Chiropractic Treatment of Ankle Sprains

Who hasn't twisted her or his ankle? Usually it happens quite suddenly and unexpectedly. You often find your self looking around to try and discover what it was that you stepped on. Most of the time, there's nothing there; no irregular surface, no stone or kid's toy, nothing that seemingly causes you to turn your ankle so abruptly. Does this sound familiar? If it does, then this isn't the first time you've done it. The first time was probably a dilly; swelling, maybe bruising, a real sense that you couldn't bear your weight. It took several days, or even weeks to get the ankle to look normal and to begin to feel some strength in it again. Since then, you've flipped it more times then you can count, but fortunately, not too seriously. But you begin to wonder if you can trust the thing again. So what's this about, this weak ankle? Won't it ever heal? The answer is probably not. At least not without some real proactive therapy. Almost all treatment of ankle sprains is reactive. You know the RICE thing, but nothing usually preventive in nature. Medically, they say that a sprain is worse than a break. That's because a broken bone heals, while a sprain never seems to. Let me try to explain why that is. The ankle is a ‘mortise-tenon joint'. What's that you ask? Mortise-tenons are a common means of joining pieces of wood, such as in making a chair. It is a particularly strong joint, by design incapable of movement. The mortise is a hole in one piece of wood. It can be round, square or rectangular. A tenon is a projection on another piece of wood that matches the mortise and fits into the hole. In the ankle, the mortise is formed by the two lower leg bones; the tibia and the fibula. At the ankle, these are the large bumps on either side. The tenon of the ankle joint is called the talus. The talus is roughly a rectangular cube and it fits into the bony mortise above it. Unlike the woodworking mortise-tenon joint, the ankle does allow one range of movement. It allows you to bend your ankle up thereby raising your foot and toes off the floor (dorsiflexion). It also allows the opposite motion that of pushing your foot and toes down (plantarflexion). What the mortise does not allow is sideways movement. It is this sideways rotation of the foot and ankle that caused the sprain. The most common sprain is the one in which the foot ends up looking in, as it were and you end up standing on the outside of your ankle. The opposite motion can occur, but not without some violent trauma, such as in a lateral football tackle. The ligaments on the inside of the ankle are far stronger than on the outside and generally what ends up happening is a ligament tear or what is known as an ‘avulsion' fracture. An avulsion fracture occurs when the ligament pulls out of the bone, usually taking a piece of bone with it. These are nasty, and not really what we are discussing here. What we've been learning is a sprain to the outside of the ankle; a far more common scenario. So other than rest, ice, support and elevation, what else can be done, you ask? The thing that needs to be done is the talus needs to be put right. The reason that a sprain is considered worse than a break is that the talus after a sprain is now and forever sitting twisted in the mortise. It is forever doomed to be crooked because the talus is the only bone in the body that has no muscles attached to it, so it can't pull itself right as other bones can; at least theoretically other bones can anyway. Resetting the talus is one of the many things that chiropractors are taught to do. This treatment or adjustment of the ankle can be very effective, especially when performed early, as soon after the sprain as possible. If done immediately any swelling and bruising is greatly reduced and the overall healing time is far, far shorter. In the case of the chronic, longstanding ankle sprain, adjustments to the ankle are still effective, but not as dramatically so. After the chronic ankle is adjusted, it helps to apply strong tape. The twisted talus has, in effect, spread the mortise and, over time, stretched the ligaments between the leg bones. Tape helps to hold the tibia and fibula together while the ligaments re-tighten and maintain the newly reset talus. So a sprain does not need to be worse than a break, as long as it is attended to properly and promptly. See your chiropractor ASAP after twisting your ankle.

Author Contact Info: David L. Phillips, D.C.
http://miltonchiropractic.chiroweb.com/