Diary of a Common Sports Injury, By: Brad Walker
I thought I'd start the New Year with something a little different and write about my own personal experience with a sports injury I recently suffered, and the process I used to get myself back to 110%. I say 110% because it's always my goal to rehabilitate the injured area to the point where it's stronger after the injury, than it was before the injury.
Let me paint you a picture. It's Sunday afternoon in late September (spring time in the southern hemisphere). It's a perfect 26 degrees C, clear sky, light breeze and I'm enjoying the day with family and friends at a local park by the beach.
After feasting on a barbeque lunch a few us decide to kick the soccer ball around to work off all that food. So here I am; no warm-up, no stretching, and running around in bare feet on very un-even ground. I should have known better, and I bet you can guess what happened next.
So the inevitable happens. I step into a hole and I go over on my left ankle. Nothing too severe. Most likely just some minor stretching of the ligaments. So minor in fact, that I keep playing for another 15 or 20 minutes.
By the time I got home that evening I knew I needed to do something about the ankle. I'd never injured it before and I didn't want it to turn into one of those nagging, re-occurring injuries, so I thought I would take some of my own advice.
The treatment begins
Sunday evening: I start by getting an ice pack out of the fridge, sticking my ankle up on the coffee table and applying the ice pack directly to the injured area. I keep the ice on for about 15 minutes and then give it a rest for a while. Over the course of the evening I applied the ice another 2 or 3 times for about 15 minutes at a time.
Monday morning: The first thing I notice is that my ankle is very stiff and a little sore. It feels tight and difficult to move. I'm not too concerned about it at this point in time, I've had my fair share of sprains and strains, and I know this is all part of the healing process. I keep up with the ice, applying it 5 to 6 times throughout the day. I also try to keep off it as much as I can, not wanting to put too much weight on it.
Tuesday morning: My ankle is still a bit stiff, but most of the soreness has gone. I do my best to stay off it as much as possible and apply ice a couple of times throughout the course of the day.
Wednesday morning: My ankle feels good; still a little stiff but no swelling or pain. It's time to move onto a few easy range-of-movement exercises and apply some light weight to the ankle. I start with a few gentle movements; pushing my foot forward and stretching out the ankle; then pulling my toes back towards my shin; and then move onto some gentle circling motion.
Later in the day I start to apply normal pressure to my ankle by standing with equal weight on both feet, and by the end of the day I'm walking without favouring my good ankle.
A quick word of warning! Never, Never, Never do any activity that hurts the injured area. Of course you may feel some discomfort, but NEVER, NEVER push yourself to the point where you're feeling pain. Listen to your body and don't over do it at this early stage of the recovery.
Thursday morning: My ankle feels fine, ...but it's at this point that most people will make the mistake of thinking that everything is okay and discontinue any further treatment. Just because the injury feels better doesn't mean it has fully recovered and if you stop treatment now, you're at risk of continual re-injury until the complete rehabilitation has been successful.
To see what's been going on under the surface, let's take a quick look at how damaged ligaments repair.
When any sort of damage occurs to the ligaments, the body immediately goes into a process of repair. Where the individual fibres have been ruptured, or torn, the body begins to bind the damaged fibres together using a fibrous protein called collagen. Or, as it's more commonly known, scar tissue.
You see, when a ligament is torn, you would expect that the body would repair that tear with new ligament. In reality, this doesn't happen. The tear, or rupture, is repaired with scar tissue.
This might not sound like a big deal, but if you have ever suffered an ankle injury, (or any soft tissue injury) you'll know how annoying it is to keep re-injuring that same old injury, over and over again.
Scar tissue is made from a very brittle, inflexible fibrous material. This fibrous material binds itself to the damaged ligaments in an effort to draw the damaged fibres back together. What results is a bulky mass of fibrous scar tissue completely surrounding the injury site. In some cases it's even possible to see and feel this bulky mass under the skin.
When scar tissue forms around an injury site, it is never as strong as the ligaments it replaces. It also has a tendency to contract and deform the surrounding tissues, so not only is the strength of the tissue diminished, but flexibility of the tissue is also compromised.
So, how do you go about getting rid of that annoying scar tissue?
=> Heat and Massage
Throughout the day I used a hot water bottle to apply heat to the injured area, which helps by stimulating blood flow. I also started to use light massage on the ankle and specifically at the injury site. Massage is a very important process that helps to breakdown, remove and align the scar tissue. Without massage very few sports injuries will heal completely.
Friday morning: My ankle feels great, so it's time to get into some serious rehabilitation. I start off with some easy mobility exercises and then follow them up with a good massage. I start with light strokes and gradually increase the pressure until I'm using firm, deep strokes. I concentrate all the pressure at the direct point of injury, and use my thumbs to get in as deep as possible to break down the scar tissue.
After a 10 minute massage, I continue with a few more mobility exercises, but this time I push them a little bit further and a little bit harder. I then finish off with some very gentle stretching exercises.
Later that evening I give my ankle another massage while sitting in front of the TV, and finish with some more stretches.
Saturday to Monday: Over the course of the next few days I massage my ankle another 2 or 3 times and keep some heat on it whenever I'm at home. I constantly stretch my ankle and do my range-of-movement exercises, and I gradually incorporate some weight bearing exercises like balancing on one leg, half squats and half lunges.
The following week: My ankle feels great. I went for an easy walk on Monday morning and included a few stretches for my ankle and lower legs. Throughout the week I continued with my range-of-movement and balancing exercises, and towards the end of the week I started on some very easy plyometric exercises. These are explosive type exercises and include things like jumping, hoping, skipping and bounding.
Over the next month: I continued with all the exercises I've listed above, gave my ankle the occasional massage and kept up with the stretching. I also included a series of more intense exercises to help really strengthen my ankles and lower legs. Exercises like single leg plyometric drills, weight training exercises like squats, lunges, leg press and various forms of calf raises, plus started to run again.
Today, my ankle feels strong and stable, and I know it's in better shape now, than it was before the injury. If you would like a more detailed article on ankle sprain treatment and recovery, have a look at one of our previous articles titled, Ankle Injuries, Ankle Pain & Sprained Ankle Treatment at http://www.thestretchinghandbook.com/archives/ankle-injuries-pt1.html
