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Ankle sprain, how to avoid a “relapse”?

January 1, 2018

If an ankle sprain is not treated appropriately, it can lead to a series of long term problems, starting with chronic pain. Appropriate treatment includes, in addition to resting, following a rehabilitation program that reduces the risk of a new event at the expense of the same ankle: ‘The first episode of ankle sprain is immediately managed with seriousness and care to make sure it won’t occur again. In fact, a second episode can suggest the presence of ankle instability, a much more complex condition’, underlines Dr. Cristiano Sconza, specialist in orthopedic rehabilitation at Humanitas.



What kind of injury is it?

There are several important anatomical structures in the ankle: ‘I often tell patients to try to imagine the ankle joint as the screw that holds together different parts of a puppet, especially the leg and the foot. What would happen if this screw loosens? Slowly, the two ends would begin to wobble, move excessively until dislocation occurs. Fortunately, our musculoskeletal system provides additional limitations to the joints: muscles, tendons and ligaments. Therefore, the injury of these components constitutes the collapse of the joint and the establishment of a situation of dangerous instability ‘.

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Distortion is a very common injury, especially in those people who do sports, but it can also happen during everyday activities. Some categories of people are more exposed: ‘Those who present postural problems or problems with alignment of the lower limb, such us valgus knees, a tibial intra-rotation, flat feet or varus, and finally those who practice sports that involve sudden changes in speed or jumps, such as volleyball, basketball or soccer’, explains the specialist.



The degree of injury will lead to the more appropriate treatment

If the degree of the ligaments injury is not the most severe, a conservative treatment is sufficient: ‘it is possible to apply some ice to reduce the swelling, whilst for the pain, anti-inflammatory drugs should be taken, as well as undergoing physical therapies. It is essential to rest before starting a rehabilitation program in order to be able to resume activities, including sports. Physiotherapy will focus on muscle strengthening and stabilizing the ankle, but proprioceptive gymnastics is very important. You can also resort to hydro-kinesitherapy, or to exercises practiced in water, if the patient still feels pain and is struggling to stand up’.


‘Proprioceptive gymnastic is used to prevent new episodes of incorrect positioning of the foot that can cause distortion. We perform exercises on unstable boards or stabilometric platforms for the recovery of the correct balance on the affected ankle limb. This way – explains Dr. Sconza – the aim is to strengthen the reflexes that the patient also involuntarily puts into place when the foot function improves. It is the nervous system that reacts to instability stimuli and automatically “controls” the muscles to avoid distortion. Finally, athletes perform rehabilitation directly in the gym or on playing fields to simulate actions that could give rise to distortion’, concludes Dr. Sconza.

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