to reduce stiffness and improve mobility are needed also. Bracing during the initial return to activity may be needed but should not replace strengthening and flexibility development.

Long-Term Prognosis

With proper rehabilitation and strengthening the athlete should not experience any limitations. A slight increase in the probability of injuring that ankle may occur.

Athletes who continue to experience difficulty with the ankle may need additional medical interventions including, in rare cases, possible surgery to tighten the ligaments. 

Trigger Points

Foot pain, ankle pain, and ankle instability are typically associated with trigger points in balancing muscles. These trigger points need to be located and treated to prevent injury recurrence.

Self Help

Stretching can often provide some temporary relief from ankle pain, and possibly help to treat some trigger points over time.

This is not something that's proven, but the anecdotal evidence in considerable, and some would say overwhelming.

The most common trigger point related to ankle pain is the one that forms in the tibialis anterior muscle.

The following stretch might provide relief by helping to dissipate the trigger point and aid rehabilitation.

 

 

Technique

Stand upright and place the top of your toes on the ground behind you. Push your ankle to the ground.

Muscles Being Stretched

Primary muscle: Tibialis anterior.
Secondary muscles: Extensor hallucis longus. Extensor digitorum longus. Peroneus tertius.

Injury Where Stretch May Be Useful

Ankle Pain. Ankle Weakness. Ankle Instability. Anterior compartment syndrome. Medial tibial pain syndrome (shin splints). Ankle sprain. Peroneal tendon subluxation. Peroneal tendonitis.

Additional Notes for Performing This Stretch Correctly

Regulate the intensity of this stretch by lowering your body and pushing your ankle to the ground. If need be, hold onto something for balance. 

  

   

 

Comments

Jeffrey Benton DC said:

This comprehensive article should include resetting proprioception receptors located within the ligaments and tendon. These receptors tell the brain where the ankle is positioned. These receptors need to be recalibrated post injury.

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