Is retreat a MUST after Ankle Joint Sprain?

Active exercise can accelerate the rehabilitation of the injured ankle!

According to statistics, after an ankle sprain, about 60% of people will have a series of symptoms lasting for 18 months. Such as tendon pain, joint stiffness, muscle weakness, joint instability, persistent pain and swelling. Moreover, the probability of recurrence of sprains is greatly increased.

There are a lot of friends who often crumble, but they don’t even know it. Because they only take a simple retreat after their first ankle sprain, not even with an effective rehabilitation. The seemingly normal ankles have gradually become dysfunctional and potential risk has been buried for the habitual sprains of the future.

Stephen Curry, twice selected to the regular season MVP, twice selected to the All-NBA First Team and four times in the All-Star Game Western Conference starting lineup. However, in the 2011-2012 season, Curry played only 26 games because of repeated ankle sprains.

Curry said in an interview: "I have sprained my ankle too many times. I know that there is no big problem when I sprained this time."

Theoretically, instable ankles can be divided into two types: structural ankle instability and functional ankle instability.

Structural instability refers to the problem of congenital ankle joint structure, can only be handled with surgical treatment; functional ankle instability refers to the long-term incorrect use of soft tissue (muscle, ligament, etc.) that controls joint stability (excessive or abandoned) over time, the ability to control the ankle joint's nerve control is also reduced, eventually leading to ankle joint dysfunction.

And there is a big misunderstanding about ankle joint rehabilitation. Many think that the joint instability means the weak muscle. So practicing the muscles around the ankle joint can solve it.


However, this fact is obviously different. Can ordinary person's muscle ability be compared with the athletes? Can you be that same heavily injured like the athletes do? Being uninjured is definitely not a problem of strong or not, but it is likely to be a problem of Nerve Control Ability, especially for joints such as the ankle and shoulder that are more flexible than stability.

What is neurological control?

You fall from a height. Under normal circumstances, the nervous system that controls the hip, knee, and ankle in the brain automatically senses your gravitational acceleration and position combined with the sensory system to sense the distance of the fall, and will quickly make a choice to "notify" the joints of the body. What kind of posture should be placed to deal with landing?

Once the nerve control system is disordered, the strong muscles can't save the dislocated joint in position, so the injury appears. From being indifferent to conscious to finally sensitive, our nerve control can also be obtained through constant stimulation, and this feature of nerve control ability is helpful to recovery.

However, how to get neuromuscular control through stimulation?

By constantly forcing the joint to be in an unstable state, simulating the actual situation in actual movement, and letting the muscles respond correctly, so that the brain remembers that such a phenomenon should respond. Such practice can help the brain grows gradually from "indifferent" to "conscious" to the final "sensitive.

We hereby introduce a basic process for applying nerve stimulation to realize ankle sprain recovery (ligament intact, not fractured):

1. (Initial 72 hours after sprain) Police Principle

The rehabilitation of the ankle sprain should start immediately after the sprain. Cold compress and Raise affected limb immediately after the sprain (POLICE or PRICE principle). This step well done means a good foundation for future rehabilitation.

The 72 hours after a sprain is an acute phase. During this period, the Police principle can be applied to treat the sprained ankle joint acutely.

2. (The 2~6 weeks after sprain) Ankle Pump

After the sprain, the ankle will be swollen. At this time, we need to do ankle pump practice to accelerate the circulation of the tissue fluid and reduce swelling.

The so-called ankle pump means to stretch and hook the foot alternatively, which can not only accelerate the circulation of tissue fluid and reduce the swelling, but also remain its motion range in the braking status of case of joint injury. Except the stretch and hook, ankle movement within 360 degrees can be also exercised within the allowable range. As long as no pain t caused, any small range of motion is meaningful.

3. (2~6 weeks after sprain) Resistance joint exercise

As the swelling disappeared, some resistance can be added to the previous unrestrained ankle pump practice, say resistance ankle pump exercise. The Resistance can be generated with elastic bands, elastic rings, or other self-made resistance.

The lower leg in the figure is the affected limb, and the arrow indicates the direction of the force. Then the method shown in the figure practices the force of the dorsiflexion (hook) of the affected side.

Left: Practice the force of varus and dorsiflexion on both sides of the ankle; Right: Exercise the strength of the bilateral ankle valgus and the plantar flexion (hook).

Of course, you can also use the elastic band. The advantage is that the force is better controlled. The disadvantage is that the practice of adding the resistance to the hook foot needs the assistance of others.

There is also kind of elastic ring that specializes in the practice of valgus and plantar flexion. It’s easy to use without others to assist, but only with single function.

4. (The 2~6 weeks after sprain) Plantar muscle exercises

Many people are prone to plantar fasciitis after rehabilitation of the ankle. It is because the long-term foot brakes weaken the plantar muscles, and the sudden movement stimulates the plantar points of the plantar muscles. Therefore, the plantar muscles practice during the rehabilitation period is also essential.

Toe towel. This is the easiest and most effective way to practice the plantar muscles.

Soonest roll the towel into a roll with the toes, and during the movement the patient in the supine position for long time can also adapt to the feeling of landing on the lower limb as soon as possible.


5. (2~6 weeks after sprain) weight-bearing exercises

After painless standing and fully weight-bearing period, one can start standing exercises with weight bearing.


Long-term ankle joint braking will cause the surrounding muscles to shrink, and stretching must be done well.

The left picture shows the gastrocnemius muscle stretching, and the right picture shows the soleus muscle stretching. The difference is that the former needs the knee to be straight.


Calf Raises. The picture shows three levels, the patients can choose the appropriate action according to their own situation, and the general principle is painless and no discomfort.

Calf raises when standing up, try to stay at the high point for about 3 seconds. Don't lean forward, then fall and repeat about 15 times.

Shallow squat on one foot. The affected foot side touches the ground, noticing the knees not to exceed the toes. The difference between the left and the right figures is that the right is shallow squat plus calf raises, which is with more difficult.


6. (8 weeks after Sprain)

During this period, the load capacity of the ankle is basically up to standard, and it is the balance ability that needs to improve.


Clock Practice. The affected limb touches the ground, and the other foot points at different directions, and the toes point to the ground, just like the clock travels. Attention no shaking the body.


Balance exercise for unstable planes (family version). Without professional equipment, some household articles can be used to achieve similar effects, too.

The figures from left to right increases in difficulties, and everyone should practice according to the actual situation.

It takes about 8 weeks to complete the whole rehabilitation process, and your ankle sprain is basically recovered then.

But to fully recover to the pre-injury level still requires constant training.

Here only list the recovery methods of the surrounding muscles related to the ankle joint, but don't forget that human body is in a whole. During the time when you are in bed, the whole body muscles are in a state of decreased muscle strength, so the gluteal muscles and the thigh muscle groups, even the core muscles, all need to be practiced bit by bit during the healing phase.

In short, don't stay still after the injury, and don't rush to find an overnight way during the recovery process. Gradual practice would lead to a lasting and stable effect.

Post time: May-28-2019

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