Wednesday, December 10, 2008

Ankle Sprains... What Do You Do?

So, you step wrong while running and you hear that crack from your ankle. From my past blogs, you know the first thing you do is to apply ice compresses. Hopefully you make your way to a good sports chiropractor (hint-hint) or athletic trainer for a proper exam and good care.

But, you're likely to go to the local drugstore and buy an Ace-bandage or a neoprene ankle support or somthing else similar. I've always liked a good elaborate tape job with lateral & medial ankle stays (stirrups), double heel locks and the classic figure eight around the ankle. Of course that was a pain to have to have done every day, especially to try doing it to yourself. I went from classic white to self-grip tape, but the effectiveness of the tape wears off after maybe an hour, if that. Ace-type elastic bandages will give you some support, not much and similarly those neoprene sleeve give you a little support as well. Nothing really great.

When used properlt, the air-ankle stirrup is probably the best. Used properly means wearing it with a properly laced up sneaker or shoe. As I've said previously, I like to use it in hi-top basketball sneakers.

So it seems this is the best.....or so I thought until June 2006

A couple years ago I came across an article in The American Journal of Sports Medicine. The authors of the study concluded that the best, most efficient method is a combination of using an elastic bandage around the ankle AND the air-stirrup. Here's an excerpt from the article


Results: Treatment of grade I sprains with the Air-Stirrup brace combined
with an elastic wrap returned subjects to normal walking and stair climbing in
half the time required for those treated with the Air-Stirrup brace alone and in
half the time required for those treated with an elastic wrap alone. Treatment
of grade II sprains with the Air-Stirrup brace combined with the elastic wrap
allowed patients to return to normal walking and stair climbing in the shortest
time interval. Treatment of grade III sprains with the Air-Stirrup brace or a
walking cast for 10 days followed by bracing returned subjects to normal walking and stair climbing in the same time intervals. The 6-month follow-up of each sprain severity group revealed no difference between the treatments for
frequency of reinjury, ankle motion, and function.

Conclusion: Treatment of first-time grade I and II ankle ligament
sprains with the Air-Stirrup brace combined with an elastic wrap provides
earlier return to preinjury function compared to use of the Air-Stirrup brace
alone, an elastic wrap alone, or a walking cast for 10 days.

Here's a link to the antire abstract: http://ajs.sagepub.com/cgi/content/abstract/34/9/1401

Today is day 5 of my ankle sprain ordeal. I guess you can call this the the Ankle Sprain Chronicles..... The things I'm telling you in this and the 2 prior blog posts are the things I do for myself(and other sports chiropractors do...). My ankle is a Grade II+ sprain possibly a grade 3. It is quite unstable, very painful if not kept in a neutral position. But, with the 3" elastic bandage around the ankle and the air-stirrup and my hi-top sneakers(Love thos New Balance B-Sall Sneakers), I'm able to walk around my office and treat patients. Yesterday, I even went to the gym and worked out with my trainer....non-weight bearing of course.
Here are pictures of the air-stirrup with the elastic bandage and a picture of it in the sneaker. This is how it's done. If you have any questions about ankle sprain diagnosis, treatment or rehab, feel free to email me at miamibeachdoc@yahoo.com



As soon as I'm ready I will be posting short videos to show you the types of rehab I'll be doing...look for that in future blog posts.

'nuff said

DocT

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.









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