When it comes to ankle injuries, it is just not enough to check if it is a fracture or not? Fractures are serious injuries, no doubt; but soft tissue injuries, particularly ligament injuries may be as difficult to treat in case of the ankle joint. Lateral (outer side) three ligaments are very vulnerable to sustain injuries during ankle twist and it is possible that patient may feel a pop during a severe tear. Many ankle twists may also hurt muscle tendons like the Tendo Achilles or involve more than one ligament group. Though initial physical assessment is sufficient for diagnosis in most cases; some cases may need X Ray or even MRI to do a precise differential diagnosis. On field injuries are usually first seen by the team Physio who may have seen the fall happening. Seeing the mechanism of injury makes it easier for on field Physios to immediately conclude about the area and extent of injury. Early referral to nearest hospital for further examination should be done if Physio feels the necessity because continuing to play with a minor soft tissue injury may only worsen the injury.
Initial immobilization using ankle support/ strap/ brace/ plaster/ taping may be useful. Physio prescribed exercises like the isometrics for surrounding muscles must be started early to avoid unnecessary weakness and stiffness from setting in. Established Physical Rehabilitation Protocols may help as a guidance during recovery but your of Physio must help to modify the protocols and help in achieving better results.
Most of the soft tissue injury patients get back to normal life within few weeks.This is mainly done by progression through various stages of mobility and strengthening of the associated joint structures. Athletes and dancers should take special care. Getting back to regular sport or dancing routine must be closely monitored because at various stages of recovery, proper Bio Mechanical and Balance analysis is essential. Choice of rehabilitation exercise largely depends on the form of activity that you are supposed to take up after recovery. Dancers, Cricketers, Runners or Football players may all need different variations of sport specific training during recovery. As you progress, you can gradually add exercises involving body weight and later start some weight training too.
You may need to stay in touch with Physio for few months to get time to time guidance for a complete recovery. A good follow up leads to a perfect recovery, otherwise chances of the pain troubling you later in life are very high. Ligaments and soft tissues are such important structures that their injuries may lead to early arthritic changes, if not treated well at the right time.
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