By Christine Johnston BA, CSCS, CAT(C)
Most commonly, when an ankle injury occurs during basketball, the foot
moves laterally into an inversion motion. When this inversion motion
occurs, the ligaments of the ankle are put on a stretch causing a
sprain to the ligaments. These ligaments are connective tissue that
connects bone to bone creating stability in the joint to allow strong
basketball movements to occur. However there are times when these
ligaments cannot withstand the forces put upon them or the positions
that they are put in, such as landing from a jump shot on someone
else’s foot resulting in injury. Most typically in basketball, this
will result in a sprain to the Anterior Talofibular ligament of the
ankle.
Symptoms that occur with this injury are pain, inflammation located at the side of the foot often in a ball shape on the ankle bone, as well as bruising to the ankle and foot area.
TREATMENT OF AN ANKLE INJURY:
THE PIER PRINCIPLE
ACUTE = FIRST 24 TO 48 HOURS
P = PRESSURE
Pressure can be applied with the application of a taping technique with a horseshoe pad or a tensor bandage. The horseshoe pad goes around the ankle bone, leaving the ankle bone exposed, forcing the inflammation to other areas of the ankle and foot.
Pressure is important to close the boundaries of the inflammation. In other words, pressure is to close the gate on the fluid rushing into the joint. The body sends the fluid as a protective mechanism however does not know how to shut off once it begins, therefore creating pressure will help it shut off.
Tensor Bandage & Horse shoe pad
I = ICE
This can be applied through an ice bag, some snow, or even a bucket of cold water with some ice. Treatment time can be for 15 minutes every hour
Ice is used to assist with pain and can assist with slowing the inflammation by narrowing the vessels of the joint.
E = ELEVATION
This can be applied by elevating the foot on a chair, and at night by elevating the entire mattress with a suitcase or something more rigid to maintain the elevation.
Elevation is another step that you can take to decrease the inflammation by promoting flow away from the ankle and back into the system.
R = REST
Rest does not mean becoming a couch potato. The rest required is active rest, which means that you are removing yourself from the activity that caused the injury and any other activities that would put undue pressure on the area while continuing to move the area as pain and inflammation allows. Crutches may be required to facilitate this time of rest.
Rest is important to allow the healing process to occur.
SUBACUTE = 48 HOURS PLUS
*ONCE THE ANKLE IS NO LONGER SWELLING
* No redness, no longer hot to touch
FLEXIBILITY = Maintaining flexibility and range of motion is really important once you have injured your ankle. The calf muscle will often become tight due to change of walking patterns and pain associated with the injured ankle. Flexibility exercises that can be done at this time are towel stretches performed by pulling the toes to the shin with the towel around the toes, or regular calf stretches with the knee bent as well as straight
STRENGTHENING = Injury often causes atrophy, or loss of strength of the muscles surrounding the joint. Strength can be maintained by performing toe taps, tap your toes on the ground as fast as you can for 30 seconds and then rest for 30 seconds, do this three times. Furthermore you can place a towel on the floor and pull it towards you in a side to side motion until the towel runs out, do this 3 times each way.
PROPRIOCEPTION = Proprioception is balance training and is one of the most important activities to do after you have injured your ankle before you return to the court. A sprain injury to the ligament stretches the ligament out much like if you were to stretch out an elastic band. However ligaments can be trained to become tight and strong again through balance training. When the ankle is on its way to recovery, you may begin proprioception exercises by standing on one leg for 30 seconds, then progress to standing on a pillow and then repeat with your eyes closed.
Closing Tips = Always ice after activities that might have aggravated the ankle, protect the area once you begin activities again and if you don’t know how serious the injury is, don’t hesitate to get it checked!
Christine Johnston is an Athletic Therapist and Strength and Conditioning Coach, she can be contacted at Christine.johnston@shaw.ca.