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Ankle Mobility – Significance in Injury Prevention

Ankle mobility and its significance in injury prevention

Let it be walking, running, jumping or landing, ankle is the first major joint, from where the forces are transferred up in the body. So it makes the ankle joint a lot more important than what people think of it. Ankle joint is often overlooked while dealing with conditions occurring at knee joint, hip joint or lower back. Primarily ankle joint movements include dorsiflexion (toes coming closer to shin) and plantar flexion (tip toeing) (Fig 1 & 2). Limited dorsiflexion at ankle joint affects shock absorption and many functional movements such as squats and going downstairs.

Every time our foot lands on the ground while walking, running or landing, there is ‘Ground Reaction Force’ produced. To keep the forces acting on the body within limits, it is important for the body’s musculature to absorb the forces.  Under impact activities every joint involved should work in their optimal range. If any joint’s range of motion is affected, it will increase stress on the other joints. This will also influence the muscle function and shock absorption around the affected joint.This is why ankle mobility is important to prevent injuries at foot, knee, hip and Lower back.

dorsiflexion

Fig 1 – Dorsiflexion

plantar-flexion

Fig 2 – Plantarflexion


 



A simple example to better understand it is to do a small jump, landing with stiff joints and another landing while bending at different joints. Landing with stiff joints will feel heavier and impart high forces on the joints. On the other hand, same landing done while allowing ankle knee and hip joints to bend, will feel much lighter. A good range of motion in joints allows the muscle to stretch more and absorb the forces optimally. Therefore limited/restricted joint range at ankle joint will increase the share of Ground reaction force more on knee and hip joint. In addition, a stiff ankle not only lacks in absorbing shock but it also reduces your overall agility and control.


 



Factors leading to reduce ankle mobility – Click here


 


When and why to use an Ice Pack?

When and why to use an Ice Pack?

Article by Adele Ang

adele

Senior Sports and Musculoskeletal Physiotherapist

About the Author : Adele specialize in Sports and Musculoskeletal Physiotherapy.  She also pursued the Polestar Pilates Method, which is a comprehensive method using Pilates as exercise therapy for rehabilitation of injuries.


In Asian cultures, applying cold packs to injured body parts is frowned upon. As there is a belief that it can lead to ‘rheumatism’, which is typically characterised as stiff and achy joints. As a kid, my dad would rub a hard-boiled egg, straight out of boiling water, on a bruise formed on my head or my knees the very moment after sustaining these bruises.

I was told that this is done to improve blood circulation to the bruise, for the bruise to dissolve, as well as to avoid having to cut the bruise out as it will be ‘dead flesh’, should blood permanently fail to return to the bruise. Really frightened that this threat might really happen, I endured the painful hot egg treatment with every bruise I sustained as a kid.




Applying cold therapy to injuries is not common practice in Asian cultures, whether it’s Traditional Chinese Medicine or Ayurvedic Medicine, heat therapy is still a treatment of choice. As such, it’s not common knowledge among some patients when to apply heat and when to apply cold.

Here are 3 pointers to help you decide to reach for ice whenever you sustained an injury.




1.First 72 hours

The basic guideline is that cold therapy should be applied in the first 3 days following an injury. Inflammation which is our bodies healing mechanism happens immediately following an injury, whereby blood flow is increased to that area to commence healing. As a result of inflammation, pain is experienced and the injured area will be swollen and warm to touch.

2.Red, swollen and warm to touch (past 72 hours)

When the area concerned presents with redness, swelling and is warm to touch. These 3 things suggest that the injured structures are still inflamed. Cold therapy may at times need to be continued after 72 hours especially when the injury sustained is extensive and/or it affects parts of our body such as the foot and ankle which usually have more persistent swelling due to continuous load on these areas if weight is placed on then as well as due to gravity pulling more fluid down to those areas.




3.Difficulty moving the injured area due to pain

Usually pain is intense and unremitting and episodic as well. May have been more than a few days, could be weeks or months prior but is episodic. A recurring injury to the same area may result in such a presentation, usually heat therapy is applied but should you feel worse or in more pain after, you may respond better to cold therapy. This may be due to repeated inflammatory responses to the injured area usually resulting from repeated aggravation of the same area as a result of insufficient rest as well as not receiving proper treatment, including physiotherapy and rehabilitation following the injury.

Rehab Mantra
Stay Fit. Love Life

 


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Ankle Mobility – Significance in Injury Prevention

Ankle mobility and its significance in injury prevention

Let it be walking, running, jumping or landing, ankle is the first major joint, from where the forces are transferred up in the body. So it makes the ankle joint a lot more important than what people think of it. Ankle joint is often overlooked while dealing with conditions occurring at knee joint, hip joint or lower back. Primarily ankle joint movements include dorsiflexion (toes coming closer to shin) and plantar flexion (tip toeing) (Fig 1 & 2). Limited dorsiflexion at ankle joint affects shock absorption and many functional movements such as squats and going downstairs.

Every time our foot lands on the ground while walking, running or landing, there is ‘Ground Reaction Force’ produced. To keep the forces acting on the body within limits, it is important for the body’s musculature to absorb the forces.  Under impact activities every joint involved should work in their optimal range. If any joint’s range of motion is affected, it will increase stress on the other joints. This will also influence the muscle function and shock absorption around the affected joint.This is why ankle mobility is important to prevent injuries at foot, knee, hip and Lower back.

dorsiflexion

Fig 1 – Dorsiflexion

plantar-flexion

Fig 2 – Plantarflexion


 



A simple example to better understand it is to do a small jump, landing with stiff joints and another landing while bending at different joints. Landing with stiff joints will feel heavier and impart high forces on the joints. On the other hand, same landing done while allowing ankle knee and hip joints to bend, will feel much lighter. A good range of motion in joints allows the muscle to stretch more and absorb the forces optimally. Therefore limited/restricted joint range at ankle joint will increase the share of Ground reaction force more on knee and hip joint. In addition, a stiff ankle not only lacks in absorbing shock but it also reduces your overall agility and control.


 



Factors leading to reduce ankle mobility – Click here


 


When and why to use an Ice Pack?

When and why to use an Ice Pack?

Article by Adele Ang

adele

Senior Sports and Musculoskeletal Physiotherapist

About the Author : Adele specialize in Sports and Musculoskeletal Physiotherapy.  She also pursued the Polestar Pilates Method, which is a comprehensive method using Pilates as exercise therapy for rehabilitation of injuries.


In Asian cultures, applying cold packs to injured body parts is frowned upon. As there is a belief that it can lead to ‘rheumatism’, which is typically characterised as stiff and achy joints. As a kid, my dad would rub a hard-boiled egg, straight out of boiling water, on a bruise formed on my head or my knees the very moment after sustaining these bruises.

I was told that this is done to improve blood circulation to the bruise, for the bruise to dissolve, as well as to avoid having to cut the bruise out as it will be ‘dead flesh’, should blood permanently fail to return to the bruise. Really frightened that this threat might really happen, I endured the painful hot egg treatment with every bruise I sustained as a kid.




Applying cold therapy to injuries is not common practice in Asian cultures, whether it’s Traditional Chinese Medicine or Ayurvedic Medicine, heat therapy is still a treatment of choice. As such, it’s not common knowledge among some patients when to apply heat and when to apply cold.

Here are 3 pointers to help you decide to reach for ice whenever you sustained an injury.




1.First 72 hours

The basic guideline is that cold therapy should be applied in the first 3 days following an injury. Inflammation which is our bodies healing mechanism happens immediately following an injury, whereby blood flow is increased to that area to commence healing. As a result of inflammation, pain is experienced and the injured area will be swollen and warm to touch.

2.Red, swollen and warm to touch (past 72 hours)

When the area concerned presents with redness, swelling and is warm to touch. These 3 things suggest that the injured structures are still inflamed. Cold therapy may at times need to be continued after 72 hours especially when the injury sustained is extensive and/or it affects parts of our body such as the foot and ankle which usually have more persistent swelling due to continuous load on these areas if weight is placed on then as well as due to gravity pulling more fluid down to those areas.




3.Difficulty moving the injured area due to pain

Usually pain is intense and unremitting and episodic as well. May have been more than a few days, could be weeks or months prior but is episodic. A recurring injury to the same area may result in such a presentation, usually heat therapy is applied but should you feel worse or in more pain after, you may respond better to cold therapy. This may be due to repeated inflammatory responses to the injured area usually resulting from repeated aggravation of the same area as a result of insufficient rest as well as not receiving proper treatment, including physiotherapy and rehabilitation following the injury.

Rehab Mantra
Stay Fit. Love Life

 


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Can you do a full squat?

Can you do a full squat ?

Article by Adele Ang

adele

Senior Sports and Musculoskeletal Physiotherapist

About the Author : Adele specialize in Sports and Musculoskeletal Physiotherapy.  She also pursued the Polestar Pilates Method, which is a comprehensive method using Pilates as exercise therapy for rehabilitation of injuries


As a physiotherapist I teach people to assume a squat position for many reasons. Being Asian and raised in a culture where squatting toilets were the norm, most people had no problem assuming a full squat.

With the rise of sitting toilets, less and less people are able to squat fully, this is particularly true for relatively younger people. Surprising isn’t it? So sometimes you get to see a sprightly older lady make her way to the squatting cubicles while the younger ladies wait in line for the sitting ones. And guess who is going to have more problems with the hip, knee and ankle joints in future. Well, I can proudly say I am one of those ladies, though not older, who cuts to the front to use those empty squatting cubicles.




Benefits of a Full Squat

A full squat has its benefits, both in keeping the joints of your legs sufficiently flexible and the muscles moving those joints both stronger and longer, as they support the joints through their full range of movement. Lost of joint range of movement or joint mobility is a common reason for ongoing hip, knee and ankle pain in many adults, commonly but wrongly attributed to be a result of aging.




Assuming a full squat has also been touted as a valid solution for complete emptying of one’s bowels. A full squat requires you to have your thighs brought up to your chest which tightens your abdominal muscles, the position places a slack on your pelvic floor muscles which in turn relaxes the anal sphincter.

In addition, if you are experiencing recurring hip, knee or ankle injuries it is worth seeing if you can do a full squat and if not, learn to do it.

Here are 3 things you can do to assume a full squat and in doing so, keep your legs and bowels happy and healthy!




How to Give Your Ankle Sprains the Perfect Rehabilitation and Reduce Risks of Recurrence

 

Article by Timothy Maiden

Tim photo
Senior Podiatrist at The Foot Practice (Singapore)

 

Untreated ankle sprains can lead to chronic problems such as pain, joint instability, and diminished range of motion. Yet many patients with acute ankle injuries never seek medical attention [1].

Not to scare you, but poor recovery from ankle injury and long-term ankle instability ­­is associated with the development of painful degenerative joint disease. This risk can be reduced or eliminated with proper ankle care and rehabilitation. Ankle sprains are among the most common injuries to the musculoskeletal system, accounting for approximately 2 million injuries per year [2].

It’s no surprise that the most important risk factor for ankle sprains is a history of previous ankle sprains! Therefore, it’s absolutely imperative to follow an up-to-date rehabilitation program. An ounce of prevention is worth a pound of cure, and prevention of ankle sprains is especially crucial during the seven-week period after acute injury. In this guide, we’ll discuss ankle injury severity, the four-step rehabilitation process and the application of an orthosis (brace for an ankle injury).

 




Ankle Injury Severity

Depending on injury severity, ankle sprains are graded from I to III. It’s helpful to familiarize yourself with the grades, since injury severity informs treatment.

Grade I ankle sprains exhibit minimal loss of functional ability, pain or swelling, and an intact ankle ligament. A grade II ankle sprain entails a partial ligament tear and moderate pain, swelling, and loss of function. Finally, grade III is characterized by a complete ligament tear, with severe loss of function, pain, and swelling, as well as marked difficulty bearing weight.

The Perfect Ankle Sprain Rehabilitation Regimen

What’s the goal of ankle rehabilitation? Isn’t it enough to relax on the couch and let the healing process occur by itself? Rest and relaxation are certainly an important part of rehabilitation, but there are a number of other steps you can take to hasten recovery and prevent future injuries.

The goal of ankle sprain rehab is to I) decrease inflammation, II) regain your full range of motion, III) increase muscle strength, power, and endurance, and IV) improve proprioception. Proprioception is just a fancy word for how you perceive different parts of your body. Amputees, for example, would have disturbed proprioception as a consequence of their injury.



Start Rehabilitation Early! 

Early rehabilitation hastens recovery after ankle sprains [3]. Recent evidence suggests that early movement by range-of-motion exercises and isometric/isotonic strength exercises improves healing. Or in medical jargon: a study that found early mobilization leads to a beneficial orientation of collagen fibers compared to an immobilized ligament [4].

Remember grade III ankle sprains? This was the most severe kind of ankle injury. Well, for grade III ankle sprains, 7-14 days of immobilization (using a brase or orthosis) assisted by crutches may be needed if you’re in constant pain. Oral NSAIDS are useful for pain relief and reduce inflammation. Remember, decreasing inflammation was goal #1 of ankle sprain rehabilitation.

There are four phases of ankle rehabilitation:

  1. Manage pain and swelling
  2. Restore range of motion
  3. Begin muscle strengthening
  4. Regain full strength, functional rehabilitation, and return to normal activity

 




Ankle Bracing and Orthotic Therapy

Orthotics is a medical specialty that designs and applies orthoses – devices used to modify the structure or function of the musculoskeletal system. An example of an orthosis is an ankle brace.  Ankle braces come in three flavors: I) lace-up, II) stirrup, or III) an elastic configuration.

What are ankle braces for? They provide mechanical stability to the injured area and facilitate the healing process. Orthosis has a number of advantages: cost-effectiveness, ease of use, and you can do it yourself at home (you don’t need assistance from a medical professional to apply it!)

Orthotic therapy has been shown to enhance joint position sense, provide added stabilization, support, and sensorimotor feedback during exercise, improve balance after injury, reduce postural sway, fatigue and pain perception and protect against future injuries without significantly affecting athletic performance.

 

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