How many of you have this problem?
You've sprained your ankle weeks ago and can't seem to shake the injury. You can do tentative activity with it, but you wouldn't bet on it for that netball game, or the upcoming football trial. It just isn't coming right quick enough.
A group of researchers in Belfast have proven what seems to be physiotherapy's best kept secret: Targeted immediate exercise accelerates recovery and has been proven to shorten the time away from sport and work activities.
Chris Bleakley and friends led a study into 101 subjects who had grade one to two ankle sprains. They found that there are an estimated 5000 new cases a day of ankle sprain in the UK. Apply this percentage to New Zealand and we might see 33,000 of these injuries a year.
Just as Gordon Sumner is known as Sting, so the talo-crural joint is known on stage as the ankle. An ankle sprain is an injury to the supportive structures of this joint — its ligaments. Ligaments have to be strong enough to hold the ankle together, but have to also have some give to provide suppleness. To clarify the grades of ligament injury, here is the scheme we use in medicine: Grade 1 is the least severe, yet often more painful than you can believe. Many people recount strong nausea and extreme pain with these injuries. The ligament looks inflamed and microscopic tears have developed. It looks intact and feels to the trained hand, solid and not lax. A grade 2 is a partial tear. The ligament has most of its fibres torn but enough remain to keep a hold on the joint still. The risk is that left alone, and not rehabilitated, these can rupture and do further damage to not only ligament, but joint surfaces as well. A grade 3 is the final straw of structural integrity lost. The ligament has torn through and offers zero support or functional use. In some parts of the body you will not get repaired surgically and you can call upon muscles to support the joint instead, but you won't be the same. If you are involved in dynamic forceful activities you are more likely to receive surgical intervention.
With muscle injuries we often treat these with stretching, however ligaments don't usually need to be stretched, because this promotes laxity: An excess of mobility, also called hypermobility. If you roll your ankle a lot, then your ankle becomes hypermobile. It's then easier to roll it next time, and so on. This can be the reason for your ankle giving way or collapsing on uneven ground or in sudden change of direction. If you regularly experience giving way in your joints, you should seek the assistance of your physio who can help you re-strengthen to get the stability and performance back.