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Ankle Resprain Treatment Options.?

Last year during basketball I injured my ankle and was put on crutches for two weeks. In september I reinjured my ankle in cheerleading and was put on crutches for two weeks. My ankle is still swollen and is black qnd blue. What are some treatment options I can do at home?
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replied December 9th, 2011
Hi Songwriter998,

that is a little cocern. I have had ankle injury and i have used a accupressure foot mat, that helps circulate blood underneath the foot. And have a look.
Amit
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replied December 10th, 2011
Especially eHealthy
songwriter998,

If you have an athletic trainer at your school, you might want to enlist his/her help.

You need first to work on getting the swelling and edema out of the ankle. The bruising will have to resolve on its own, which will usually take about two weeks or so, depending upon how much blood has leaked into the soft tissues.

You can try using contrast baths of ice, then heat, then ice, going back and forth several times. This is supposed to increase the circulation, helping to pump the blood, edema, and lymphatic fluid back into the body.

You can use some compression around the lower leg. At night, wrap ace wraps from the toes to at least the knee. This will also help to push fluid back into the core. You may want to get an ankle brace, either a neoprene one or a lace up one, to wear during the day. The stirrup braces are good for immobilization while you are on crutches, but the lace up ones have actually been found to provide better support once therapy is started.

Range of motion of the ankle will also help pump the fluids back into the body. As will elevation of the foot, to above heart level, when you are resting.


When doing therapy, you might want to ice the ankle before and after the sessions. Slush buckets of ice water are great, but are very uncomfortable. Many athletes cannot take submersing their foot in that cold of water for too long. You can use ice packs or make up ice cups to use. Ice cups are great, because you can rub the ice directly where it is needed. Take small paper cups and fill them with water, put them in the freezer. When you need one, take one out, peel down the paper, holding onto the bottom part while you rub the ice over the whole ankle.

As to therapy, range of motion is the first thing to work on. Writing the alphabet with your toes in the air, will put the ankle through a full range of motion. Make sure go as far as you can in every direction.

In the early stages, the toes actually need to be worked. Even before you can walk on the ankle, you can exercise the toes. Try picking up small objects with the toes, such as marbles. Toe schrunches are great for building strength in the foot muscles and in the toe flexor muscles of the calf. Place a small towel flat on the floor straight out in front of you. Put your toes on the edge at one end. Using just the toes, pull the towel towards you, schrunching up the towel as you go. If this is too easy, put a can of soup on the other end of the towel for weight. This will really build up the flexor muscles.

Once you are allowed to start working on strengthening, you can do this in a couple of ways. The calf muscles are worked with toe raises. Once you can stretch the Achilles tendon really well, you can do toe raises on the edge of a board or on a stair step, so that the heel goes down below the level of the toes.

The dorsiflexors (pulling the toes up towards the knee), everters (sole of foot to outside), and inverters (sole of foot to inside) all need to be worked. Using a rubber tube is great for this. You can buy a product called TheraBand which comes in different strengths (colors). But, you can also use an old bicycle inner tube, cut into strips. Make a loop. Put the loop around a table leg or something similar. Put the loop around your forefoot. Then work all the different muscles by moving the foot up, out, and in against resistance. The peroneal muscles, the ones on the lateral aspect of the leg (outside) are very important to strengthen, because these help to keep your ankle from rolling inward. These muscles are everters of the ankle, so really work on them.


One thing that athletes forget to work on before getting back into activity, is proprioception. This is the ability to subconsciously know where your body parts are in space, without having to think about it. Agility and balance are also part of this. It is the ability to chew gum and walk at the same time.

The best way to do this is with an appliance that physical therapy departments have, which is a round platform with half of a ball on the under side. Different sized balls make the platform more unstable and large degrees of movement. But, most of us don't have one of these lying around the house.

To do the same thing, you can use bath towels. Take a plush, big bath towel or beach towel, and fold it into the size of about a foot square. Put the folded towel on the floor, next to a table (so you can use the table for support if needed). Put the bad foot on the towel. Pick the good foot up in the air. Close you eyes and balance on your bad foot. Use the table if you need to. If one towel is too easy, use two or even three. This is dangerous, when you have a sore ankle, so be sure you are strong enough to do this. But, this will help with your proprioception.


Once you can do all of this really well, then you are ready to go back and do sport specific exercises.


So:

Get the swelling down
Work on range of motion
Work on toe strengthening
Calf muscle strengthening with toe raises
Strengthen the other muscles around the ankle, especially the everters (peroneals)
Work on proprioception (balance and agility)
Do sport specific exercises


You have your work cut out for you if you do not want to keep spraining your ankle. Many times athletes will try to return to activities before they have completely rehabilitated the ankle. It takes a lot of hard work and time to get over a significant ankle sprain. It usually takes about 2 days of rehab for every day that you are out. So, if you are out for 2 weeks, it will take about 4 weeks of rehab, or 6 weeks total before you are back to "normal" (or longer).

Good luck.
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