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Wednesday, September 3 Ankle Injuries, RICER Rolled over by Ankle Pain? A practical Guide to prevent and manage ankle sprains Why do ankle sprains occur? Acute ankle sprains result form a force being applied to the ankle joint which causes excessive range of movement at the joint. The player is immediately aware of the condition. Players may hear an audible snap' or pop', due to the tearing or stretching of the ligaments, similar to snapping a tight rubber band. If managed improperly, long-tern problems may develop from an ankle sprain. Proven risk factors: Previous or existing ankle injury. Lack of strength and stability related to the ankle. Poor balance. Sudden change of direction (acceleration or deceleration). Increasing age of player. Suspected risk factors: Poor condition of the playing surface. Inappropriate, inadequate, or no warm-up. Wearing inappropriate footwear for the activity. Lack of external ankle support (taping, bracing) for previously injured ankles. Some research suggests that female athletes may have a higher risk of ankle sprains. Prevention. What can you do to prevent ankle sprains? In order to reduce the risk of an ankle sprain, players should: Complete a thorough general body warm-up, which should include sport specific muscle stretching as well as sport specific skill drills. Wear correct footwear that fits well, provides adequate protection and has the appropriate type of sole and traction for the playing surface. After recommendation from a qualified health professional, tape or brace the ankle. Check the training and playing area to ensure a flat and even surface. Stretch and cool down after every training session and competition. Include flexibility, balance, stretching and strengthening exercises in weekly training program(s) Include agility work in the training program so that the ankle joint is capable of sustaining the high acceleration forces and quick changes in direction that occur in their specific sport. What do you need to remember? The biggest risk factor for an ankle sprain is a previous ankle sprain. Once players have suffered an ankle sprain, it is important to ensure that they are appropriately rehabilitated prior to returning to either training of competition. Players with significant ligament injuries (grade II or III) are advised to use bracing or protective taping when playing sport for a minimum of 6 to 12 months post injury. Before you return to play can you... Walk with a normal gait over 5-10m? Walk forwards on you toes and then on your heels over 5-10m? Balance on the injured and uninjured leg for an equal amount of time? Perform heel raises, lifting the body by rising up on the toes? Run forwards and backwards at speed over 1-15m? Jump and hop over 5-10m? Run at speed in a figure of eight over 3-5m or zig-zag pattern over 10m? Complete static sport-specific skill activities (e.g. catching a netball while pivoting on the injured foot)? Complete dynamic sport specific skill activities of 50% intensity (e.g. jogging to catch a netball)? Complete dynamic sport specific skill activities under match conditions (e.g. running an jumping to catch a netball, against opposition, in full game play drills)? Does the player have 100% confidence? There should be no swelling of stiffness at the site. Full range of motion should be restored, compared with the uninjured leg. There should be no pain when performing any flexibility, balance, stretching, strengthening or sport specific exercises through a full range of motion. There should be similar flexibility, strength, power and endurance of the lower leg muscles in both legs. If in doubt give it any extra week. Ankle rehabilitation should be continued for sometime after a player has returned to training or competition. Once players have suffered an ankle sprain, it is important to ensure that they are appropriately rehabilitated prior to returning to either training or competition. Advice from a sports physician or physiotherapist is recommended. For further information please check out the SMA WA website. http://www.smawa.asn.au/_uploads/res/120_838.pdf RICER Early, aggressive and proper use of the RICER regime is essential for the initial management of a soft tissue injury. How Why R Rest Place the athlete in a comfortable position, preferable lying down. The injured part should be immobilized and supported. Activity will promote bleeding by increasing blood flow. I Ice The conventional methods are: Crushed ice in a wet towel/plastic bag immersion in icy water. Commercial cold packs wrapped in wet towel Cold water from the tap is better than nothing. Apply for 20 Minutes every 2 hours for the first 48 hours. CAUTION: Do not apply ice directly to skin as ice burns can occur. Do not apply ice to people who are sensitive to cold or have circulatory problems And children have a lower tolerance to ice. Ice reduces: Swelling Pain Muscle spasm Secondary damage to the injured area C Compression Apply a firm wide compression bandage over a large area covering the injured part, as well as, above and below the injured part. Compression: Reduces bleeding and swelling Provides support for the injured part. E Elevation Raise injured area above the level of the heart at all possible times. Elevation: Reduces bleeding and swelling Reduces Pain R Referral Refer to a suitable qualified professional such as a Doctor or Physiotherapist for a definitive diagnosis and ongoing care. Early referral for a definitive diagnosis to ascertain the exact nature of the injury and to gain expert advice on the rehabilitation program required. |
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