Ankle Injuries

Ankle injuries are one of the most common types of injuries we treat as physiotherapists.  It is also one of the most overlooked injuries; less than half of those who sprain their ankles seek help or rehab, which actually increases the chances of an ankle injury recurring.

There is no such thing as a simple ankle sprain. The foot and ankle complex consists of 26 bones, 112 ligaments and 40 joints. If you think about the mechanism of an ankle injury and how small and complex your foot is, you may start to understand why that statement holds true.  If you stand on 1 foot, an average of 70kg of weight passes through that foot to help you balance. Running increases the weight through your foot more than 300%.

Did you know: recreational runners who have less than 2 days rest a week have a 520% increase in the risk of an overuse injury? This is why rest is so important. Not only for prevention of injuries but the body needs time to recover from the pounding that running can give it. Substitute the ‘rest days’ with something like Pilates or strength work to maintain strength and work on areas in your body that are weak.

One of the most common types of ankle injuries is one that involves twisting the foot inwards and down (inversion and plantarflexion) this usually happens when walking or running on uneven terrain or stepping into a hole. The damage that occurs with this type of injury usually involves your lateral ligament complex, consisting of 3 ligaments: the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament) (please insert a picture of the lateral ankle complex)

Other common and often overlooked injuries are syndesmosis injuries (the space between your tibia and fibular bones) the mechanism of injury here is similar to the lateral ankle injury mentioned above but usually involves some kind of shear force. Signs and symptoms are similar (pain and or swelling) these type of injuries can be diagnosed with accurate assessment or if necessary a scan.

Plantar fasciitis which is pain under the arch of your foot which is often worse early in the mornings or painful when walking or running and Achilles tendinopathy (pain in the tendon at the back of your heel.) The Achilles tendon attaches to your calf muscle and both of these are common overuse injuries, poor biomechanics or excessively tight calves.

It is very important not to ignore what you may think is a simple ankle sprain. Strengthening the core parts of your feet are an essential part of rehabilitating any ankle injury. Proper diagnosis, treatment and rehabilitation will ensure you don’t develop secondary complications to your ankle injury, e.g back, hip, knee or even shoulder pain, and will help prevent further ankle injuries. Ankle injuries can alter the proprioception in your foot. Proprioception is the ability to know where your body is in space; when you step on an uneven surface you are able to adjust the position of your foot accordingly. When you damage your ankle, these receptors don’t work as well as they used to and the signal to your brain is slower, which is why the risk of re-injury is higher.

The best management for any ankle injury initially is rest with ice and to reduce weight bearing through the ankle for the first 2-3 days (depending on the extent of your injury) The earlier you see a physiotherapist for an accurate diagnosis and management plan, the better.

In summary- if you sprain your ankle (even mildly) we suggest you make an appointment with your nearest physio to get a proper diagnosis and assessment.

Sarah Ferguson

Physiotherapist & Pilates Instructor

Silver License Swimming Coach (Australia 2010)

Practice No. 0312037

Tel: +27 87  700 4800 Cell: +27 82 754 7930

Address: 20 Gainsborough Drive, Durban North, 4051

Email: sarah@coremedical.co.za

Shoulder Injuries

The shoulder is one of the most mobile joints in the body. It is a ball and socket joint which means it can rotate in several different directions, unlike your knee or elbow, which are 2-direction hinge joints.

One of the most common injuries with shoulders stems from poor biomechanics. An instability between your big shoulder muscles and your small shoulder muscles results in the ball of your shoulder sitting forwards and causing a pinching between the socket and the ball. Your rotator cuff is the core of your shoulder and usually strengthening this with your scapular stabilizers will go a long way towards correcting shoulder biomechanics (posture) and reducing pain. (please insert a picture of the shoulder joint )

Many shoulder injuries occur over time from consistently poor posture. Our lifestyles today involve a lot more sitting than even a decade ago. We drive to work, sit at a desk for 8 hours a day, and then drive home to sit in front of the TV. Those of us who exercise are not always consistent about it, and sports such as cycling, paddling, swimming and even running can exacerbate the forward stooped posture that we have developed over the years with a more sedentary lifestyle. Our upper back (thoracic) spine becomes stiff and tight and this can further limit shoulder mobility. Sports involving repetitive overarm activity like any throwing sports, swimming and even paddling, if not managed well, can lead to shoulder overuse injuries.

Being aware of your posture throughout the day is key in preventing and managing shoulder injuries. There are some basic core shoulder exercises that will help you prevent injury and maintain good biomechanics. These exercises include correct posture and ‘setting’ of the shoulder.

Shoulder surgery is complex, and the rehab following this is extensive and requires a lot of patience. One of the complications we sometimes see post-surgery, is “frozen shoulder.” (this is when the shoulder becomes stiff and you are no longer able to move the shoulder freely) Many people recover completely from shoulder surgery but it is important to see your physiotherapist and work through a good rehabilitation program to restore your range of motion and muscle strength to full capacity after your surgery.

If you suffer from shoulder pain or if you are an athlete and want to prevent injury, please contact one of our physios for help.

Sarah Ferguson

Physiotherapist & Pilates Instructor

Silver License Swimming Coach (Australia 2010)

Practice No. 0312037

Tel: +27 87  700 4800 Cell: +27 82 754 7930

Address: 20 Gainsborough Drive, Durban North, 4051

Email: sarah@coremedical.co.za

MY TOP TIP AS A PHYSIO

“Keep active!’ Movement is better than rest. Our bodies are designed to move and with our modern day living, driving to work, sitting at a desk, using laptops, tablets and cell phones, our bodies are not getting enough movement. We start to develop poor habits and weak muscles. Learn to move correctly and do it often.

If you have pain or stiffness somewhere it is usually your body telling you something is wrong. Listen to your body- see a professional, sign up for a Pilates class. You don’t have to do something crazy to start moving. start with getting up at your desk every minutes and walking down the passage.

Sarah Ferguson

Physiotherapist & Pilates Instructor

Silver License Swimming Coach (Australia 2010)

Practice No. 0312037

Tel: +27 87  700 4800 Cell: +27 82 754 7930

Address: 20 Gainsborough Drive, Durban North, 4051

Email: sarah@coremedical.co.za

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