Wednesday, October 12, 2011

Thesis: Ankle Injuries

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.0 Literature Review


.1.0 Autonomy of the ankle


The foot and ankle combine flexibility with stability, thus providing two main functions � propulsion and support. (M. A. Hutso) The ankle joint is made up of the shinbones (tibia and fibula) and the foot bones (talus and calcaneus). On the outside, the bones are held together by three ligaments. This is where a high percentage of ankle injuries occur because these ligaments are laxer than the inside ligaments. (Internet 1) Refer to figure 1.





Custom Essays on Thesis: Ankle Injuries




Figure 1 (Internet 1)


.1.1 Types of injuries


.1.1 Sprain


Ankle sprains are usually caused by a twist of the ankle. An ankle that sprains because the athlete rolls over on the outside of the ankle is known as an inversion sprain; sprains caused by turn-ins are eversion sprains. (Dr L.J Micheli, et al)


Sprains are graded in to three categories, minor, moderate and severe. A mild sprain usually affects only the anterior talofibular ligaments, causing a partial rupture. A moderate sprain involves the anterior talofibular and the calcaneofibular ligaments, resulting in increased damage to the structure of the ligaments. A severe sprain affects the previous two ligaments as well as the posterior talofibular ligament. (P.M. Taylor et al).


.1. Minor Sprain


A minor sprain occurs with mild swelling, pain and little loss of stability or function. A player would expect to be back playing within three days up to two to three weeks.


.1. Moderate Sprain


A moderate sprain occurs when ligaments are partially torn, more swelling/bruising and loss of function and stability occurs. A player would expect to be back playing within three to six weeks time.





.1.4 Severe Sprain


A severe sprain occurs when the ligaments are completely torn, there is swelling/bruising and possible bone or tendon damage. A player can take up to eight to twelve months to heal. (Internet 1)


.1.5 Fracture


A fracture is a crack, break, or complete shattering of the bone. Ankle fractures usually affect the bottom end of the fibula on the outer side of the lower leg, an usually occur in same way many inversion sprains do; the athlete rolls over on the ankle and, the body’s momentum breaks the bone. (Dr. L.J Micheli, et al).


.1.6 Strain


Numerous muscles originating from and contained within the lower leg are responsible for a variety of foot and ankle motions. Given the large mechanical forces associated with running, jumping and other similar activities, strains commonly occur due to an over stretch in a muscle. With a roll of the ankle a strain is extremely common due to rapid muscle expansion during in the roll. (P.A. Houlgulm, et al).


..0 Treatment of an injury


..1 Initial treatment


· Rest the injures ankle


· Ice the injured ankle (wet towel and ice for ten � fifteen minutes every two hours for forty eight hours).


· Compress the injured ankle


· Elevate the ankle above the level of the heart. ( Internet 1)


.. Post treatment


· See your general practitioner


· Anti- inflammatory medication my be prescribed


· Crutches may be needed the person can not walk without pain


· See a physiotherapist (P. Fitzgerald, et al).


.. What if it is left untreated.


The ankle will be prone to recurrent injuries if it is not rehabilitated to its maximum potential. (Internet 1).


..0 Rehabilitation


..1 What is rehabilitation


Many people have had injuries in there life and have probably treated them in the correct way. However, like most people the rehabilitation under-gone would have been the usual � rest. As a result, the area of injury will probably have a number of weaknesses. Rehabilitation is improving your body so that your are not injured again. ( Auty, Davis, et al).


.. Ankle rehabilitation


Every ligament needs rehabilitation. Otherwise, your ankle might not heal completely and you might re-injure it. All ankle sprains from mild to severe, require three phases of recovery


1. Phase 1 includes resting, protecting and reducing swelling of the injured ankle. Early weight bearing with proper protection is actually a benefit for healing.


. Phase includes restoring your ankles flexibility, range of motion and strength.


. Phase includes gradually returning to straight ahead activity and doing maintenance exercises, followed later by more cutting sports, such as tennis, basketball or football. Once you can stand on your ankle again, your doctor will prescribe routines to strengthen you muscles and ligaments, and increase flexibility, balance and coordination. Later, you may walk, jog and run figure eights with your ankle taped or in an air cast. (Internet )


.. The rehabilitation sequence


1. Static(isometric) exercises


Muscles are rested at various joint angles using rubber bands, towels, weights of a partner.


. Dynamic exercises


These exercises are performed over a range of movement allowed by the pain threshold. As strength returns, the load should gradually be increased.


. Stretching exercises


Stretching exercises improve the range of movement. These must be within your pain tolerance.


4. Co-ordination and balance exercises


After you have been injured, co-ordination between nerves, muscles and joints is usually impaired. Co- ordination exercises are designed to re-teach correct functioning between joint receptors and muscles spindles. Using a wobble board or skateboard to practise balance is ideal co-ordination work.


5. Sport-specific training


As recovery progresses, gradually you move back into the specific strength and flexibility work required by your sport, and then eventually to full training.


(Auty, Davis, et al).








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