A sprained ankle , also known as bent ankle or rolled ankle , is a common injury in which a sprain occurs on one or more wrist ligaments feet.
Video Sprained ankle
Signs and symptoms
Knowing the symptoms that can be experienced with sprains is important in determining that the injury is not really a fracture. When a sprain occurs, the blood vessels will secrete fluid to the tissue that surrounds the joint. White blood cells are responsible for the inflammation migrate to the area, and the blood flow increases as well. Along with this inflammation, swelling of fluid and pain is experienced. The nerves in the area become more sensitive when the injury is suffered, so the pain is felt as it beats and will worsen if there is pressure placed in the area. Warmth and redness are also seen as blood flow increases. There is also a decrease in the ability to move joints.
Maps Sprained ankle
Cause
Movements - especially twisting, and turning the legs - are a major cause of ankle sprain.
The biggest risk of sprains during activities involving explosive side-to-side motions, such as squash, tennis, or basketball. Dislocated brains may also occur during normal everyday activities such as stepping out of the sidewalk or slipping on the ice. Returning to activity before the ligaments heal completely can cause them to heal in a stretched position, resulting in less stability in the ankle joint. This can lead to a condition known as Chronic Ankle Instability (CAI), and an increased risk of ankle sprain.
The following factors may contribute to an increased risk of ankle sprains:
- Weak muscles/tendons that cross the ankle joint, especially the lower leg muscles that cross the outside, or the lateral aspect of the ankle joint (ie the peroneal or fibular muscles);
- Weak or weak ligaments that join the joints of the ankle joints - these may be hereditary or due to excessive lstramen due to repeated strikes of the ankle;
- Inadequate joint proprioception (ie sense of joint position);
- Slow neuron muscle response to unbalanced position;
- Runs on uneven surfaces;
- Shoes with inadequate heel support; and
- Wear high heels - due to weak ankle position with elevated heel, and a small support base.
A sprained ankle usually occurs through excessive stress on the ankle ligaments. This can be caused by excessive external rotation, inversion or foot eversion caused by external forces. As the foot moves through its range of motion, excessive stress puts strain on the ligaments. If the strain is large enough to ligament past the melting point, then the ligaments become damaged, or sprained.
Diagnosis
The diagnosis of sprains depends on the medical history, including symptoms, as well as making differential diagnoses, particularly in distinguishing them from strains or fractures. The Ottawa ankle rule is a simple rule that is widely used to help distinguish ankle or mid-foot fractures from other ankle injuries that do not require x-ray radiography. It has a sensitivity of nearly 100%, meaning a patient who performs a negative test, by rule almost certainly not having an ankle fracture.
Severity classification
The sprained ankle is class 1, 2, and 3. Depending on the amount of damage or the number of damaged ligaments, each sprain is classified from mild to severe. A grade 1 sprain is defined as mild damage to the ligaments or ligaments without the instability of the affected joint. A class 2 sprain is thought to be partially torn into the ligaments, where it is pulled to the point of being loosened. The grade 3 sprain is a complete ligament rupture, causing instability in the affected joint. Bruising can occur around the ankle.
The type and method of ankle sprain
Reversal of the lateral ankle (lateral)
The most common type of ankle sprain occurs when the foot is too upside down, affecting the lateral side of the foot. When this type of ankle sprain occurs, the outer ligament, or laterally, stretches too much. The anterior talofibular ligament is one of the most commonly involved ligaments in this type of sprain. Approximately 70-85% of ankle sprain is an inversion injury.
When the ankles become reversed, the anterior talofibular and anterior calcaneofibula ligaments are damaged. This is the most common ankle sprain.
Eversion (medial) ankle sprain
The less common type of ankle sprain is called eversion injury, which affects the medial side of the foot. This occurs when the leg, rather than the medial spinning ankle, produces inversion (the inward-moving leg), the lateral spinning ankle produces eversion (when the foot rolls out). When this happens, medial, or deltoid, the ligaments are too stretched. High hysterical ankle (syndesmotic) A high ankle sprain is an injury to the large ligaments above the ankle that joins together two long bones from the lower leg, called the tibia and fibula. High ankle wrists usually occur from a sudden and strong outstretched thigh, which usually occurs in contact and cutting out sports such as soccer, rugby, ice hockey, roller derby, basketball, volleyball, lacrosse, softball, baseball, track, frisbee, soccer, tennis and badminton and riding.
Treatment
Initial treatment generally consists of rest, icing, compression and elevation (often referred to by RICE mnemonics or sometimes PRICE with P being "protection"). These elements have been recommended by doctors for decades for the treatment of soft tissue damage, and ankle sprain, one of the most common soft-tissue injuries. Rice helps limit the amount of swelling to the area, and "facilitates venous and lymphatic drainage". Although almost universally accepted as a treatment, the National Athletic Trainers Association notes: Most of the reasons for using RICE or individual components are largely based on low quality clinical trials and laboratory studies with non-injured participants or animal models
Conservative size
Ice is often used to reduce swelling in cycles of 15-20 minutes and 20-30 minutes. Tightening the ankle too long can cause cold sores, indicated if the area turns white. Also, it is often recommended that ice is not directly applied to the skin, but must have a thin buffer between the ice and the affected area, and some experts think ice does not need to be applied at all. Recently, Gabe Mirkin, MD, who created and popularized RICE acronyms in his 1976 book Medicine Sports Book, now has some problems with "i" in RICE. After reviewing modern studies, he notes that since the ice closes the blood vessels "ice does not improve healing - it delayed it." and now suggests skipping the ice altogether unless necessary to reduce the pain of swelling. It is still widely accepted and although clinical evidence is rare, cryotherapy (es) has been the mainstay of clinical practice for rehabilitation specialists.
In uncomplicated ankle sprains, soft tissue swelling can be prevented by compression around malleoli, elevation of an injured ankle higher than the heart, and pain-free exercise.
The orthopedic walking boot is often used for the treatment of sprained ankle injuries. Braces and crutches are also used to help relieve pain so that the injured ankle can heal as quickly and painlessly as possible.
Although found to be less effective than gypsum, compression bandages are used to provide support and compression for sprained ankles. The wrap starts at the ball of the foot and slowly continues to the base of the calf muscle, which pushes the swelling towards the center of the body so it does not converge on the legs.
Rehabilitation and recovery
Many different types of rehabilitation exercises can be performed to help sprain ankle irrespective of the severity of the injury. The purpose of rehabilitation gives the ankle the ability to regain strength and flexibility. A sprained ankle becomes swollen due to an increase in the amount of edema in the tissues, because this physiological effect is the foundation of the pain of decreased edema is the primary goal during early rehabilitation. This can be done instantly by applying RICE mechanisms that rest the ankle, apply ice, compress, and lift it. The emphasis of the first week of rehabilitation should protect the ankle to avoid further damage. As the healing progresses, stress can be applied by different mechanisms until the ankle is fully restored. The key to quick recovery is to apply all kinds of ankle sprain exercises so that the range of motion will increase while the pain decreases.
In cases where the ankle does not heal in the right amount of time, other exercises need to be exercised so that strength and flexibility can come back. The physical therapist assigns various types of ankle sprain exercises that are associated with flexibility, strengthening, balance, and ankle agility. If an ankle sprain does not heal properly, the joint may become unstable and may cause chronic pain. Receiving proper care and doing exercises that promote ankle function is important to strengthen the ankle and prevent further injury.
Immobilization movement
A short period of immobilization in the cast below the knee or in the Aircast leads to a faster recovery at 3 months compared to the tubular compression bandage. In contrast, randomized controlled trials have concluded that proper exercise soon after sprains improves function and recovery. These exercises focused on increasing the range of ankle movement, activation and strengthening of the ankle muscles, and restoring normal sensorimotor control, and performed for 20 minutes, three times a day. After an injury, it is advisable not to walk for several days. Bed rest will help speed up the healing process and eliminate the possibility of incorrect handling of affected limbs. Driving a vehicle or operating a machine should not be attempted.
The number of therapies that a person can handle will depend on the level of pain and level of sprain they experience. Not recommended to return to sports or extreme physical activity to jump on the ankle may be painless. Wearing high tennis shoes can also help prevent ankle sprain if the shoe used is fitted properly and if the ankle is taped with a wide, non-elastic tape.
Ankle/manipulation
For acute ankle sprains, manual mobilization of the joints/manipulations of the ankles has been found to reduce pain and increase movement. For the chronic subacute/ankle lateral ankle treatment, these techniques increase the range of ankle motion, reduce pain and improve function.
Wrist ankle
To prevent sprains or back injuries from the exercises, strengthening and stretching should be done through various ankle movements. To improve ankle mobility, ankle circles can be done by extending the legs in front of the body and then moving the legs up and down, side to side, or turning the foot in a circle. Another common practice to improve mobility and proprioception is to use your toes to draw the alphabet letters in the air. Most importantly, the lateral aspect of the ankle joint should be strengthened by eversion exercises (ie, the bottom of the foot facing outward against resistance) to improve lateral ankle stability. Stretching is also an important component of strengthening programs, to help maintain joint flexibility.
Balance and stability exercises are essential to train the ankle muscles to work together to support the joints. This includes exercises performed by standing on one leg and using a wounded ankle to lift the body to his toes. To further improve balance and stability, sports devices such as wobble boards can be used, advancing from the double-leg to the single-foot position, first with the eyes open and then with the eyes closed, to increase effectiveness.
Flexibility training
Examples of flexibility exercises are stretching the towel and writing the alphabet with the toes that will increase the range of motion.
Strengthening exercises
Ankle strengthening exercise is a step up and running on the toes that will strengthen the muscles around the swollen area.
Exercise balance
Balancing exercises include the use of a balance board, which helps the whole body function to maintain balance. The use of balance boards has been shown to produce significant positive results in getting the right balance.
Agility Exercise
Plyometrics exercises such as squats and electric skipping jumps should not be performed until the ankle regains full agility.
Other strategies that can be used to prevent ankle injuries include:
- Ensure proper heating before stretching and activity;
- When running, select a level surface and avoid rocks or holes;
- Make sure that the shoes have adequate heel support; and...
- If high heels are worn, make sure that the heels are no more than 2 inches in height, and avoid heels with narrow pads.
Prognosis
Most people increase significantly in the first two weeks. However, some still experience problems with pain and instability after one year (5-30%). Re-injury is also very common.
Epidemiology
A sprained ankle can occur either through exercise or daily life activities, and the individual may be at a higher or lower risk depending on circumstances including country, race, age, gender, or profession. In addition, there are various types of ankle sprains such as ankle sprain sprain and ankle sprain inversion. Overall, the most common type of ankle sprain occurs is an inversion ankle sprain, where excessive plantar flexion and supination cause the anterior talofibular ligament to be affected. A study showed that for the Scandinavian population, sprain ankle inversion accounted for 85% of all ankle sprains. Most ankle sprains occur in more active people, such as athletes and regular athletes.
Previous ankle sprains
When ankle sprain occurs, subsequent ankle sprains are much more likely to follow. The most recommended precautions for recurrent sprains are wearing ankle protective shield (tape, or ankle barrier) and applying exercises designed to strengthen the ankle and improve one's balance (eg ball balance practice). In an article review of ankle sprain prevention research, authors reference long-term studies on a group of soccer players. 60 players wore footwear (tape or ankle-braces) throughout the football season, and 171 other players were registered in the control group, as they were not wearing leg protectors. At the end of the season, 17% of players who do not wear ankle braces/tape sprained their ankles, while only 3% of players wearing a protector suffered the same injury. Among the players who dislocated their ankles and did not wear ankle shields, 25% had a history of previous ankle sprain. Other articles reviewed by colleagues refer to studies that conclude that ankle work can reduce the risk of recurrent sprains by 11%.
Age
In a study comparing the prevalence of ankle sprains between age, race, and gender, individuals aged 10-19 years had the highest incidence of ankle sprain. It can be suggested that teens are more physically active, leading to a higher likelihood of ankle sprain. Due to sports deals with high ankle utilization, over 50% of ankle sprain is caused due to sports-related injuries.
US Military
In addition, the average ankle sprain for the general US population is estimated at 5-7 ankle sprains for every 1,000 person-years; But a study shows that for military cadet incidents for ankle sprains about 10 times that of the general population
Men vs. women
Another study comparing the effects of sex on ankle sprains found that male and female counterparts had similar incidence rates in ankle sprains. However, in certain age ranges from 19 to 25 years, men are found to have an ankle sprain rate that is much larger than women. Furthermore, at age 30 and over, women show a higher incidence of ankle sprains than men. From this, it can be said that age and activity levels are a better indicator of the risk of ankle sprains than sex.
References
External links
- Right Foot Right ICD 10
Source of the article : Wikipedia
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