Home Exercise and Rehab
Gina John is a Pilates Practitioner and Registered Osteopath who has spent many years offering help and advice, especially to the over 50 age group.
She is founder of The Osprey Clinic in the St. Johns Wood area of London and now specialises in Home Exercise and Rehabilitation Programmes. For further advice on exercising safely, and a selection of exercise films for general fitness and medical conditions, visit the website: www.home-exercise-rehab.com
This month: Ankle Sprain – Reducing the risk of repeated injury
The ligament at the side of the ankle, called the talo-fibular ligament is most commonly affected, but in 20% of cases, there is also damage to the calcaneo-fibular ligament at the back of the ankle.
Tendons which cross the ankle joint may also be damaged, depending on the foot and leg position when the strain occurs.
The correct management of the injury is imperative immediately following the sprain to ensure that tissues heal correctly and to mitigate the risk of repeated sprains. In the acute phase of injury it is advisable to see a physiotherapist and determine the best course of treatment and exercise. Initially, it is important to apply an ice pack or cold therapy gel to resolve inflammation in the first 1-3 days following injury, and wear a compression bandage to reduce the swelling and provide support for the injured ankle. While sitting, moving the ankle gently, within the pain-free range, helps to avoid stiffness and reduce the swelling further. Exercises to stretch the muscles in the legs and around the ankle joint can be undertaken as the swelling subsides and strengthening exercises should be done within the pain-free range of movement and as advised by your therapist. Severe sprains may require complete immobilization and crutches may be required.
To mitigate the risk of repeated ankle sprain, exercises should be continued even when you are able to resume your normal daily activities. Improving the muscle balance and stability of the joint is the key objective.
Stability of the joint is dependent on efficient neurological functioning as well as muscle balance and strength. Neurological feedback mechanisms enable our muscles to react swiftly and effectively, for normal movement to occur and to avoid overstretch or strain. Our ability to sense the joint position is termed ‘proprioception’. So, when the foot or ankle is positioned incorrectly, perhaps from tripping on a pavement or slipping on wet leaves, the muscles can adjust their activity promptly to avoid injury.
Regular proprioception and muscle balancing exercises help to maintain this efficient response. And, the following exercises should be performed around four times weekly.
Please send your questions for future columns, or feedback, by email to Gina John on firstname.lastname@example.org
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