Posts for: July, 2018
For anyone who has ever laced up a pair of cleats, running shoes, or as my boys like to tease me, “sneakers”, then almost all of you have probably suffered an ankle sprain at some time in your life. The most common variety: Inversion ankle sprain, which is more casually referred to as “rolling your ankle” (where the foot turns in while all the weight goes to the outside of the lower leg). Other ankle injuries can occur, but let’s stick to the more common type.
First priority: determine if it is simply a low grade type of ankle sprain, and not something more serious. One of the classic signs of a serious injury is the inability, or refusal, of the individual to bear any weight immediately after the injury. This may indicate the need for more formal diagnostic imaging and medical care.
Second priority: control the swelling. This is most likely caused by small vessel damage and subsequent bleeding. This is the best time for ice, compression, and elevation to be used. Once 2-3 days have passed, and more serious conditions are eliminated, switching to heat and gentle movement is probably best. But the swelling and soreness from the initial vascular injury are not the only causes of ankle pain.
Third priority: assess for joint dysfunctions and nerve irritability. Some ankle pain may linger for a time after the initial bruising and swelling have cleared. Causes could be the joint is stuck out of position, or shifted. In fact, a one-degree deviation from the normal resting position of the ankle increases the forces in the ankle by 42% when your full weight is on it (ACSM, 2017). Manipulation to restore proper alignment and mobility may be needed.
In base level orthopedic physical therapy, nerve pain is often overlooked when treating the ankle. The Intermediate Dorsal Cutaneous Nerve, a branch of the Superficial Fibular (peroneal) Nerve, travels directly over the front of the talofibular ligament, and may also be what is tender when pressed (see bottom left portion of image). Austin Manual Therapy Fellowship-trained Manual Physical Therapists are specifically trained to examine and evaluate every potential source of pain for a “simple” ankle sprain, including nerve pain.
At Austin Manual Therapy, we provide a uniquely thorough and holistic evaluation for every patient, every time (no two ankle injuries are the same). We have the highest expertise, the most advanced specialized training in Orthopedic Physical Therapy comprehensive examination and diagnosis to get to the root of the problem, the “cause of the cause”, if you will. Whether you wear sneakers or not, our treatments will address your immediate needs, and add preventative measures to help reduce likelihood of a recurrence.
Ask yourself the next time it happens, if your “simple” ankle sprain is just that; simple. Come see us at Austin Manual Therapy and we’ll help you figure out what the problem is, correct it, and help you protect the ankle in the future. You can reach us at (512) 832-9411, or www.austinmanualtherapy.com.
One of the unexpected “benefits” of being a physical therapist is that family, friends, and strangers ask your advice on all sorts of health related topics:
“What kind of exercises should I do for my back?”
“Why does my knee hurt right here?”
“Should I use heat or ice?”
“What medication should I take for pain?”
“Does this look normal?”
While I love that people trust my opinion and want my advice, most of the time there is a lot more to answering those questions than just a simple recommendation. Often times, my answer begins with, “Well it depends…” and after a few follow up questions the person who wanted a simple answer is no longer that interested because I have made the situation more complex. But here’s the thing, it should be complex and also comprehensive.
There’s a reason that becoming a PT requires 4 years of undergraduate education, 3 years of a clinical doctorate, and in the case of Austin Manual Therapy Associates, 3 years of advanced training in manual therapy to become a credentialed Fellow of Orthopedic Manual Physical Therapy. Bodies are extremely complicated; it takes a lot of knowledge, experience, and training to properly evaluate, diagnose, and treat the complexities of the musculoskeletal and nervous systems. I’d be doing someone a disservice if I answered their questions with a simple response without taking the time to ask specific questions and gather more information. That’s also why I advise people not to rely on google, instagram, facebook, and other social media for self-treatment approaches; a one-size fits all approach to treating injury and pain is not always the best option.
The benefit of going to a PT with advanced training and experience is that they will take the time to ask the right questions, get a comprehensive history of your injury and pain experience, identify your goals, assess and evaluate the body as a whole system working together, address any soft tissue or joint dysfunctions, and develop a personalized and achievable treatment plan. A good PT can give you advice on how to treat that shoulder pain that you developed while doing yard work last weekend, but a great PT will take a comprehensive look at your movement system as a whole and work with you and educate you to prevent that injury from reoccurring.
So if you’ve been dealing with aches, pain, injuries (new or recurring) or have had similar questions like the one above for a PT or consulted “Dr. Google”, give us a try at Austin Manual Therapy Associates and let us show you the benefit and difference of being treated by highly qualified PT’s. After all, we are the movement experts!
Jacqueline Stine, PT, DPT