Basketball is a sport of cutting, jumping, and landing. I’m always amazed at the ability of the body withstand forces especially through March Madness and the added break down of contact or fatigue. It’s no wonder the most common basketball injury is an ankle sprain.
Just because our name is the Center for Spine Care and Mobility (CSC+M) it doesn’t mean we only treat the spine. Our NYC chiropractors treat ankles too! At CSC+M we utilize a patient centered active approach to guide you through rehab to performance. We get you better faster through the integration of chiropractic, physical therapy, massage therapy, medical services, and acupuncture.
Typical medical treatment will consist of an exam confirming the sprain, a recommendation to stay off the ankle for 8 weeks, RICE protocol and a boot.
At CSC+M treatment starts with the fundamentals, however we don’t leave you there, we pride ourselves on our ability to accurately diagnose and specifically treat your injury to get you out of pain and back into activity. You are not alone, ankle sprains are the most frequent injury sustained by athletes. Statistics show up to 40% of Injuries are ankle sprains.
Ankle Sprains – A Midtown NYC Chiropractor’s Perspective
The Inversion Ankle Sprain
- -85% of ankle injuries are inversion sprains.
- -An ankle sprain is the most common basketball injury.
- The ankle rolls inward the outside ligaments get stretched or even torn.
- When an X-Ray rules out a fracture the anterior talofibular ligament (ATF) is one of the most commonly involved ligaments in this type of sprain. The anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, posterior talofibular ligament and/or calcaneofibular can be involved.
The High Ankle Sprain
A high ankle sprain is a disruption of the syndesmotic ligaments that hold the distal tibia and fibula “mortise joint” together. The high ankle type of sprain needs special testing like an ultrasound or MRI.
At our midtown manhattan Chiropractic office, we see this ankle injury frequently with our soccer players, Australian Rules footballers (NYC Magpies), runners, triathlon athletes, crossfit athletes, tennis players, and weekend warriors. Time and time again, I hear patients describe an old ankle injury that has never been treated, pain resolves in a few weeks, and has developed into a “weak” ankle and they sustain chronic re-injury. Janet Travell the author of the myofascial trigger point manuals says it well that, “after an injury, tissues heal, but muscles learn. They readily develop habits of guarding that outlast the injury.” Early treatment and re-education is the key to successful rehabilitation and returning quickly to a high level activity.
Ankle sprains are graded according to severity grade I-III.
Grade I
Microscopic tears in the ligaments, stretching of ligaments, swelling, lateral stability is maintained however painful. Difficulty in weight bearing typically take 2-4 weeks to regain full mobility and fully resolve.
Grade II
Partial tear through ligaments, swelling slight bruising appear, deficient lateral ankle stability with intense pain. Difficulty in weight bearing usually associated with steppage or toe gait. Typically take about 6-8 weeks to heal.
Grade III
Full thickness tear of 1 or multiple ligaments, swelling, pooling bruising at lowest point intense discoloration worse 2-3 days after injury. Usually inability to weight bear. Recovery time depends on several factors
The immediate treatment is to follow the the P.R.I.C.E. rule
P.-Protect-don’t re-injure it .
R. Rest-no matter the severity
I. Ice-anti inflammatory
C. compression ace bandage/brace to decrease swelling
E. Elevate/lift leg above your heart to best allow your system to regulate the edema.
Chiropractic Treatment for Ankle Sprains in Midtown Manhattan, NYC AT CSC+M
PHASE I: MANUAL THERAPY, AND ANTI-INFLAMMATORY
Manual Therapy: Our NYC chiropractors address the mortise joint, proximal tib/fib joint, distal fibula manipulation with movement, ligamentous active release ATF and CF, we look to restore isometric ankle ROM in the Sagital plane first, then the Frontal plane, and finally Transverse. We also use RockTape and Braces/Supports as needed to decrease inflammation.
PHASE II: STABILIZATION, EDEMA CONTROL, TISSUE REMODELING
Standard treatment is non-weight-bearing and to give the patient a brace or boot for 8 weeks. At CSC+M we reload tissues for regeneration and early healing to injured tissues through the combination of Active Release Technique, Graston Technique, Acupuncture, Taping, and Physical Therapy in functional positions.
PHASE III: RE-ACTIVATION, CORRECTIVE EXERCISE
Strength: the ankle must be able to withstand an incredible amount of force. Walking puts stresses up to 2-3 times your body weight on each foot, while jogging puts 3-5x your body weight, and jumping puts 5-7 x your body weight.
We want the athlete to at least be able perform alternate toe lifts 2x their body weight 30x before discharge.
We want the athlete to be able to perform a symmetric single leg squat to 90 degrees.
Flexibility: the ankle needs 10-15 degrees of dorsiflexion.
Stability: the athlete need to be able to perform a tri-plane lunge
