Ankle Injuries - Prevention and Treatment (Muscle Balance, Static dynamic and reactive stabilization phases)

The ankle takes the full weight of the body and this makes it scecptible to injury. When running and jumping the forces that are exerted on the ankle are considerable. The most common ankle problems are sprains and fractures. A sprain is an injury to the ligaments, which may take many months to heal completely. You can also injure other parts of the ankle such as tendons and cartilage.

1. Band resistance work

Push against a resistance band, and you should feel this strengthening the calf muscles and Achilles tendon. Start with 3 sets of 10 once a day.

2. Small foot circles

Move foot around in circles against the resistance band. You should feel medial and lateral ankle ligaments lengthening.

3. Seated calf raise.

You should do this exercise seated to build up strength slowly. 3 sets of 10 should be performed.

Progressions

3b. Seated calf raise with barbell

Add barbell onto knees while doing calf raise

3c. Seated lateral calf raise with barbell

Add barbell onto knees while doing calf raises in a lateral direction to strengthen both lateral and medial ligaments.

4. Calf raise on stable swiss ball with base

5.Wobble board ankle ligament exercise

6. Single leg calf raises on swiss ball with base

Heel Pain

Heel pain can be caused by a variety of problems. It may be due to a traumatic injury, such as landing on the heel on a hard surface, or may be an overuse injury, such as plantar fasciitis. Here are the most common causes of heel pain:
A bruised heel can be caused by either a sudden impact (such as landing heavily) or repetitive pounding. The heel bone (calcaneus) is protected by a pad of fat. Repeated pounding of the heel can cause the fat pad to be pushed up the side of the heel leaving less of a protective layer causing heel pain. This injury is also sometimes known as Policeman's heel. It is common in sports requiring a lot of impact onto the heel and in particular soldiers marching up and down on the parade square.

Treatment of Heel Pain

What can the athlete do about heel pain?

• Rest until there is no more heel pain
• Pad the heel of shoes with shock absorbing insoles or heel pad
• Replace running shoes if they are old (more than 400 miles of running) or the soles are weakened through use

What can a professional do?

• A sports injury professional will confirm the diagnosis
• Advise on insoles heel pads to protect the fat pad in the heel
• Tape heel to provide pain relief and compress the soft tissue under the heel giving more protection to the bone

How long will it take to recover?

If you catch heel pain early and rest then it should recover quite quickly - within a few days. If you ignore the first onset of pain and the fat pad gets damaged beyond easy repair then this is a very difficult injury to treat. Rest means rest. There is no point you stopping running for a week if you put up scaffolding for a living and are on your feet every day. If you have to be on your feet then ensure you put a shock absorbing and cushioning heel insert into your shoes.

Muscle Cramps

Muscle Cramps Causes

Muscle cramps are felt to be caused by excessively excited nerves that stimulate the muscles. This can occur particularly after injury to nerve and/or muscle; dehydration; with low blood levels of calcium, magnesium, or potassium; from certain medications; and even at rest. The pain that is associated with muscle cramps that are caused by poor circulation to the legs that worsens with walking is referred to as claudication. Deficiencies of certain vitamins, including thiamine (B1), pantothenic acid (B5), and pyridoxine (B6), can also cause muscle cramps.
Common medications that can cause muscle cramps include furosemide (Lasix diuretic), donepezil (Aricept for Alzheimer's disease), neostigmine (Prostigmin for myasthenia gravis), raloxifene (Evista to prevent osteoporosis in postmenopausal women), tolcapone (Tasmar for Parkinson's disease), nifedipine (Procardia for angina, high blood pressure), and the asthma drugs terbutaline (Brethine) and albuterol (Proventil, Ventolin, and others). Some medicines used to lower cholesterol, including clofibrate (Atromid-S), pravastatin (Pravachol), atorvastatin (Lipitor), and lovastatin (Mevacor), can also cause cramps.

Muscle Cramps Symptoms

Muscle cramps cause local pain, tenderness, and firmness of the involved muscle. This disturbs the function of the involved extremity. When a hand muscle is affected, it can lead to difficulty in writing (writer's cramp) or grasping. When the muscles of the calf or foot are affected, it can lead to difficulty walking.

When to Seek Medical Care

Muscle cramps usually cause a temporary nuisance and typically resolve on their own without treatment. When muscle cramps continually recur, it is time to seek an evaluation by a health-care professional.

Exams and Tests

The health-care professional will review your history to analyze the character, location, intensity, and frequency of your muscle cramps. Your medications will be reviewed to determine if they may be playing a role in causing your muscle cramps. The physical examination will include evaluation of muscle strength, dexterity, and nerve function. Blood tests for the muscle enzymes (CPK, aldolase, LDH, ALT, AST) can be helpful to determine if muscle injury is occurring. Other blood testing may include evaluation of the levels of calcium, phosphorus, potassium, and magnesium, as well as thyroid function. Occasionally, testing with a neurologist might include tests of nerve conduction velocity (NCV) and an electromyogram (EMG).

Muscle Cramps Treatment

The primary treatment of muscle cramps involves methods to relax the affected muscle. This typically involves stretching, massage, and heat application. Other treatments are directed toward the underlying cause of the muscle cramps and can include rehydration, electrolyte repletion, hormone treatment, calcium supplementation, etc.

Self-Care at Home

Most cramps can be stopped if the involved muscle can be stretched. For many cramps of the feet and legs, this stretching can often be accomplished by standing up and walking around. For a calf muscle cramp, the person can stand about 2-2½ feet from a wall (possibly farther for a tall person) and lean into the wall to place the forearms against the wall with the knees and back straight and the heels in contact with the floor. Another technique involves flexing the ankle by pulling the toes up toward the head while still lying in bed with the leg as straight as possible. For writer's cramp (contractures in the hand), pressing the hand on a wall with the fingers facing down will stretch the cramping finger flexor muscles.

Gently massaging the muscle will often help it to relax, as will applying warmth from a heating pad or hot soak. If the cramp is associated with fluid loss, as is often the case with vigorous physical activity, fluid and electrolyte (especially sodium and potassium) replacement is essential. Medicines are not generally needed to treat an ordinary cramp that is active since most cramps subside spontaneously before enough medicine would be absorbed to even have an effect.

Medications

Muscle relaxants such as cyclobenzaprine (Flexeril), orphenadrine (Norflex), and baclofen (Lioresal) can be helpful to relax cramping muscles. Some people benefit by drinking simple quinine water (tonic water) before bedtime. In recent years, injections of therapeutic doses of botulism toxin (Botox) have been used successfully for some spastic muscle disorders that are localized to a limited group of muscles.
A good response may last several months or more, and the injection may then be repeated.

Ankle Fracture

Ankle Fracture
Medical Treatment

Doctors usually place a splint on your injured ankle for a few days to 2 weeks until the swelling goes down around the joint. The type of fracture and the stability of your joint will determine the type of splint that will be used.

If your bones are not aligned properly, the doctor may realign them before placing the splint.
If the bones cannot be realigned properly in the emergency department, then you may require an operation.

An operation will also be needed if any bone has broken through the skin. If the bone breaks through the skin, the fracture is then called a compound fracture. This is more serious than a simple fracture.

Some minor ankle fractures do not require a splint or cast. In these cases the fracture will be managed as an ankle sprain.

Because these fractures are very small, they heal well with this management.
With any injured ankle, however, you should not bear weight until a cast is placed or you are pain free.

After the swelling decreases and you are reexamined, then an orthopedic doctor or your primary care doctor may place a better-fitting cast on the ankle. Depending on the type of fracture, you may be placed in a walking cast, which can bear some weight, or you may still need a non-weight-bearing cast that will require the use of crutches to help you walk.

Depending on the degree of pain you are experiencing, your doctor may give you prescription-strength pain medication. These should be used only as needed. You should not drive or operate heavy machinery while using these medications.