Prevention and Treatment of Acute and Recurrent Ankle Sprains     



Considering the amount of force your feet and ankles are subjected to bone.


Ankle Sprains and CAI


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 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, meaning your brain receives less information about your foot and ankle position, increasing instability and the risk of injury.


Treatment for CAI


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:


  • Strengthening exercises: Initially using a therapy band for resistance, and then progressing to side, ankle circles in both directions, and turning the foot inward and outward from the ankle.


  • Flexibility training: Being able to misplant your foot, setting you up for a sprain.


  • Balance training: Your ankles make a significant contribution to balance as you stand and move. Balance training can enhance proprioception and promote strengthening of the muscles that help you establish and correct your foot and ankle position.


  • Bracing and taping: In some instances, your therapist may recommend athletic taping or wearing an elastic brace during physical activity to your ankle joints.


  • Pre-sport conditioning: Overall physical conditioning helps you move more efficiently, both on and off the playing field. Off-field training is an important element of injury prevention, whether you play recreationally or professionally. Make sure you are in shape before engaging in sports, and be sure to warm up all your joints, including your ankles, before engaging in vigorous activity.


Diagnosis and Treatment of Ankle Sprains and CAI in NYC


The sports medicine team at NYDNRehab is privileged today, and let our foot and ankle specialists provide you with the very best physical therapy in NYC.


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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