Rehabilitation Procedures
Addressing the correct Rehabilitation methods is important after an ankle sprain. If you do not take the right approach, the ligaments will not heal properly and the ankle will become weak. For a surfer, this could lead to significantly worse injuries just after applying too much pressure on the ankle during a manoeuvre due to the ankles weakness. Hence, addressing the appropriate Rehabilitation techniques is a must.
Progressive Mobilisation is important to apply to a sprained ankle. It is crucial to gradually introduce movement to the injured area. Through this, the injury will restore full movement to the injured area gradually through active and passive movement. However, when starting progressive mobilisation, your movements should be slow, progressive and pain free. Progressive Mobilisation is the first step to rehabilitation and will allow a sprained ankle to recover with full strength, and to achieve a successful rehabilitation period and prevent future ankle injuries. There are a variety of rehabilitation strategies which can be used independently or in unison.
Progressive Mobilisation is important to apply to a sprained ankle. It is crucial to gradually introduce movement to the injured area. Through this, the injury will restore full movement to the injured area gradually through active and passive movement. However, when starting progressive mobilisation, your movements should be slow, progressive and pain free. Progressive Mobilisation is the first step to rehabilitation and will allow a sprained ankle to recover with full strength, and to achieve a successful rehabilitation period and prevent future ankle injuries. There are a variety of rehabilitation strategies which can be used independently or in unison.
Some good Progressive Mobilisation techniques are participating movements such as Plantar Flexion and Dorsi flexion. When participating these movements, you should apply a Dorsiflexion movement as far as possible, feeling tension in your calf, hold for 10 seconds then rest. Complete 10 repetitions.
Eversion and inversion exercises are also important. A good exercise for this is holding your foot in an inverted position for 10 seconds then rest. Complete 10 repetitions.
After these exercises, you can participate inversion and Dorsiflexion movement exercise regime. You should introduce the alphabet training exercise. This involves writing out letters of the alphabet which had a wide range of motions. This will strengthen the sprained ankle. By applying progressive mobilisation, this will inherit a quick recovery for your sprained ankle and will prevent future injuries.
Graduated exercise.
Graduated exercise refers to stretching, There are two types of stretches, one being Neuro-muscular facilitation (PNF) and the other being Static stretching. PNF stretching refers to static stretch followed by an isometric contraction and a relaxation phase, usually assisted by someone else or a utensil. Static stretchers refers to muscle groups gradually stretched beyond normal range.
These stretches should be held for 30 seconds and be pain free. PNF stretches are best. The muscle surrounding an injury loses strength when they are not used. This should also apply principle of specificity and improve the physical and conditioning requirements for the surfer Through this, the injured ankle will restore motion and will contribute to muscle and tendon length. This is significantly important to apply this method during the rehabilitation stage, due to if you were not to apply this the muscle fibres will seize, and scar tissue builds up. However, by stretching, this allows muscles to regain elasticity and will significantly influence the sprained ankle by regaining strength.
These stretches should be held for 30 seconds and be pain free. PNF stretches are best. The muscle surrounding an injury loses strength when they are not used. This should also apply principle of specificity and improve the physical and conditioning requirements for the surfer Through this, the injured ankle will restore motion and will contribute to muscle and tendon length. This is significantly important to apply this method during the rehabilitation stage, due to if you were not to apply this the muscle fibres will seize, and scar tissue builds up. However, by stretching, this allows muscles to regain elasticity and will significantly influence the sprained ankle by regaining strength.
Some good PNF stretches to apply for a sprained ankle are fairly similar to the Dorsi/Plantar flexion exercise.
However, you should now apply a resistance band which will introduce more pressure on the ligaments.
-How to correctly perform this exercise:
Making sure that your leg is completely straight, extend your foot in a plantar flexion motion. However, allow no movement through your leg or hip during this exercise. You should be using the muscles in your lower leg. When starting this exercise, apply this movement for 10-15 seconds with around 2-3 repetitions. After you feel comfortable doing this exercise, extend the time to 30 seconds. Through applying weight and pressure on your sprained ankle more intensive exercises such as Soleus and gastrocnemius Stretchers.
However, you should now apply a resistance band which will introduce more pressure on the ligaments.
-How to correctly perform this exercise:
Making sure that your leg is completely straight, extend your foot in a plantar flexion motion. However, allow no movement through your leg or hip during this exercise. You should be using the muscles in your lower leg. When starting this exercise, apply this movement for 10-15 seconds with around 2-3 repetitions. After you feel comfortable doing this exercise, extend the time to 30 seconds. Through applying weight and pressure on your sprained ankle more intensive exercises such as Soleus and gastrocnemius Stretchers.
In edition to these strategies, static stretching can be adopted. This involves gradually and incrementally moving the effected joint beyond its normal range of movement. In the case of an ankle sprain, during the rehabilitation procedures, the normal range of movement is initially much reduced. With time static stretching can restore and improve upon the range of movement prior to the injury.
Conditioning
Conditioning refers to the process by which athletes fitness must be gradually built up. The OVERLOAD PRINCIPLE must be used to ensure a greater than normal load is gradually added to allow rehabilitation. Periods of rest and recovery are fallowed by gradually increasing periods of work. An example of the conditioning process is isometric exercises. This involves gradually increasing the load on the muscles surrounding the affected area while undertaking the exercise with no movement to the area of injury itself. Over time this will increase the strength of the muscles surrounding the injured area and allow recovery for the loss of muscle mass due to in activity.
An example of such an exercise would involve standing in front of an object and placing the injured ankle such that the object was against the inside of the foot so your foot is facing inversionally. Maintaing a rigid ankle, press against the object and hold the position for 10 seconds before relaxing and repeating this process 10 times. This can also be applied with eversion, as well as Dorsiflexion and Plantarflexion. This will, overtime increase the muscle strength within the foot surrounding the ankle.
Total body fitness
Whilst the injured ankle is in recovery, in so far as the injury will permit, it is important to preserve and restore total body fitness. This will involve the undertaking of exercises deigned to maintain the strength and mobility of muscles by progressively and gradually overloading the muscle groups and energy systems that are significant for surfing. This can be achieved by focusing on upper body and core strength. For example, crunches and Lat pull downs as these are key strengths that you will need to maintain for surfing. This must be achieved before returning to play.
Training
This is the final stage of rehabilitation. This involves developing muscle coordination. A surfer must be able to illuminate that his skills and strengths are the same to what they were before the ankle sprained occurred. This refers to the surfer not facing fatigue and being able to perform skills under pressure, for example during competition or big surf. However, this could reveal when trying to protect the injury, this is known as 'Favouring'. For example this could be reflected when a surfer attempts to go for an Ariel manoeuvre and not committing to it. This can result in landing awkwardly on your feet which will disturb your ankle. The Surfer may have successfully completed the rehabilitation procedures and has full movement and flexibility in the ankle as well as achieving total body fitness, but may not be able to return to full competition. This is because the risk of re injuring the previously sprained ankle could be highly, as the surfer may be lacking confidence. This is why it is important for a surfer to only participate in a session where the surfer is confident.
Heat and Cold
Applying heat and cold to a sprained ankle is crucial to the healing process. Cold is used for immediate treatment of an injury, due to it reduces swelling. There are many cold modalities that can be applied such as ice packs, making sure that its wrapped in a towel applying it on the injury for short periods. Cold is also beneficial after exercise and training when the injured ankle has been through a workout. Heat should not be applied in the early stages of a sprained ankle due to internal bleeding still occurring through the injured area. However, heat modalities are beneficial later on during the rehabilitation stage due to increase of circulation which influences a decrease in pain, increased tissue healing, increased ability to stretch etc. This should be applied before a training session. There are two different approaches; superficial heating which refers to heating of a depth up to 1 cm, in contrast to deep heating which is greater that 1 cm. Superficial heat can be applied through heat packs, and deep heat can be applied through ultrasound machinery.
Through heat and cold, this will greatly influence the rehabilitation stage of a sprained ankle and will allow a surfer to progress to the return to play stage.