Ankle Injuries!

I have been seeing a few of those horrible looking boots in my office.  The one you get to stabilize and ankle injury.  My biggest concern is the boot being thicker than your shoe and the boot screwing up your low back.  Of course, those are on people who are being treated for an ankle injury.  For those of you who are going it alone, much like your Woodbridge, Dale City VA Chiropractor would, here is some things that may help you.

Ankle Rehabilitation Program1

As described in Human Locomotion, the following is a sample ankle sprain rehabilitation plan.

Phase 1. The patient is unable to bear weight.

  1. A) Compressive wrap with U-shaped felt balance around fibula. Change every 4 hours.
  2. B) Patient actively abducts/adducts toes for 5 seconds, repeat 10 times.
  3. C) Write out alphabet with toes, 5 times per day.
  4. D) Stationary bike, 15 minutes per day.
  5. E) Ankle rock board performed while seated (off weight-bearing), 30 circles, performed clockwise and counterclockwise 2 times per day. Perform on uninjured ankle while standing for 3 minutes. The standing rock board performed on the uninjured ankle has been shown to increase proprioception in the contralateral limb.
  6. F) Mild Grade 3 and 4 mobilization of the joints of the foot and ankle.

Phase 2. Patient can walk with minimal discomfort, and the sprained ankle has 90 percent full range of motion.

  1. A) Mobilize all stiff joints in the lower extremity and pelvis.
  2. B) Thera-Band exercises in all planes, 3 sets of 25 in each direction.
  3. C) Double-leg and then single-leg heel raises on the involved side, 3 sets of 10 reps, performed 2 times per day.
  4. D) Standing closed-eye balance, 30 seconds, 5 times per day.
  5. E) Standing single-leg ankle rock board, performed for 1 minute, 5 times per day.
  6. F) Closed kinetic chain exercises. (The sprained ankle is positioned securely on the ground while the patient pulls a resistance band forward and to the side. The patient then rotates 180° and the exercise is repeated by extending and abducting the uninvolved limb.)

Phase 3. Patient can hop on involved ankle without pain.

  1. A) Run at 80 percent full speed, avoid forefront touch down.
  2. B) Minitrampoline: 3 sets of 30 jumps forward, backward, and side to side. Begin on both legs, progress to single limb.
  3. C) Plyometrics performed on a 50cm and a 25cm box, positioned one meter apart. Jump from one box to the ground and then to the other box, landing as softly as possible. Perform 3 sets of 5 repetitions.

Resource:

Michaud, T. 2011. Human Locomotion: The Conservative Management of Gait-Related Disorders. Newton Biomechanics.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Why you should ice

I know you are all tired of hearing me say it!  Put some ice on it…. Makes sure you ice….  Well as you chiropractor in the Woodbridge, Dale City VA area I am now making you read why you should.   Here is some great information on how and why you should ice.

General comments

Icing may be used along with compression, elevation, bracing, and/or support when treating acute injuries.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can produce a similar effect to icing. However, they may delay healing with acute injuries (like sprains, strains, and fractures). If your doctor recommends medicine, make sure you are aware of the right dosage and when to take it, and if there are any side effects.

The use of ice and heat is just one part of a treatment program. Even if symptoms are relieved, there is usually a need for exercises to restore flexibility and joint motion, strength, general fitness, and sport-specific skills.

Use of ice

Effects of ice: Decreases circulation, metabolic activity, and inflammation and numbs the skin.

Benefits of ice: Decreases pain, swelling, inflammation, and muscle spasm/cramping. Best used after exercise or after pain-producing activity.

Risks of ice: Prolonged use can cause frostbite.

Methods for applying cold therapy: Ice packs, ice bath/ice whirlpool, ice massage. (See “Options for applying ice.”)

When not to use ice

Immediately before physical activity

If area of icing is numb

When the pain or swelling involves a nerve (such as the ulnar nerve or “funny bone”)

If the athlete has sympathetic dysfunction (an abnormality of nerves that control blood flow and sweat gland activity)

If the athlete has vascular disease (such as poor circulation due to blood loss, blood vessel injury, compartment syndrome, vasculitis, blood clots, or Raynaud disease)

If there is skin compromise (such as an open wound; a wound that has not healed; skin that is stretched, blistered, burned, or thin)

If the athlete has cold hypersensitivity, including cold-induced urticaria (hives from cold)

How long to use ice

Two to 3 times per day (minimum); up to once per hour.

Duration varies with technique; usually 20 to 30 minutes per session. (See “Options for applying ice.”)

Ice may continue to be useful in treatment as long as there is pain, swelling, inflammation, or spasm. There is no need to switch to heat after 48 hours or alternate between ice and heat.

3 options for applying ice

  1. Ice packs are best for icing larger areas of pain, swelling, or spasm (like a swollen knee, deep thigh bruise, muscle strain, shoulder tendonitis, or neck or back spasm).

 

Materials

Small cubes or crushed ice in plastic bag.

Bag of frozen vegetables (such as frozen peas).

Reusable commercial ice pack or circulating “cryocuff” (made specifically for therapeutic icing). Do not use blue ice packs directly on the skin; they are colder than frozen water and can cause frostbite

Method

Place on the affected area for at least 20 minutes per session. Hold in place with a towel, elastic wrap, or shrink-wrap.

 

  1. Ice bath/ice whirlpool is used to reduce swelling in peripheral joints (such as with ankle sprain, wrist sprain, or severe shin splints).

 

Materials

Bucket or tub with mixture of ice and water

Method

Immerse affected area for 20 to 30 minutes per session. Do not use an ice bath if there is an open wound, bleeding, or a skin infection.

 

  1. Ice massage is used to reduce superficial, well-localized inflammation (for example, tendonitis of the hand, wrist, or elbow; heel or elbow bursitis; ganglion cyst; apophysitis; or irritation of a growth plate).

 

Materials

Ice cube or frozen ice cup (made by freezing water in a paper or Styrofoam cup)

Method

Rub ice in a circular pattern over the affected region for 8 to 10 minutes per session.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link