I have attached a picture and breakdown of a client I am currently treating for a medial (inside) ankle sprain. This is a rarity for me, and I guess most therapists, as it usually occurs on the outside of the ankle. Ankle sprains happen a lot in sport, during other activities and more than likely happen on those drunken nights out. Once the ankle is sprained it loses a certain degree of stability, mainly due to the ligaments damaged becoming more lax, putting more pressure on the dynamic stabilisers of the ankle. This can cause an array of more chronic injuries such as Achilles pain and a possible stress fracture on the outer sides of the foot, due to the mechanics of the ankle/foot changing. Although most importantly it makes an secondary ankle sprain more likely to occur again if not dealt with swiftly and safely from the moment of the injury to return to full fitness. The current client presented with a sprain to the deltoid ligament (left hand side) - anterior tibiotalar/tibionavicualr ligament with further damage to the pereneal tendons and their sheaths). The injury occurred during a football match were the client went out to clear the ball, planting his foot on an un even surface (accidently) of ground, causing him to loose balance on the planted foot, resulting in spraining his ankle. In the attached picture, 9 days post injury the swelling can be seen clearly. On assessment the clients gait was effected to the point he lost his natural heel to toe strike resulting in an unnatural gait. The circumference of the injured side was 3cm up on the uninjured side showing the extent of the swelling still present. No blood flow problems to the toes distally, loss of skin sensation or muscles function. Pain was felt during nearly all active, passive and resisted movements, with only a slight loss in range of movement due to the current swelling and willingness to move due to pain. Lastly the client had a positive talar tilt test - https://youtube/watch?v=2qF_DOe2jPE. I initially treated out with extensive soft tissue massage, mainly effleurage to help drainage of waste products and to help promote new oxygenated blood to the area. I also applied mobilisations for pain and to help further promote a pump like action to again help with pain and drain waste products. I advised the client to start a progressively overloaded rehabilitation programme based on the clients current injury and assessment. Watch this space for updates on this specific client. I hope this write up gives a good insight into the approach I take to all clients, which is upmost care, attention and to promote a safe environment to get the client back to full fitness.
Posted on: Thu, 15 May 2014 11:34:28 +0000
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