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Ankle Sprains in Football
Players
Ankle sprains account
for 10 to 15 percent of all time lost to injuries in football on the
professional, college, and high school levels. One study reported that these
players lost an average of five weeks with each injury. Artificial turf may
increase the risk of sprains, but retrospective studies have not confirmed
this. Defects in grass fields can also contribute to ankle injuries. It is safe
to say a good number of football players, because of the amount of running
they do, will suffer at some time from significant ankle sprains.
For the athlete who
is prone to ankle sprains or already hears or feels cracking in the ankles, a
visit to the Prolotherapy
doctor is definitely warranted. By palpating the ankles a
Prolotherapist can determine if the ankle ligaments are weakened and prone to
injury. If palpation produces tender points, the athlete should receive
Prolotherapy to strengthen the ligaments and prevent a significant ankle
sprain from occurring.
Grading the Sprain
Sprains anywhere in
the body, including the ankle, are graded according to severity. A grade 1
sprain involves a stretched ligament with minimal swelling or pain. A grade 2
sprain is a partial tear of the ligament which causes moderate pain and
swelling, and a grade 3 sprain is a complete tear of the ligament with
instability, and noticeable bruising and swelling. The vast majority of
ligament sprains are grade 1 and 2 but rarely a grade 3, complete tear.
Prolotherapy is warranted for grade 1 and 2 ligament sprains. Surgery is
generally performed for grade 3, complete tears. The difficulty lies in being
able to differentiate between a partial tear (grade 2) and a complete tear.
Prolotherapy cannot cause two ends of a ligament to rejoin if a complete tear
is present.
The problem is that
there is no 100 percent completely accurate test to diagnose a grade 3 tear
unless the joint is obviously unstable. Even injecting the ankle joint with
dye (arthrography) to aid in determining complete tears is unreliable because
of the following reasons.
Unreliability of Arthrography:
There is a variable,
but normal communication between the ankle joint and various bursae
(fluid-filled sacs) that are located outside of the joint and the peroneal
tendons which frequently give false-positive readings on the test. Hematomas
(blood clots) from the injury may block the dye through a true rupture, thus
giving a false-negative study. The major lateral ligament, the calcaneofibular
ligament is outside the joint, therefore, the anterior and posterior
talofibular ligament tears cannot be differentiated using this test.
If an athlete does
have a grade 3
ligament injury, surgery is still not necessarily warranted.
The ankle and foot are seas of ligaments. Prolotherapy can strengthen all the
ligaments surrounding the damaged ligaments, often causing a complete
stabilization of the injured joint. This is another reason why, prior to
surgical intervention, the athlete undergoes a trial of Prolotherapy for any
type of ligament sprain (except for obvious joint instability).
Treatment of Ankle Sprains and
Fractures
Have you ever
wondered why 30 to 40 percent of ankle sprains remain unhealed and result in
residual weakness, clicking, and pain? The likely cause is that the
usual and customary treatments are stopping the healing process. These typical
treatments are called the
RICE treatments and consist of rest, ice, compression,
and elevation. These treatments decrease the blood supply to the area and limit
healing. On top of this, athletes are given NSAIDS (nonsteroidal anti-inflammatory drugs) which further stop the natural
inflammatory healing process. A better choice for healing is movement,
exercise, analgesics, and treatment, as depicted in other articles on this
website.
If you have an
unstable ankle or an orthopedist believes you have a grade 3 ligament injury,
casting will be recommended. Athletes, do not do it. Casting is another word
for complete
immobilization and usually lasts three to four weeks. This is
usually followed by a period of protective range-of-motion exercises, which
lasts another four to five weeks. If surgery is performed on the ankle, the
same process is followed. Remember, for every day you are not playing, an
additional day of rehabilitation is needed to return you to your previous
level of play. If you start adding up the days, it will be a long-long time
before you are ready to play again. Think about this: you are off for four
weeks after the initial injury with a cast; prior to being cleared to return,
you are off for another five weeks doing protective range-of-motion exercises;
so far we are up to nine weeks. Now add another nine weeks for significant
training and rehabilitation. Now our total is 18 weeks or four and a half
months for an ankle sprain. I think not. Most athletes do not have four and a
half months to wait for an ankle sprain to heal. A much better approach is to
stimulate the body to heal the ankle sprain with
Prolotherapy. Perhaps this is
why many athletes are choosing to cure their sports injuries and enhance their
athletic performance with Prolotherapy.
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