Considering the amount of force your feet and ankles are subjected to on a daily basis, especially if you are an athlete or exercise enthusiast, it is a wonder they manage to bear up under so much stress. It is particularly remarkable when you consider that your ankle joints are not supported by a strong network of muscles like many of your other joints, but they are primarily held together by a network of ligaments, strong connective tissue that connects bone to bone.
Ankle sprains occur when the ligaments surrounding your ankle joint are stretched and torn, often in the course of a fall where your ankle rolls outward. Ankle sprains often occur during sports, or when walking or running on uneven surfaces.
An initial acute ankle sprain can lead to ongoing instability of your ankle joint, predisposing you to recurring episodes. Chronic ankle instability, or CAI, often results from single or recurring sprains. In addition to stretching and tearing of the ligaments, it is thought that chronic instability may stem in part from the brain and central nervous system.
Ligaments surrounding your ankle contain neural receptors that send information to your brain about the position and motion of your foot and ankle. A ligament sprain can cause damage to neural receptors, meaning your brain receives less information about your foot and ankle position, increasing instability and the risk of injury.
Despite the limited number and size of muscles contributing to ankle stability, athletes or anyone with CAI can reduce the risk of ankle injury through physical therapy and exercises aimed at strengthening the structures surrounding the ankles. Therapy should address proprioception, gait training, balance, strengthening, stability, mobility and weight bearing.
Some strategies for ankle sprain prevention and risk reduction include:
The sports medicine team at NYDNRehab is privileged to have access to the most advanced technologies, right under the roof of our Manhattan clinic. We use real-time ultrasonography to pinpoint the exact location and nature of your ankle injury. Our computer assisted rehabilitation environment (C.A.R.E.N) is one of few in the United States, and it enables us to provide full gait and motion analysis and retraining. If you suffer from chronic ankle instability and want to prevent future sprains, contact NYDNRehab today, and let our foot and ankle specialists provide you with the very best physical therapy in NYC.
and a faulty diagnosis can make treatment a total waste of time.
Failure to accurately diagnose a condition in its early stages can lead
to chronic problems and sometimes devastating results.
Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.Successful Treatment
A bad physical therapy experience is one of the primary causes of unnecessary surgery.
We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.
Most importantly, we are the only facility in the US where structural medical diagnosis is reflected in functional treatment, and vice versa.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris
with large hematoma (blood)
Separation of muscle ends due to tear elicited
on dynamic sonography examination
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