0 comments on “Ankle sprains can have lasting effects”

Ankle sprains can have lasting effects

Ankle Sprains are one of the most common musculoskeletal problem effecting all ages and people of all different activity levels.  There are different locations and several different grades depending on severity, with the high and low lateral ankle sprains being the most common.

We have probably all felt the immediate pain of a “twisted” ankle. Sometimes it subsides, and there is not much bruising or swelling and walking is fine in a few days. Other times, your ankle might turn all kinds of interesting colors and swell up more than you ever thought possible. In more severe cases, weight bearing is not possible, and you are in for a long haul of surgery and rehab.

But even the mildest of sprains can leave you feeling “stiff” with a some loss of range of motion at the ankle joint that can have lasting effects not only for your ankle, but have a domino effect all the way up your leg to your pelvis. Once walking is compromised, you begin to lose calf musculature and become less efficient.  Eventually you can even start to have pelvic alignment issues and muscle inhibition. Severe grade 2 and 3 cases can cause chronic pain, stiffness and proprioceptive issues if left untreated, as often the effect of immobilization are almost as bad as the injury.

So the next time you “twist” your ankle, do yourself a favor and seek medical advice from your doctor and physical therapist to make sure you don’t have any last effects. To get on my soap box,  the RICE principle has been proven to prevent healing and icing is best only if you want to reduce pain.  The British Journal of Sports Medicine, for example, investigated 22 separate studies and concluded that “ice is commonly used after acute muscle strains, but there are no clinical studies of its effectiveness.” A report in the Journal of Strength and Conditioning Research was even more alarming. Not only does icing fail to help injuries heal, the authors found, it may well delay recovery from injury. Think “ARITA” …Active Recovery Is The Answer. More on that later!

So for acute injuries…avoid ice and NSAIDS and let the body go through the healing stages. Your body is much smarter than you are. Compression and warm baths are best, with some active movement around the compromised area to enhance the lymphatic drainage system.

Grades of ankle sprain severity

Severity Damage to ligaments Symptoms Recovery time
Grade 1 Minimal stretching, no tearing Mild pain, swelling, and tenderness. Usually no bruising. No joint instability. No difficulty bearing weight. 1–3 weeks
Grade 2 Partial tear Moderate pain, swelling, and tenderness. Possible bruising. Mild to moderate joint instability. Some loss of range of motion and function. Pain with weight bearing and walking. 3–6 weeks
Grade 3 Full tear or rupture Severe pain, swelling, tenderness, and bruising. Considerable instability and loss of function and range of motion. Unable to bear weight or walk. Several months
Source: Adapted from Maughan KL, “Ankle Sprain,” UpToDate, version 14.3, and Ivins D, “Acute Ankle Sprain: An Update,” American Family Physician (Nov. 15, 2006), Vol. 74, No. 10, pp. 1714–20.

 

My son wanting his ankle taped:)

Medical Disclaimer:

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

 

 

 

 

0 comments on “Make your health a priority”

Make your health a priority

What can On Track Physical Therapy do for you?

Get you information: I often get calls from patients that have a new pain or issue and want to get some information and a thorough medical evaluation. Many of my patients do not have a primary care doctor, so starting with a physical therapist is a great way to get into the health care system. I am embarrassed to admit, I don’t even have a primary doctor. The good news is, physical therapist are highly trained in orthopedics, neuro and everything in between. Though On Track Physical Therapy specialized in general orthopedic issues, we see clients with all diagnoses including post -surgical and vestibular to name a few.

Help you navigate the health care world: On Track Physical Therapy is happy to work closely with your doctor and prefers to have your doctor informed throughout your therapy. If you do not have a doctor or specialist, we will make sure to refer you to the right specialist if your diagnosis deems it necessary. In almost all cases, your doctor will recommend a course of physical therapy before costly MRIs and surgical procedures.

Direct Access: California is a Direct Access state for Physical Therapy meaning you can refer yourself to Physical Therapy and be seen without a doctors referral. Often insurances require a referral for you to use them, but since On Track Physical Therapy is private- pay, we do not require a referral.

Consierge Treatment: Many of our patients enjoy the convenience of online booking and flexible scheduling. We are also available to talk vie phone or skype if any issues come up before your next appointment. In home visits are are also available.

Save you money in long run: We are private pay, but It is rare that we would need to see you 3x a week for 6 six weeks like many traditional clinics. Once a week or bi-weekly appointments are more usual. Our focused 55 minute ,1 on 1 treatment session is effective, and we use online and video technology for our home programs. We also do not take co-pays which is helpful with many insurance policies that have very high deductibles and co-oays that add up quickly. Lastly, if you are working towards your deductible, we can give you a superbill documenting all your visits.

Bottom line…YOU and your health are worth it!

Blake Russell, PT and Owner of On Track Physical Therapy and Performance

 

 

0 comments on “First Toe Extension and Running Mechanics”

First Toe Extension and Running Mechanics

It’s  tiny joint, but your big toe joint (MTP) can be an important one. Yep, you probably don’t often think of your big toe unless you are stubbing it on some concrete path or whacking it on some furniture, but it’s a key joint for balance and locomotion- not to mention running.  As you push off, your big toe must extend which causes your plantar fascia to tighten which helps to stabilize the foot. This rigidity it causes in your foot as it extends  is good because it makes a strong lever for propulsion.

0 comments on “Pain with Downhill Running”

Pain with Downhill Running

Oh my knees!

If you do a lot of running, you’ve probably experienced some sort of knee pain at one point or another. There can be lots of reasons why your knees hurt…Soft tissue restrictions, joint irritation, spinal alignment, or strength and stability to name a few. Often it may be a hip or ankle issue that is contributing to your pain. It’s a good idea to get your whole body checked out and even assess your running form to make sure you address the route of the problem rather than the site of the pain.

If I find a patient has a stability issue, a good exercise to begin with is a mini squat with your heel elevated. Having your feet in an elevated position will mimic the position your foot is in as you are running downhill. I like to start patients with both heels elevated and have them bend to about 20 degrees (or in a pain-free range). Start first with 2 sets of 15-20 daily, then progress to 1 leg at a time to make it more challenging. Running is an endurance sport, so higher reps with good form are key.

As always, consult your Primary Care Physician with any conditions you are concerned about and exercise in a pain-free range.

 

 

0 comments on “Lateral Epicondylitis (aka Tennis Elbow)”

Lateral Epicondylitis (aka Tennis Elbow)

Tennis elbow is a repetitive-motion injury that is caused when the wrist forearm muscles (extensors and supinators) are overloaded. When the tendons cannot handle the load, small micro tears begin to occur and eventually you feel pain and weakness. Common activities like the following can evoke your symptoms:

  • playing tennis
  • using tools (plumbers, painters, cooks, etc…)
  • holding a coffee mug
  • turning a door knob
  • shaking hands
  • gripping anything
0 comments on “Full-Body Dynamic Warmup”

Full-Body Dynamic Warmup

Get your body ready

The best way to get ready for your workout or sport is to incorporate a dynamic warmup.  The purpose of taking a few minutes beforehand is to stimulate the nervous system, increase body temperature, work on range of motion, flexibility and address any limitations. Getting your joints, muscles and ligaments ready to start taking load and speed is necessary for optimal performance and will also help decrease your risk of injury.

0 comments on “Perfecting the Hip Hinge”

Perfecting the Hip Hinge

The Hip Hinge:

The hip hinge is a fundamental movement that all humans should know how to do. It is the backbone for all athletic movements as there is no way to jump, land, change directions or train power without being able to get in this position. Spinal bending (flexion) is fine for certain motions like tying your shoes, but not for movements that require a greater load or more explosion.

0 comments on “Pitcher’s warmup between innings”

Pitcher’s warmup between innings

Keeping your arm fresh between innings

Throwing a baseball is one of the most demanding movements you can do with your shoulder. Making sure your arm is warmed up properly is important for safe throwing. Obviously, it’s a full body movement, but baseball throwing requires strength, mobility and stability at extreme end ranges of the gleno-humeral joint into external rotation. In addition, you must have good thoracic mobility and core control.

0 comments on “Throwing arm warmup”

Throwing arm warmup

Warming up your throwing arm

Working on you shoulder and thoracic mobility and stability are key components for proper arm care. Start with spinal mobility, concentrating on thoracic extension and rotation. Scapular stability is key to throwing and safe over-head arm mechanics, so make sure to address the sequencing of these muscles routinely.

The video below has a few specific mobility and stability exercises designed to do just this. Keeping your full range of motion in your thoracic spine and shoulder joint is  important and needs daily attention particularly as your strength training and season progresses.

References:

Erickson, B. J., Thorsness, R. J., Hamamoto, J. T., & Verma, N. N. (2016). The biomechanics of throwing. Operative Techniques in Sports Medicine, 24(3), 156-161.

Faries, M. D., & Greenwood, M. (2007). Core training: Stabilizing the confusion. Strength and Conditioning Journal, 29(2), 10-25.

Hurd, Wendy J, PhD,P.T., S.C.S., & Kaufman, Kenton R,PhD., P.E. (2012). Glenohumeral rotational motion and strength and baseball pitching biomechanics. Journal of Athletic Training, 47(3), 247-56.

Jeran, J. J., & Chetlin, R. D. (2005). Training the shoulder complex in baseball pitchers: A sport-specific approach. Strength and Conditioning Journal, 24(4), 14-31.

Kibler, W. B., Ludewig, P. M., McClure, P. W., Michener, L. A., Bak, K., & Sciascia, A. D. (2013). Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the ‘scapular summit’. British Journal of Sports Medicine, 47(14), 877.

W, B. K. (1998). The role of the scapula in athletic shoulder function. The American Journal of Sports Medicine, 26(2), 325-37.

Wilk, K. E., Williams, R. A., Dugas, J. R., Cain, E. L., & Andrews, J. R. (2016). Current concepts in the assessment and rehabilitation of the thrower’s shoulder. Operative Techniques in Sports Medicine, 24(3), 170-180.