Ankle Sprains and Bracing
Charles McCombs
12/23/2012
Ankle injuries are among the most common injuries to competitive and recreational athletes who participate in sports with high intensity running, jumping and cutting. Because the joint is freely movable it can be easily injured in sports such as basketball, soccer, and volleyball which involve these types of movements. Athletes of any level who sustain an ankle sprain become much more likely to re-injure the same ankle. There are, however, preventative measures that athletes can take such as ankle taping or wearing an ankle brace. These measures are recommended for all athletes involved in similar activities, including those who have never sprained an ankle.
When a patient who sprains his or her ankle is recommended to a health care practitioner, there are many questions that need to be asked to create a clear picture of how the sprain occurred and the degree to which the ankle is sprained. It is important to first gather information on the patient’s current condition. This can be done by asking about the patient’s chief complaint as well as the symptoms and pain that he is currently experiencing. Once that is done, the therapist, nurse or doctor should investigate how the injury occurred. What are the patient’s age and activity level? Is he involved in sports that have high incidences of ankle sprains? Has there been a previous sprain that would make the patient more likely to sprain his ankle? It is also important to ask if the patient can remember the specific cause of the sprain or if the gradual increase in symptoms is from repeated minor sprains. If the injury is chronic, health care practitioners need to ask about the onset of similar symptoms before the patient decided to come in as well as what the patient did to manage his symptoms. Questions like these will help the clinician to form an accurate picture of the degree of sprain.
After the initial background information is gathered, it is important to visually and physically assess the site of injury. Therapists should visually check to see if there is any discoloration or edema. Edema can indicate tissue trauma where as discoloration can indicate poor circulation, an inflammatory response, and bruising. When physically assessing the patient, the uninjured side should be assessed for strength and flexibility so that a norm can be established. Only after the uninjured side has been assessed should the injured side be tested. It is important to note any strength and flexibility deficits that the patient has between sides as well as what they want to be improved. It is always important to consider the patient’s opinions when determining what problems due to the injury need to be dealt with.
Trauma to a joint often results in stability, strength and mobility problems. Ankle sprains can provide a major problem in that the patient cannot simply stop using the affected joint as easily as they could an injured arm. As such, it is important to help the patient reach a point where he feels comfortable with his progress before going back to normal activity so that there are no adverse effects on his performance. To reach this point, physical therapists must first work to help the patient regain mobility and flexibility in the ligaments and muscles affected by the sprain. After flexibility is addressed, any remaining strength deficits should be dealt with to help prevent re-injury.
Before returning to activity levels that the patient had prior to the ankle sprain, it is necessary to ensure that the patient has increased the injured ankle’s mobility and strength as well as decreased any instability, pain, and swelling. Because the greatest predictor for ankle sprains is previous ankle sprains, patients need to be sure to take some preventative measures when they return to their previous activity levels. One was to do this is with ankle bracing.
There are many different types of braces, semi-rigid and rigid braces are the most common types prescribed by physicians. Wearing a brace has been shown to decrease the likelihood of sustaining another sprain when compared to athletes who do not wear any sort of brace. Most of the studies reviewed in the Clinical Commentary: The Role of Ankle Bracing for Prevention of Ankle Sprain Injuries by Michael Gross and Hsin-Yi Liu, stated that ankle bracing rarely has adverse effects on athletic performance and sometimes has even been shown to increase performance. Problems with ankle braces typically arise because patients often choose not to wear the brace. This may be because they feel that the brace hampers their performance or the brace may simply be uncomfortable if it irritates the patient’s skin causing blisters or abrasions. To remedy this, physicians may prescribe semi-rigid braces such as cloth lace-up braces. These braces may fit slightly better and not irritate the patient’s skin. It is important that physicians do not simply give up on the idea of ankle bracing because a patient does not like one type, the only way to find the best ankle brace for a specific patient is through trial and error to see what works for that patient.
Ankle sprains commonly occur in recreational and competitive athletes who participate in sports with running, jumping and cutting. Athletes in any sport who have sustained a previous sprain are predisposed to re-injury. To help prevent injury and re-injury of the ankle, athletes involved in sports deemed high risk for sprains should wear ankle braces. Ankle braces do not appear to have an adverse affect on performance and have shown that they help reduce the frequency of ankle sprains in athletes.
12/23/2012
Ankle injuries are among the most common injuries to competitive and recreational athletes who participate in sports with high intensity running, jumping and cutting. Because the joint is freely movable it can be easily injured in sports such as basketball, soccer, and volleyball which involve these types of movements. Athletes of any level who sustain an ankle sprain become much more likely to re-injure the same ankle. There are, however, preventative measures that athletes can take such as ankle taping or wearing an ankle brace. These measures are recommended for all athletes involved in similar activities, including those who have never sprained an ankle.
When a patient who sprains his or her ankle is recommended to a health care practitioner, there are many questions that need to be asked to create a clear picture of how the sprain occurred and the degree to which the ankle is sprained. It is important to first gather information on the patient’s current condition. This can be done by asking about the patient’s chief complaint as well as the symptoms and pain that he is currently experiencing. Once that is done, the therapist, nurse or doctor should investigate how the injury occurred. What are the patient’s age and activity level? Is he involved in sports that have high incidences of ankle sprains? Has there been a previous sprain that would make the patient more likely to sprain his ankle? It is also important to ask if the patient can remember the specific cause of the sprain or if the gradual increase in symptoms is from repeated minor sprains. If the injury is chronic, health care practitioners need to ask about the onset of similar symptoms before the patient decided to come in as well as what the patient did to manage his symptoms. Questions like these will help the clinician to form an accurate picture of the degree of sprain.
After the initial background information is gathered, it is important to visually and physically assess the site of injury. Therapists should visually check to see if there is any discoloration or edema. Edema can indicate tissue trauma where as discoloration can indicate poor circulation, an inflammatory response, and bruising. When physically assessing the patient, the uninjured side should be assessed for strength and flexibility so that a norm can be established. Only after the uninjured side has been assessed should the injured side be tested. It is important to note any strength and flexibility deficits that the patient has between sides as well as what they want to be improved. It is always important to consider the patient’s opinions when determining what problems due to the injury need to be dealt with.
Trauma to a joint often results in stability, strength and mobility problems. Ankle sprains can provide a major problem in that the patient cannot simply stop using the affected joint as easily as they could an injured arm. As such, it is important to help the patient reach a point where he feels comfortable with his progress before going back to normal activity so that there are no adverse effects on his performance. To reach this point, physical therapists must first work to help the patient regain mobility and flexibility in the ligaments and muscles affected by the sprain. After flexibility is addressed, any remaining strength deficits should be dealt with to help prevent re-injury.
Before returning to activity levels that the patient had prior to the ankle sprain, it is necessary to ensure that the patient has increased the injured ankle’s mobility and strength as well as decreased any instability, pain, and swelling. Because the greatest predictor for ankle sprains is previous ankle sprains, patients need to be sure to take some preventative measures when they return to their previous activity levels. One was to do this is with ankle bracing.
There are many different types of braces, semi-rigid and rigid braces are the most common types prescribed by physicians. Wearing a brace has been shown to decrease the likelihood of sustaining another sprain when compared to athletes who do not wear any sort of brace. Most of the studies reviewed in the Clinical Commentary: The Role of Ankle Bracing for Prevention of Ankle Sprain Injuries by Michael Gross and Hsin-Yi Liu, stated that ankle bracing rarely has adverse effects on athletic performance and sometimes has even been shown to increase performance. Problems with ankle braces typically arise because patients often choose not to wear the brace. This may be because they feel that the brace hampers their performance or the brace may simply be uncomfortable if it irritates the patient’s skin causing blisters or abrasions. To remedy this, physicians may prescribe semi-rigid braces such as cloth lace-up braces. These braces may fit slightly better and not irritate the patient’s skin. It is important that physicians do not simply give up on the idea of ankle bracing because a patient does not like one type, the only way to find the best ankle brace for a specific patient is through trial and error to see what works for that patient.
Ankle sprains commonly occur in recreational and competitive athletes who participate in sports with running, jumping and cutting. Athletes in any sport who have sustained a previous sprain are predisposed to re-injury. To help prevent injury and re-injury of the ankle, athletes involved in sports deemed high risk for sprains should wear ankle braces. Ankle braces do not appear to have an adverse affect on performance and have shown that they help reduce the frequency of ankle sprains in athletes.