How to prevent sprained ankles in basketball

Treatments For Common Basketball Injuries

06-26-20 - Athletes

Common Basketball Injuries

What are the most common basketball injuries, how can you differentiate each injury, and what forms of treatment are offered? We have a few facts on basketball injuries that were taken by surveying high school basketball players in the United States, by the National Athletic Trainers’ Association:

• 22% of all male basketball players sustained at least one time-loss injury each year.
• 42% of the injuries were to the ankle/foot
• 11% of the injuries were to the hip and thigh
• 9% of the injuries were to the knee
• Sprains were the most common type of injury (43%).
• General trauma was the second most common type of injury (22%).
• 60% percent of the injuries occurred during practice highlighting the need to warm up and strap for training.
• 59% of game-related injuries occurred during the second half of the game, which identifies fatigue as a predisposing factor.

Ankle Sprain

This common injury often happens if a player rolls or twists their ankle the wrong way, damaging the ligaments in the joint. An ankle sprain can take anywhere between a few weeks to a few months to fully heal, depending on the severity.   Players can prevent this ankle injury by wearing the proper athletic shoes that provide support and will help to avoid slipping on the court. An ankle brace is also a great way for players to support the joint and prevent a sprained ankle. Talk with your doctor or physical therapist about what is best for you.

Achilles Tendonitis

Achilles tendonitis can occur from frequent, high-intensity workouts that cause stress on the feet. Often an overuse injury, players may also experience tendonitis if they are wearing old or overworn athletic shoes. If caught early enough, the injury will take between 4-6 weeks to heal.

Players can prevent this injury by adequately warming up before each workout, icing the area, and slowly increasing the intensity of every workout.

Patellar Tendonitis

Patellar tendonitis, another overuse injury, is commonly caused by recurrent stress on the patellar tendon. Over time, this causes tiny tears in the tendon, causing the area to become inflamed. If treated properly, this knee injury takes around 6 weeks to heal.

This injury can be prevented by warming up before exercise, wearing a knee brace, and being careful not to jump or land too hard on hard surfaces.

Muscle Strains

If a muscle is overworked, overstretched, or torn, it could potentially cause a strain. This could occur in a variety of places, including the back, hamstrings, and neck.

This injury can be prevented by taking precautions and practicing proper form and posture. It is important to always stretch and warm-up beforehand.

ACL Tears

An ACL tear is one of the most painful knee injuries and usually requires surgery. Athletes may tear their ACL from suddenly shifting direction on the court, landing awkwardly on one leg, frequent stress to the knee, or accidentally causing the knee to bend backward. After surgery, an ACL tear can take between 6-9 months to fully heal.

Players can avoid this basketball-related injury by always warming up, stretching, building strength in the hips and thighs, and jumping and landing safely on the court.

​Symptoms

• An audible “pop” at the moment of injury
• The slippage of the knee out of its joint
• Severe swelling
• Painful movement ​

​Treatment: Treatment may be surgical or non-surgical, depending on your desired lifestyle. The question is not so much your level of activity in the past, but the expectations for the future.

• Surgical: If your goal is to continue an active lifestyle, surgery may be the treatment of choice because a torn ACL does not heal
• Non-surgical: Therapy consists of a period of protective bracing, with a progressive return to the range of motion and muscle-strengthening exercises. The goal is to create natural stability for the knee by developing the quadriceps and hamstring muscles.

Finger Injuries

Finger injuries are often caused when the ball strikes the hand, jamming or fracturing one or more fingers. Depending on the specific damage to the finger, these injuries can take a few weeks to heal.

Players can prevent this injury by simply being mindful while they are on the court. Being aware of your surroundings is the best way to avoid a finger injury.

What can you do?

Just remember, avoiding a basketball-related injury ultimately comes down to being aware of your body, warming up properly, and stretching frequently. Attending physical therapy, or athletic training, are great ways to help keep your body in great condition. You can book an appointment for a basketball injury screening here.

Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA is a practicing physical therapist and a partner and Director of Clinical Services at Ivy Rehab Network. Deur is board certified as a geriatric clinical specialist and certified exercise expert for aging adults with more than 35 years of clinical experience.  She is certified as an aquatic and oncology rehabilitation specialist and serves as adjunct faculty at Central Michigan University and Grand Valley State University.  

The medical information contained herein is provided as an information resource only, and does not substitute professional medical advice or consultation with healthcare professionals. This information is not intended to be patient education, does not create any patient-provider relationship, and should not be used as a substitute for professional diagnosis, treatment or medical advice. Please consult with your healthcare provider before making any healthcare decisions or for guidance about a specific medical condition. If you think you have a medical emergency, call your doctor or 911 immediately. IvyRehab Network, Inc. disclaims any and all responsibility, and shall have no liability, for any damages, loss, injury or liability whatsoever suffered as a result of your reliance on the information contained herein.

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Don't get one in the first place. — Clutch Physical Therapy

Sports have always served as a unifying entity in this country, and some hope arrived when the NBA announced that they will be returning to action on July 31st in Orlando, FL. Unfortunately, my New York Knicks did not make the cut as only 22 teams will be participating in this abridged version of the remainder season, but it will be interesting to observe the injury rates when play does resume. 

I’d like to highlight one of those common basketball injuries — ankle sprains — and break down how to decrease the risk of injury when returning to the court.  

Let’s start with defining what we’re discussing. An ankle sprain is a sliding scale from microscopic tear to full rupture of a ligament surrounding the ankle joint. The most common ligament sprains are on the lateral (outside) portion of the ankle. 

There are three grades of ankle sprains that correlate with degree of injury and recovery time.  Grade I is considered mild and is characterized by some local tenderness and swelling without a large impact on function. An athlete may not have to miss time for a Grade I ankle sprain, but the usual timeline for recovery is 1-3 weeks. A Grade II ankle sprain will have more notable tenderness and swelling, and will also impact function by decreasing joint range of motion and stability. Recovery time is on the order of 3-6 weeks. A Grade III sprain is a full rupture of an ankle ligament which requires months of healing time, but usually does not require surgery. Inability to walk can be a key dissociating factor between a Grade II and Grade III ankle sprain.  

Ankle sprains are the most common basketball injury and lead to missed playing time. At the professional level, they occur at an alarmingly high rate. Approximately 25% of pro ball players sustain an ankle sprain over the course of a season.* It doesn’t matter how good you are if you can’t be on the court! So it’s incredibly important to prioritize reducing injury risk in the first place, especially since the major prognostic indicator for an ankle sprain is a history of ankle sprains. This study in the British Journal of Sports Medicine shows that over 70% of athletes who sustained an ankle sprain experienced recurrent ankle sprains. This further highlights the importance of ankle sprain injury risk reduction.

Do the work to prevent the first one from ever happening.

Based on my own personal anecdotal evidence, here are several physical capabilities that, if optimized, will decrease the risk of ankle sprain injury: 

Ankle Range of Motion

When self-assessing ankle range of motion, stand facing a wall with your big toe 5 inches from the wall. While keeping your heel planted into the ground, drive your knee forward in a straight line as far as you can. If you can touch the wall with your knee, awesome. If you can’t, that’s absolutely something to work on. Range of motion can be limited due to limitations in flexibility or in the ankle joint itself, so if you fail this test, reach out to me for a consultation. We’ll get to the root cause and customize drills to your needs. 

Glute Strength

Glute strength is critical for ankle stability. Ever heard of a guy named Steph Curry? After struggles with chronic ankle sprains, he worked diligently to strengthen his glutes, and the rest is history! Weakness in your hips can create suboptimal biomechanical patterns that can place excessive torque on the ankles. Check out my glute activation series on IGTV here, where I cover: 

The hip hinge “Skills and Drills”series is a great watch, too. I demonstrate a progression of drills to work on the hip hinge pattern:

Landing Ability 

The majority of ankle sprains occur while landing from a jump, so optimizing landing technique is critical. Landing should be practiced in different types of environments with varying parameters in order for maximal carryover to game play. Simply practicing your landing with squat jumps alone does not simulate the chaotic nature of a basketball game, so practice landing from hurdle jumps, box jumps, single leg jumps, lunge jumps, etc. and in multiple planes (vertical, horizontal, linear, lateral, rotational). Watch me discuss and demo landing mechanics and drop squat drills here.

I strongly encourage you to take the time to self-evaluate your mobility, strength, and landing technique to fully optimize your play on the court and decrease your risk of injury. Please don’t hesitate to reach out for guidance! 

Team Clutch PT

For a limited time, we’re offering an introductory special for young athletes that includes a virtual consult to review athlete history, screen movement patterns, identify goals, and map out a training program. It also includes 4 weeks of at-home personalized, sport-specific programming. Find out more here.

How to treat an ankle sprain

Contusion, sprain, tear or fracture - how to understand? First Aid

Signs bruises sprains dislocations and fractures are very similar to each other and therefore many lose precious time trying to treat torn ligaments and fractures at home. Meanwhile, only those injuries can be treated independently by applying a bandage or a cold compress to a sore spot if there is complete confidence that the victim does not have a fracture, rupture or dislocation.

Bruises - the most common type of injury, which can be either an independent injury or accompanying other more severe ones, such as a fracture, dislocation, damage to internal organs, etc. Usually a bruise is the result of a blow inflicted by a heavy object or a fall from a height. Most often, bruises of the skin and subcutaneous tissue occur, but bruises of internal organs also occur. For example, the brain, heart, kidneys, liver and lungs.

Basic bruising symptoms pain, swelling, tissue bleeding, bruising and dysfunction. Pain occurs immediately at the time of injury and can be very significant, after a few hours the pain subsides. The time of occurrence of a hematoma at the site of injury depends on its depth. With a bruise of the subcutaneous tissue and skin, hemorrhage occurs immediately, the bruise becomes visible after a few minutes, and with deeper hemorrhages, the bruise may appear only for 2-3 days.

Malfunction with a bruise usually occurs as edema and hematoma increase. The ability to move the damaged part of the body is also gradually lost. For example, a person cannot bend an injured leg or arm himself due to severe pain, but if another person helps him to do this, then the limb bends, although this is also painful. In this way, bruises differ from fractures and dislocations, in which it is impossible to move the injured limb immediately, either independently or with the help of another person.

You can treat bruises on your own. To reduce the development of edema and hematoma immediately after the injury, you need to apply a cold compress to the damaged area and provide it with peace. You can place the bruised area under cold running water, bandage it with a wet towel, apply ice or a bottle of cold water. To reduce movements in the area of ​​​​the joints, a pressure bandage should be applied, and then the limb should be placed in an elevated position.

Sprains usually occur during movements in the joint that are unusual for it or exceed its physiological volume. Most often there are injuries of the ligament of the joints, for example, the ankle joint when the foot is twisted. Signs of sprains strongly resemble the symptoms of a bruise in the joint area: hematoma, swelling and pain. But dysfunction during sprains is more pronounced than with a bruise.

For treatment of sprains, you need to apply cold and a pressure bandage to the sore spot in the same way as for bruises. To speed up recovery, it is useful to use various anti-inflammatory and analgesic ointments, gels and tinctures. For example, diclofenac gel, fastum gel, ketoprofen, indovazin, etc. All drugs are applied to the site of injury 2-3 times a day, the course of treatment is 10 days.

Ligament ruptures can be either an independent injury or accompany fractures and dislocations. The most common ligament ruptures occur in the knee and ankle. Ruptures also cause severe pain, swelling, hematoma, and marked limitation of joint function. If the rupture of the ligaments is accompanied by a hemorrhage into the cavity of the knee joint, it becomes visually swollen and hot to the touch, and when you press the patella with your fingers, you feel a “void” 1-2 cm deep, while it should immediately rest against the bone. The patella, as it were, "floats" on the surface of the liquid formed from the blood poured into the joint.

Muscle tears usually occur with a strong load: a powerful blow to a contracted muscle or exposure to excessive weight. When a muscle breaks, a sharp pain immediately appears, and then swelling and hematoma, a complete loss of function. For example, with a rupture of the quadriceps femoris, the victim cannot straighten his leg at the knee, with a rupture of the biceps of the shoulder, he cannot bend his arm.

In practice, the most common gastrocnemius tear , quadriceps femoris and biceps brachii. With an incomplete rupture of the muscle, severe pain appears in the area of ​​damage and a hematoma, but the function of the muscle is partially preserved. With a complete rupture, a “fossa” appears at the site of injury, and the function of the muscle is completely absent.

In case of tendon rupture the pain is moderate, there is also swelling in the area of ​​damage, and it is impossible to bend and unbend the joint on its own, although passive movements remain. For example, if the flexor tendon of the finger is torn, it is not possible to flex the finger, but this is easy to do with the help of another person or a doctor.

Fractures is a partial or complete violation of the integrity of the bone, resulting from injuries or diseases that lead to a violation of the structure of the bone tissue. Depending on the degree of damage to the skin, fractures can be closed or open. The symptoms of a fracture are sharp pain at the site of injury, dysfunction, swelling, and hematoma. If the fracture is open, then there are wounds and bleeding.

In case of fractures in no case should you try to straighten, set and perform other manipulations with the damaged area. Ice, a bottle of cold water, or a special cooling bag can be applied to the injury site only after it has been immobilized, and with an open fracture, the bleeding must first be stopped.

Conclusion : if you are not sure that you or your loved one has a normal bruise or sprain, apply immobilization according to the rules for treating a fracture and call an ambulance for a traumatologist to examine the injury site and make an accurate diagnosis.

Video No. 1: Emergency care for an open fracture

Video No. 2: First and emergency care for a closed fracture

- We recommend visiting our section with interesting materials on similar topics "Traumatology"

One of the most common types of injuries of the musculoskeletal system is an injury to the ligaments of the ankle joint (GS), defined by patients as "foot twisting". Most often, “tucking” occurs to the inside and is accompanied by injury to the lateral ankle ligaments (“inversion” injury). In turn, tucking the foot outward (“eversion” injury) occurs much less frequently and is characterized by injury to the deltoid (medial) ankle ligament.

This kind of damage leads to the development of a strong degree of edema, the appearance of pain and lameness. At the same time, it should be noted that, unlike fractures of certain sections of the ankle, an injury to its ligaments allows at least a slight load on the diseased limb, which indicates a high probability of a favorable outcome of treatment. Of course, in medical practice there are situations when patients, due to strong tucking, disrupt the articular functionality. However, such cases are extremely rare and, in the presence of timely and competent medical intervention, are completely eliminated.

Fig. 1 The most common (inversion) type of ligament injury GS

Anatomical and functional features of the ankle

The ankle joint is formed by the articulation of the talus with the fibula and tibia, held by the interosseous membrane, as well as the tibiofibular (posterior and anterior) ligaments. In this case, the talus, shown in Figure 2, is placed in the U-shaped "fork" formed by two tibias.

Fig. 2 The talus (T) is placed in a U-shaped "fork". The distal tibiofibular syndesmosis, formed by the articulation of the fibula (Fib) and tibia (Tib) bones and stabilized by the syndesmotic ligaments (marked in red), is responsible for the normal functioning of the ankle.

In turn, the talus, which connects to the calcaneus and forms the subtalar joint, performs the function of a hinge.

In addition to the syndesmotic ligaments, the lateral collateral ligaments that run from the outside are responsible for stabilizing the ankle.

Fig. 3 Lateral ligaments of the ankle.

The so-called medial stabilizer, which ensures the normal movement of the bones of the GS among themselves, is a three-portion deltoid ligament. It is important to note that, like the talofibular ligament, this ligament usually suffers from overstretching, and only in exceptional cases is subject to complete separation.

Fig. 4 The deltoid ligament (circled in yellow) consists of portions connecting the tibia to the talus (marked in red), navicular (marked in blue), and calcaneus (marked in green).

Injury to the anterior talofibular ligament (hereinafter referred to as PTMS), which has the appearance of a thickened capsule and excludes, along with the calcaneal fibular ligament (hereinafter referred to as PMS), inversion of the GS, occurs much more often than injuries to other types of ligaments. When tucked in, lengthening (stretching) of the PTMS occurs, which, as a result, leads to instability of the ankle.

The IMS runs from the calcaneus to the top of the lateral malleolus and is considered a separate ligamentous structure.

The posterior talofibular ligament (hereinafter PTML), which runs from the dorsum of the talus to the dorsum of the lateral malleolus, is extremely rarely injured. Some of its damage is observed with significant dislocations of the HS.

The anterior inferior tibiofibular ligament (hereinafter referred to as the tibiofibular ligament), which is responsible for stabilizing the U-shaped "fork" of the tibia, is injured in case of rotation of the foot fixed on one or another surface. Often, a scar formed after healing of this type of ligament can provoke the development of impingement.

Fig. 5 Anatomy of the PNMS

The interosseous membrane, which consists of fibrous tissue, is usually damaged simultaneously with the posterior and anterior tibiofibular ligaments. This leads to a divergence of the tibia and a complete loss of joint stability.

Types of injuries of the ankle ligaments

In traumatology, certain injuries of the ankle ligaments are classified as follows:

• 1st degree: slight injury without lengthening of the ligament and without loss of ankle stability;
• Grade 2: trauma resulting in minor sprain and partial tear of the ligament, as well as possible destabilization of the joint;
• Grade 3: there is a complete separation of the ligaments, severe pain, swelling and, of course, loss of joint function.

The frequency and intensity of injuries of the ligaments of the GS

As medical practice shows, injuries of the ligaments of the GS are observed in about 2.15 patients out of 1000 who applied to emergency rooms, hospitals and emergency departments during the year. Injuries of this category occur with almost equal frequency in females and males and, to a greater extent, are caused by sports.

When diagnosing serious injuries of the ankle, it is important to determine the injured element (bone or ligament) in a timely and most accurate manner. At the same time, quite often, injuries of the HS are of a combined type (rupture / sprain of the ligament and fracture).

In this case, the presence of significant pain in the anterior region of the calcaneus may indicate the presence of a fracture in this area. Pain that passes outside the lower leg, as a rule, indicates injury to the peroneal tendons, etc.

Symptoms of SG ligament injuries

People with injured SG ligaments usually associate the moment of joint injury with the foot turning outward (rarely) or inwardly (often). At the same time, patients experience swelling, severe pain, difficulty making movements, redness of the skin, as well as other types of symptoms.

However, if no injury is found, the specialist may diagnose a soft tissue infection (cellulitis).

Fig. 6 Injury to the ligaments of the GS may be accompanied by reddening of the skin and swelling

During the physical diagnostic examination, a specialist will palpate the navicular, fifth metatarsal, and anterior calcaneus bones to identify a painful area that indicates the presence of damage in this particular area.

After the pain and swelling have been eliminated, it becomes quite possible to assess the stability of the ankle. At the same time, the condition of PMS is diagnosed by palpation of the talus, and the condition of PTMS is diagnosed by conducting the so-called “drawer test”.

Fig. 7 Drawer test

This test is performed with the patient in a sitting position with knees bent and feet dangling. The specialist grabs the lower leg and moves the heel inward and forward. The pivot here is the deltoid ligament.

High injuries of the ankle ligaments

Different types of injuries of the tibiofibular syndesmosis located above the level of the ankle are called high injuries of the ligaments of the ankle. This type of damage, although less common, is characterized by the complexity and severity of the consequences. The cause of high injuries of the ligaments of the GS is, for example, a sudden change in running during rotation of the foot completely standing on the surface.

In order to diagnose tibiofibular syndesmosis, the treating specialist uses an external rotation test, or compresses the patient's tibia, which, if there is an injury, will provoke severe pain in the area under study.

Features of diagnosing injuries of the ankle

In the case when the patient has difficulty standing on the leg, and severe pain and discomfort are felt in the ankle area, the specialist, as a diagnostic technique, prescribes an x-ray examination.

If, for example, an isolated ankle fracture can be recognized in the resulting image, the doctor may additionally prescribe an X-ray of the lower leg (more precisely, its upper third).

It is important to note that X-rays are used not only to determine certain types of fractures, but also to detect damage to the syndesmosis.

Fig. 8 The shape of the fork of the ankle fully corresponds to the shape of the talus. At the same time, the width of the joint gap (marked by arrows) is the same on each side.

Stress X-ray is another method for diagnosing ankle instability in chronic cases.

MRI is also a fairly popular technique for diagnosing injuries to the ligaments of the GS. Like stress radiography, it is relevant in the presence of chronic pain to detect various types of damage to the tibiofibular syndesmosis.

Treatment of injuries of the ligaments of the GS

Conservative methods

Initially, the treatment of any types of injuries of the ligaments of the GS is carried out simultaneously on 4 points:

• minimization of physical activity and stress on the ankle;
• local use of ice compresses to relieve puffiness;
• apply a moderately tight bandage to prevent swelling;
• placement of the injured foot above the level of the thigh.

The use of non-steroidal anti-inflammatory drugs (for example, ibuprofen), in the vast majority of cases, provides a fairly effective relief of inflammation and pain.

After the elimination of pronounced symptoms of ankle ligament injury, the specialist may prescribe physiotherapy procedures that contribute to the speedy recovery of damaged tissues (including muscles), as well as an increase in the range of movements performed, muscle strength, etc.

Here it should be noted that sometimes , after the most severe symptoms are resolved, patients still feel some joint instability (functional instability) along with a lack of proprioceptive sensitivity. In this case, to improve well-being, the specialist may recommend:

• exercise "eight", performed by a diseased limb;
• standing on one leg on various surfaces with turning the head in different directions.

All of these exercises can be performed under the guidance of a physician or at home.

Surgical techniques

Treatment with surgical techniques aimed at restoring lost function is usually indicated in patients with recurring injuries of the GA ligaments. Even in the case of stable deformation changes in the ligaments, stabilization of the ankle can be provided by muscle tissues.

However, it should be noted that trauma to the ligaments of the GS can, in some cases, affect the occurrence of post-traumatic osteoarthritis.

Arthroscopy of the ankle joint

Arthroscopic surgery is relevant in the presence of intra-articular injuries of the ankle joint, ligament rupture, and fracture of the chondral type. Most often, specialists resort to minimally invasive arthroscopic techniques aimed at restoring the HA ligaments. Such interventions are well tolerated, minimal tissue trauma, and also contribute to rapid recovery and, most importantly, effective elimination of the consequences of injury.

Prevention of injuries GS

Prevention of ankle injuries is considered to be the most effective treatment option. This can be achieved by taping the GS, fixing it with special orthopedic orthoses, a special set of exercises, stretching the Achilles, strengthening muscle tissue, etc.

At the same time, the most obvious risk factors include pre-existing HS injuries, hollow foot, playing basketball, football and other similar sports, etc.

Cost of services

First visit to the treating specialist

• Acquaintance with the origin of the disease, the main complaints of the patient, etc.
• Clinical examination
• Symptoms of disease
• Acquaintance with the results of hematological analyzes, X-ray data, MRI, CT
• Trauma Diagnosis
• Prescribing treatment

Return visit to a specialist

• Analysis of the results of diagnostics carried out at the first visit to the treating specialist
• Clarification of the diagnosis
• Prescribing treatment

Ankle ligament repair by arthroscopic type surgical technique

• Hospital stay
• Administration of epidural anesthetics
• Stabilizing arthroscopic ankle surgery
• Consumables
• Implants (biodegradable type)

Postoperative visit

• Clinical postoperative examination
• Acquaintance with postoperative results of radiographs, MRI, CT
• Providing advice on rehabilitation
• Intra-articular injection of a hyaluronic acid preparation (if necessary)
• Removal of surgical sutures

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These are reviews of real people taken from the doctor's page on the prodoctorov. ru portal

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I live in the Rostov region. For the last two years, I was very worried about pain in the hip joint, nothing helped, and I decided to have arthroplasty. On the advice of a Rostov surgeon, she turned.

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An ankle sprain usually occurs when walking or running on rough terrain, when the foot turns inward and stretches the ankle ligaments beyond its range of motion, causing them to tear.

Usually, the ankle is swollen and the victim has pain when walking.

A doctor usually diagnoses an ankle sprain based on a physical exam and sometimes x-rays.

Treatment typically includes PRICE (protection, rest, ice, pressure dressing, and elevation of the injured limb) for mild sprains, immobilization and physical therapy for moderate to severe sprains, and sometimes surgery for very severe sprains.

(See also Understanding Sprains and Other Soft Tissue Injuries Understanding Sprains and Other Soft Tissue Injuries Dislocations are tears in the ligaments (tissues that hold bones together). Other soft tissue injuries include tears (strains) in muscles

Ankle sprains are very common in the US

The severity of the sprain depends on which ligaments are injured and how much they are stretched or torn Based on severity, doctors classify sprains as follows:

Grade 1: Mild

Grade 2: Moderate to severe

Grade 3: Very severe

Most ankle sprains are mild.

Ligaments: Supports the bones of the ankle joint

Sprain usually occurs when the foot turns inward so that the sole is facing the other foot (called inversion). This injury usually results in damage to the ligaments located on the outside of the ankle joint. Inversion occurs when walking over rough terrain, especially when a person steps on a rock or walks down a curb.

Ankle sprain

The foot is twisted, tearing the ligament on the outside of the ankle joint.

More rarely, an ankle sprain occurs when the foot is turned inward (called eversion).

When the foot is turned outward, several ankle injuries can occur:

Avulsion fracture: The ligament that connects the tibia to one of the bones in the foot on the inside of the ankle can tear off a small piece of the tibia. Rolling the foot outward tends to result in an avulsion fracture rather than a sprain because the ligament is so strong.

High ankle sprain: The ligaments that connect the tibia to the other bone in the lower leg (fibula) from below can tear.

Fracture of the fibula: A fracture of the fibula can occur at the ankle or sometimes near the knee.

Sprained ankles can also damage nerves.

Certain conditions can cause the foot to turn outward (or ankle rotation) and increase the risk of sprains:

Previous sprain resulting in loose ankle ligaments

Weakness or nerve damage to leg muscles

Wearing certain types of shoes, such as stiletto heels

Symptoms of an ankle sprain ligaments. Sometimes people with an ankle sprain have muscle spasms, which are spontaneous contractions of the muscles around the ankle.

The severity of symptoms depends on the severity of the rupture. If the nerves are damaged, a person may have trouble sensing the location of the foot and ankle without visual control (this sensation is called proprioception).

Mild

Ligaments are stretched and torn, but the tears are so small that they can only be seen under a microscope. The ankle joint usually does not hurt or swell much, but is weakened, which increases the likelihood of re-injury. The recovery period takes from several hours to several days.

Moderate to severe

Ligament is partially torn. The ankle joint is often swollen and bruised, and walking is usually painful and difficult. Healing takes from several days to several weeks.

If the ankle is sprained again, nerves can be damaged.

Very severe

The ligament is completely torn. Swelling and bruising may form throughout the ankle joint. The ankle joint is unstable and the person cannot apply any load to it.

Healing usually takes 6-8 weeks. If people do not wait until their ankle joint is fully healed before resuming normal activities, they are at increased risk of future injury and the joint may not fully heal.

Nerves can also be damaged.

Very severe ankle sprains can fracture the cartilage at the end of the bones in the ankle joint. This injury can lead to long-term pain, swelling and, in some cases, trouble walking. The joint may become pinched (stuck) or protrude (involuntary arching). Occasionally, young patients develop arthritis of the ankle.

Diagnosis of ankle sprains

Sometimes x-rays to rule out fractures

The doctor asks about the circumstances of the injury and does a physical exam.

Doctors also move the ankle joint in different directions to determine the severity of the sprain. However, if the victim has severe pain and a lot of swelling or muscle spasms, examination is usually delayed until X-rays are taken to look for fractures.

To evaluate the condition of the ankle, doctors gently palpate the ankle to determine where the pain is most intense. If touching the skin over the ligament causes intense pain, the ligament has probably torn. If touching the skin over the bone causes pain, the bone may have broken. Swelling and spasms make it difficult to assess the condition of the ankle. In such cases, doctors may immobilize the joint with a splint and examine the joint again a few days later.

Diagnosis of a sprain is primarily based on physical examination. However, sometimes the doctor prescribes x-rays to rule out a fracture, if

Foot sprains are quite common. It occurs with a sharp turn of the leg inward. Clinically, sprain is manifested by pain during movement of the affected limb and on palpation, especially in the anterior part of the ankle, limitation of movement, swelling. The diagnosis is exposed on the basis of a clinical and radiological picture. The main points of treatment are to ensure the rest of the limb and the fight against swelling (applying ice, compression bandage, elevated position of the limb). In more severe cases, surgery is necessary.

Mechanism of injury

The ankle joint has the following ligaments, which are most susceptible to sprain:

• anterior and posterior talofibular;
• calcaneofibular.

There are 2 mechanisms of foot injury: inversion and eversion. In inversion (a more common mechanism), the foot is turned inward, resulting in damage to the most vulnerable lateral ligaments. In severe injuries, instability of the joint can form, which can cause additional sprains.

When eversion, the leg turns sharply outward, while the joint experiences excessive stress. This mechanism of damage to the foot can lead to both sprains and fractures of the medial malleolus.

Diagnosis of foot sprains

When taking an anamnesis, patients note a fall on the injured leg or a sharp turn of the lower leg when the foot is fixed.

The main complaints of patients are:

• pain in the ankle joint;
• violation of motor function in the ankle joint.

During examination of the patient, the following signs of ligament sprain can be noted:

• forced position of the injured limb;
• swelling in the area of ​​damage;
• pain on palpation, aggravated by movement of the ankle joint;
• possible occurrence of bruising in the surrounding tissue;

Depending on the severity of the lesion, 3 degrees are distinguished:

• Grade 1: minimal soreness and swelling, tissues are weakened and prone to re-damage. Recovery takes several days.
• 2 degree: severe soreness and swelling, walking is difficult and causes pain. Recovery can last from several days to several weeks.
• 3 degree: swelling covers the entire area of ​​the ankle joint and may spread to the overlying areas. There may be bruising, as well as numbness of the foot due to nerve compression. Recovery lasts from one to one and a half months.

A stress test is performed to assess the integrity of the ligaments. It helps to make a differential diagnosis between 2 and 3 degrees. In the initial position, the patient sits or lies with bent knee joints. One hand of the doctor lies on the anterior lower part of the lower leg and pushes the lower leg backwards, the other - on the back of the heel, pushing it forward. Pain during this manipulation appears with a high sprain of the ankle joint.

The final diagnosis is based on the results of radiography of the joint in the anteroposterior, lateral, oblique projections. The picture reveals secondary signs of soft tissue stretching in the form of an enlarged joint gap, ligament divergence.

Treatment

The conservative RICE technique is used to treat sprains:

• keeping the ankle at rest;
• applying a cold compress to the affected area for 20-30 minutes;
• tight elastic bandage to improve blood flow and reduce swelling;
• elevated position above the hip joint. This will reduce soft tissue swelling by improving venous outflow. Reducing swelling will reduce pressure on the nerves and, as a result, pain.

From drug treatment, non-narcotic and narcotic analgesics are used for the purpose of pain relief and anti-inflammatory effect. The combination of tramadol and paracetamol is effective. Proton pump inhibitors (eg, omeprazole) are given to prevent stress ulcers. To improve microcirculation and soft tissue trophism, venotonics (troxerutin, venarus) are used.

In severe cases, limb immobilization and surgery may be required.

Prevention

Injury prevention consists in:

• compliance with safety regulations at home and at work;
• compliance with traffic rules;
• compliance with measures to prevent street injuries;
• creating a safe environment on the street, at home and at work;
• holding an informational and explanatory conversation about injury prevention measures.

Medical rehabilitation

The main physiotherapeutic methods of rehabilitation are:

• cryotherapy with a course of 5-10 procedures;
• ultraviolet irradiation with a course of 5-10 procedures;
• magnetotherapy with a course of 5-10 procedures;
• UHF-therapy with a course of 5-10 procedures;
• laser therapy with a course of 5-10 procedures.

To prevent atrophic changes in the muscles and improve the regional blood flow of the injured limb, use:

• isometric tension of the muscles of the thigh and lower leg for 5-7 seconds 8-10 repetitions with a gradual increase in the intensity of tension;
• active flexion and extension of the toes, lowering and raising the injured limb to improve peripheral circulation;
• ideomotor exercises to restore the dynamic stereotype.

Exercises for a favorable course of rehabilitation

1. In the initial position, sitting or lying with an injured heel, any letters of the alphabet are drawn. The more letters the better.
2. Tie one end of the elastic bandage to the foot and the other end to a chair or table. You should slowly pull the foot towards you, and then away from you for 1-2 minutes.
3. Another option with an elastic bandage: keep the knee straight, slowly pull the tape towards you until you feel a stretch in the calf muscle. Hold the position for 15 seconds and do 15 repetitions.
4. Stand one arm away from a wall. Put the injured leg behind the healthy one. Your toes should point forward in this position. Slowly bend your knees until you feel a stretch in the calf muscle. Hold the position for 15 seconds, relax, and then perform up to 20 repetitions.

Forecast

The prognosis for sprains is favorable. With grade 1 sprain, as a rule, healing occurs without residual effects. With sprains of degrees 2 and 3, tingling and pain in the joint can be observed in the long term, which may be caused by the involvement of nerve endings in the pathological process. Restoration of ligaments occurs due to scarring, which leads to their weakening. The connective tissue is not elastic enough, so the risk of re-injury increases. The patient is recommended to wear special supports.

Conclusion
An ankle sprain is effectively restored with the timely use of the RICE technique: rest, cold, compress and elevated position. With severe pain syndrome, analgesics are indicated.

Ligament injuries of the ankle joint - partial or complete rupture of the ligaments located in the area of ​​this anatomical formation. Most often, the injury occurs in winter when the foot is twisted on ice, icy steps and platforms. The clinic depends on the severity of the damage (stretching, tear, complete rupture), includes local swelling, pain, limitation of movement in the joint of various sizes, and impaired walking. Diagnosis is carried out on the basis of complaints and clinical symptoms, X-ray is prescribed to exclude a fracture. In the treatment, physiotherapeutic methods, the imposition of a plaster splint, therapeutic punctures, warm baths and massage can be used.

ICD-10

General information

Ankle ligament injuries are a fairly common injury. Sprains, tears and torn ligaments account for 10-12% of the total number of ankle injuries. Tears, sprains and ruptures of the ligaments of this anatomical zone are one of the most common sports injuries (about 19% of all injuries in athletes). In some cases, violation of the integrity of the ligamentous apparatus can be combined with subluxation or dislocation of the ankle joint.

Causes

Most often, damage to the ligaments of the ankle joint occurs in winter when the foot is twisted on ice, icy steps and platforms. In addition, ligament damage can occur as a result of jumping from a height (often small) or walking on uneven surfaces.

Pathoanatomy

There are three groups of ligaments involved in the fixation of the ankle joint. On the outer surface of the joint are the calcaneofibular, anterior and posterior talofibular ligaments, which run along the outer ankle and keep the talus from lateral displacement.

The deltoid (internal collateral) ligament, consisting of deep and superficial layers, runs along the inner surface of the joint. The superficial layer is attached to the talus and scaphoid bones, the deep layer is attached to the inner part of the talus. The third group of ligaments, represented by the tibiofibular syndesmosis, posterior transverse, posterior and anterior tibiofibular ligaments, connects the tibia to each other. The most common injury is to the outer group of ligaments, usually the anterior talofibular ligament is affected.

Classification

There are three types of damage to the ligamentous apparatus of the ankle joint:

• Rupture of individual fibers. In everyday life, such damage is usually called an ankle sprain, however, this name does not correspond to the actual state of affairs, since the ligaments are completely inelastic and cannot be stretched.
• Ankle ligament tear. A significant part of the fibers is torn, but the ligaments continue to perform their supporting function.
• Complete rupture of ankle ligaments or separation from their attachment site.

Symptoms of ligament injury

All three types of injuries of the ligamentous apparatus of the ankle joint are accompanied by the same clinical signs, however, the severity of these signs directly depends on the severity of the injury. The patient complains of pain when walking. Visually revealed swelling and bruising in the area of ​​damage. Palpation of injured ligaments is painful. Possible hemarthrosis.

In case of an ankle sprain, the edema is local, the victim experiences pain, but retains the ability to walk. When the ligaments of the ankle joint are torn, the edema spreads to the outer and front surface of the foot. Walking is difficult due to pain. A complete rupture of the ankle ligaments is accompanied by hemarthrosis, severe edema, and bruising extending to the dorsal and plantar surfaces of the foot. Walking is sharply difficult, sometimes impossible due to pain.

Diagnosis

Diagnosis is established on the basis of complaints, anamnesis and objective examination data. Ligament failure is confirmed by a positive “drawer” symptom, to test which the doctor holds the patient’s lower leg with one hand and displaces the foot with the other. When the anterior portion of the lateral ligaments is torn, the foot is displaced anteriorly. With a rupture of the lateral ligaments, an increase in the lateral mobility of the foot is noted. The study is carried out by an orthopedic traumatologist in comparison with a healthy joint. X-rays are taken to rule out a fracture.

Treatment of ligament injuries

Treatment of first and second degree injuries is carried out on an outpatient basis. A patient with an ankle sprain is recommended to apply a tight figure-of-eight bandage to the joint. In the first two days after the injury, cold is applied to the injury site, and then heat. From 2-3 days, physiotherapy is prescribed (massage, applications of ozocerite and paraffin, an alternating magnetic field). The patient is allowed to walk.

A tight bandage will be most effective only if the application technique is followed. In case of damage to the outer group of ligaments, the foot is brought to the pronation position (plantar side outward), in case of injury to the inner group of ligaments - to the supination position (plantar side inwards), in case of tears and ruptures of the tibiofibular ligaments - to the flexion position. This ensures minimal tension on the damaged ligaments. The bandage is applied so that each round of the bandage brings together the ends of the injured ligaments.

In case of sprains of the ankle joint, the ability to work is restored within 7 to 14 days. In case of torn ligaments of the ankle joint, a plaster splint is applied to the patient's lower leg for a period of 10 days. Physiotherapy is prescribed from 2-3 days after the injury. During the treatment, the plaster is removed. Ability to work is restored after about 3 weeks.

Patients with a complete rupture of the ankle ligaments are hospitalized in the Department of Traumatology and Orthopedics. With severe pain syndrome, 1-2% novocaine is injected into the area of ​​damage. With hemarthrosis, a puncture is performed to remove blood and introduce 10-15 ml of novocaine into the joint. A plaster splint is applied to the leg for a period of 2-3 weeks. Assign UHF to the area of ​​injury.

To improve the nutrition of the damaged area, the patient is recommended from the first days to move the toes, tighten the muscles of the lower leg, bend and unbend the knee joint. After removing the bandage, exercise therapy, massage and warm therapeutic baths are prescribed. Within two months from the moment of damage, wearing a tight bandage is indicated to completely restore the ligament and prevent its repeated ruptures at the healing site.

5 most common basketball injuries and how to prevent them

We'll take a look at the types of injuries most common among basketball players, according to the National Athletic Coaches Association report, to see what the numbers can tell us. As with most sports, sprains, deformities, and common injuries are all the nasty things that can happen, but this information doesn't tell you the interesting details. Let's take a closer look at what injuries basketball players usually get and what to do to avoid them.

1. Foot/ankle injuries

As stated in the report, lower extremity injuries were the most common, with foot or ankle injuries considered to be the most serious problems. This could have happened after an ankle slip or an awkward jump after a ball. Also, the player can accidentally stumble. Naturally, basketball makes athletes more prone to this kind of injury.

Prevention: Ankle must be supported to prevent injury. Before entering the playground, make sure your shoes are suitable for this activity. Closed basketball shoes help prevent slipping on smooth playground surfaces. In general, a good pair of basketball shoes will create a higher profile and better ankle support. It will not be superfluous to tape the leg with a special tape to provide additional preventive measures. This method is recommended for people prone to ankle injuries.

2. Hip and calf injuries

Spinning, running, jumping and bouncing put extra strain on the legs and hips, making players vulnerable to various types of injury. Hip sprains and bruises can occur from contact with the ground or from overstretching of the ligaments and muscles.

How to Prevent: Some contact injuries cannot be prevented, but without a doubt, stretching has always been a good start to any workout or game. The more elastic your muscles and tendons are, the less likely you are to overstretch them and injure yourself while playing. Stretching your thighs is the key to warming up before a workout or game.

3. Knee Injuries

Severe injuries such as an anterior cruciate ligament tear are not common in basketball. But knee injuries, which are mostly minor sprains and deformities, still rank third on the list of the most common injuries in basketball.

Prevention: Strengthening the leg muscles will help create good support for the knees, so this is where going to the gym can really help. And, as mentioned above, never forget to stretch well before training and playing. If you know that you have problems with your knees, that you are prone to frequent injuries, it would be a good idea to put on a knee brace or fix a brace around your knee.

4. Wrist/Hand Injuries

In fact, it is surprising that these parts of the body are not the most vulnerable to injury, given that the game is played mainly with the hands. But according to the study, only about 11% of basketball injuries occur in the wrist, hand, or forearm.

Prevention: keep hands and wrists healthy and fit. Be sure to make sure that the ball goes straight into your hands when someone makes a strong pass to you. If you lose visual contact with the ball just before catching it, you can easily injure your fingers. Also, always be careful on the court and avoid clashes of the hands with other players. The less you deal with them, the better. Although, of course, in the context of basketball, this advice seems ridiculous.

5. Head/Face Injuries

When players hit their heads or an unintentional elbow to the face occurs, it's not funny at all. Hitting the ball in the face, of course, is less traumatic, but still unpleasant and also creates an awkward situation.

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