ANKLE SPRAIN looked at by Dr Les Bailey,phd,DO,acopm,apta (int part )
A look at ankle sprain and physical therapy by Dr Les Bailey from his clinic in Banstead,Surrey
By: Dr Les Bailey
Dr Les Bailey 2012
One of the most common acute conditions I am called upon to treat is ankle sprain.
These are more often caused from sporting injuries, but may be from walking, wearing high heeled shoes, hypermobile ankles, or just missing ones footing.
The most common are INVERSION injuries where the ankle rolls outward and hits the ligaments on the outside of the ankle.
Less common are EVERSION injuries where the ankle rolls inward and hits the inner ankle.
These injuries are graded one to three.
1 is when there is mild damage
2 is when there is partial tearing
3 is where there is complete tear
Grades 1 or 2 are within our scope to give physical therapies, grade 3 will generally need plaster casting, air boots or at worst, surgical intervention.
For differentiation in diagnosis between broken bone and ligament tear, it is wise to keep the "ottawa ankle rules" in mind. These were developed in emergency room conditions to lessen the need for x rays in ottawa.
These rules are worth learning, but ALWAYS X RAY IF IN DOUBT .
Look out for acute pain to the body of the malleolus bone.
Bone tenderness along the distal 6cm of posterior edge of tibia or malleolus tip.
Bone tenderness along the distal 6cm posterior edge of fibula or lateral malleolus.
Or the simple "4 step rule" whereby we observe if the patient can walk 4 steps or more.
We cannot use these tests on pregnant, drunken, or very young patients for obvious reasons.
My preferred regime is to immediately apply ice and elevate the leg if we catch these injuries immediately.
However, we usually get them when they are a while old, as patients usually wait to see if they will just go away as if by magic !
The general rule is to ensure we have the patient until the injury is completely healed. If we half treat it, there is a danger of , not only leaving a weakness, but of scar tissue building up.
The reader may like to look up my article "Arnica...the new Hydrocortisone"
My first task would be to apply deep tissue massage to the ligaments to encourage fresh blood supply and to dissipate inflammatory deposits.
Secondly I apply ultrasound to give heat and micro massage, again, removing inflammatory deposits and promoting healing.
I then use lasertherapy to further promote healing and encourage new cell growth.
If the patient is in alot of pain, I may use electroacupuncture to ease their symptoms.
Lastly, and possibly most importantly, I strongly advise them to use hot/cold packs at home for as many hours a day as possible. This involves using a hot water bottle followed by ice packs at strict 5 minute intervals. This rapidly supports healing and dissipates inflammation.
Depending on the severity, I may also employ immobilisation in the early stages of healing.
Dr Les Bailey phd,DO,acopm,apta (int part)
About Dr Les Bailey phd,DO, acopm.apta(int part)
Direct phone 07801418080
Dr Les Bailey began in the physical therapies in 1981,qualifying in remedial massage,and later going on to qualify as an osteopath.
He gained his phd (doctorate) from OIUCM for his thesis on the treatment of plantar fasciitis.
He was awarded a teaching/lecturing diploma from the northern school of osteopaths in co durham in 1993.
He also holds the diploma in foot biomechanics .
A clinician with over 30 years experience who has worked in many clinics across the UK as well as in Kalubowila Hospital in Sri Lanka. I have been senior osteopathic lecturer at the Northern college of osteopaths teaching osteopathic technique and lecturing on rheumatic spectrum diseases and contraindications to treatment as well as teaching at sequoia college in Cardiff (Remedial massage, acupuncture for musculoskeletal pain, manipulative therapy, advanced manipulative therapy, ayurvedic head massage, anatomy and physiology, differential diagnosis, NVQ preparation, orthotic prescription. I taught all of the above to professional level.
- Andrew still college osteopaths diploma 1983
- Qualified osteopathy 1993 northern college of osteopaths (DO).
- Awarded teaching/lecturer diploma northern college of osteopaths 1993 where I was a senior lecturer for 3 years.
- remedial massage diploma first awarded 1981 (London academy of massage and physical culture)
- Phd awarded by thesis from OIUCM 2009 for research into plantar fasciitis
- Awarded lifetime membership medicina alternativa 1992
- Awarded the fellowship international lasertherapy association 1994
- Diploma in manipulative medical science 1991 (medicina alternativa)
- Former adviser on standards in therapy at the institute of complimentary medicine.
- Certificate in acupuncture for musculoskeletal pain control 1995
- Diploma in biomechanics DipBmec,college of foot health practitioners 2008
- Author of "the laymans guide to foot and heel pain”, 1st edition 2005, final 3rd edition 2010
- Registered with ACOPM and APTA (international partner)
copyright Dr Les Bailey 2012
Dr Les Bailey works from his clinic near Banstead in surrey.