Strathclyde Telegraph

Ask Dr Goals

THE STAR STRIKER WRITES EXCLUSIVELY FOR THE TELEGRAPH

 

UNIVERSITY of Strathclyde graduate and professional footballer Kenny Deuchar has made a career out of banging in goals for fun – but it’s not just on the pitch where he is recognised for scoring top marks.

The record-scoring star – known best for his time at big-spenders Gretna – graduated from Strathclyde with a Postgraduate Diploma in Sports and Exercise Medicine as the club shot to overnight success.

And in every edition of the Telegraph, the Livingston striker will be helping solve the injury problems of Strathclyde students.

This week the medical doctor talks about…

 

Ankle Ligament Sprain

It was suggested that it may be useful to talk about acute ankle ligament sprains so I will try and take you through a bit about the actual injury and then, more importantly about the recovery and rehabilitation.

When we talk about a sprained ankle we are normally referring to a lateral ligament sprain.  This is a very common injury in all sports and many athletes even have their ankles tapped to prevent this type of injury as they are so common.  There is certainly a place for ankle tapping but I would strongly advise that this only be used after an injury and the main reason for tapping is to aid rehabilitation and reduce the risk of further injury to the ankle.

Lateral ankle sprains vary in severity, ranging from a mild injury to the ankle’s main ligament through partial tearing of multiple ligaments to the most severe tearing that can affect all three main ligaments.

The normal mechanism of injury is an inversion injury commonly referred to as a twisting of the ankle or rolling the ankle.

Individuals may experience varying degrees of bruising and swelling and this is normally related to the seriousness of the injury but everyone is different.

When an individual sustains this type of injury the immediate concern is normally that they may have broken their ankle.  This is certainly possible but it is not advised that we x-ray every twisted ankle.

Generally, if an athlete is able to walk, even with a significant limp at any time immediately after the injury or later, then it is very unlikely that the ankle is broken.  If however, the athlete is unable to put any weight through the affected leg, an x-ray would be required.

Immediate management involves the mnemonic “RICE” which stands for Rest, Ice, Compression and Elevation.  This course of action should be followed for the first 48 hours following the injury.  Ice should be applied every two hours for 10-15 minutes at a time. Paracetamol and ibuprofen are recommended for pain relief.

Rehabilitation will very depending on the severity of the injury but involves massage techniques and non weight bearing flexion, extension, inversion and eversion exercises.  An elastic band may also be introduced such as a Theraband as progress is made. Swimming or cycling may be useful in order to maintain aerobic fitness while rehabbing from an ankle sprain.

By far the most important part of the rehabilitation process is proprioception exercises.  Proprioception is used by the brain to sense the relative position of neighbouring parts of the body.  It is essential that after injury the brain is retrained appropriately in order to prevent further injury and damage, this mainly involves a variety of balance exercises increasing in difficulty.

A very useful four-part series has been produced and placed on YouTube by DVOrthodoc, covering ankle sprains and is worth a look.

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