Ankle Sprain Treatment and Prevention

An ankle sprain occurs when the ligaments in the ankle are stretched or torn, and most commonly occurs on the outside of the ankle. This occurs when the foot rolls inward, placing excessive stress on the ligaments and can occur during a fall, landing awkwardly after jumping, or running or walking on an uneven surface.

Signs & Symptoms

  • Swelling
  • Bruising
  • Painful to touch ankle
  • Painful to move ankle

Treatment

  • Within the first 48-72 hours, it is important to utilize the RICE principle (Rest, Ice, Compression, Elevation) to minimize inflammation, pain, and swelling.
  • Range of motion exercises in all directions and stretching of the calf muscle will help to minimize loss of mobility and stiffness in the ankle joint.
  • Ankle strengthening exercises will increase the stability of the ankle to allow full return to all activities with decreased risk of re-injury.
  • Proprioception allows you to sense where your body parts are in space and in relation to the rest of your body. This is accomplished through sensory receptors called proprioceptors located in the muscles, tendons, and joints. Using proprioceptive and balance exercises helps to train this sense, thereby increasing ankle stability. These exercises are an important component to any ankle sprain treatment program.

A physical therapist will devise the most appropriate treatment and exercise plan for your specific injury, progressing you to a point where you are able to return to all functional and sport-related activities. If you suspect an ankle sprain, the physical therapists at Harbor Physical Therapy can evaluate you to determine the degree of injury.  Based on the severity, we may refer you to a medical doctor if a more serious injury such as a fracture or complete ligament or muscle tear is suspected.

Common Gym Injuries

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Common injuries that occur at the gym:

  • Muscle Strain
  • Tendonitis
  • Bursitis

Common injury areas that occur at the gym:

  • Back
  • Shoulders

Muscle strain is the most common injury. There are different degrees of muscle strains from a minor overstretching injury to a muscle tear. To avoid muscle strains, make sure you perform a warm up and a cool down.  It is important to listen to your body.  If something hurts, stop and stretch.

Tendinitis is caused by a repetitive strain to the tendon of the muscle. If you overwork a muscle, you can develop tendonitis.

Bursitis is inflammation to the bursa.  A Bursa is a fluid filled sac that provides decrease friction and helps to give a fluid movement to the joint. Avoid doing the same exercises all the time; change it up to avoid overuse of one particular area.

Back pain is one of the most common areas injured at the gym because the back is at the center of the body for all movement and exercise. To avoid injury, bend with your knees and tighten your abdominal muscles during exercises.

Shoulder impingement injuries occur due to lack of rotator cuff strength and or overuse of the rotator cuff muscles. To avoid injury, limit overhead weighted exercises and make sure to work on shoulder stability before increases the weight with strengthening exercises.

Harbor Physical Therapy can evaluate your gym injury and determine the most optimal course of treatment to get you back to the gym as quick as possible.  Our physical therapists will review your gym routine, educate you on proper body mechanics, and exercise routine to reach your fitness goals without injury.

Poor Posture Can Cause Headaches

There are 3 major types of headaches:

  1. Cluster
  2. Migraine
  3. Tension

Cluster and migraine headaches generally are due to a problem with the blood vessels while tension headaches are typically due to poor posture. Tension headaches usually cause a dull pain in the head, neck, temples, scalp or shoulders.

Forward head posture is a leading cause of neck pain, headaches, and shoulder pain. For every inch your head is located more forward from sitting right on top of your shoulders, the perceived weight of your head increases by 10 pounds.

Steps to improve posture:

  1. Set-up your work station to decrease strain on your neck.
    • The top 1/3 of the screen should be even with your eyes.
    • Elbows should rest comfortably by your sides.
    • Hips should be slightly higher than your knees with your feet flat on the floor.
  2. Use a supportive neck pillow for sleeping.
  3. Perform neck stretches throughout the day.
  4. Perform postural strengthening exercises throughout the day.

If these steps do not improve your posture, schedule an appointment at Harbor Physical Therapy to address tight musculature and receive a catered exercise program based upon your presentation.

What is Shoulder Impingement?

Shoulder Impingement occurs when one of your rotator cuff muscle tendons becomes pinched, or impinged, between the bone in your arm and your shoulder blade. The friction on the muscle can cause increased pain and inflammation when lifting up the arm as the muscle becomes pinched between the two bony landmarks. If you feel pain in the front of your shoulder when lifting your arm overhead, it may be caused by shoulder impingement.  It is important to address the cause of shoulder impingement, as repetitive stress on the muscle can lead to a rotator cuff tear.
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Causes:

  • Repetitive overhead movements performed during sports such as swimming, baseball, tennis, and volleyball, or during such activities such as overhead weightlifting or painting.
  • Weakness of the rotator cuff muscles, causing decreased shoulder stability and abnormal shoulder mechanics.
  • An injury or fall onto the shoulder.
  • Bony abnormalities that narrow the space underneath the shoulder blade.

How Harbor Physical Therapy can help:

  • Reducing pain and inflammation in the shoulder through modalities such as ice, heat, and electrical stimulation.
  • Patient education on which activities should be performed and which should be avoided.
  • Restoring range of motion to the shoulder through exercise and manual therapy.
  • Promoting normalized movement patterns with proper body mechanics.
  • Strengthening the shoulder complex and rotator cuff to increase shoulder stability and prevent further injury.

What is Knee Valgus?

Knee valgus is characterized by your knee collapsing inward when your hip flexes. You may also notice that the opposite side of your pelvis may collapse downward. This is seen most often in squats, lunges, jumps, landing, and descending steps. Women are more susceptible to knee valgus because women have a wider hip angle compared to men. Knee Valgus can lead to patellofemoral knee pain, ACL tears, and IT band syndrome.

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Listed below are causes of Knee Valgus:
1. Weak gluteal muscles allows for over compensation of inner thigh muscles pulling the knee inwards.
2. Restricted ankle mobility does not allow for knee to progress forwards over the toe.
3. Inadequate quad strength (specifically vastus medialis function) effects knee stability and can cause the patella to track improperly.
4. Weak hamstrings may similarly allow the knee to cave in.
5. Improper motor planning of movement and poor execution of movement.

A physical therapist can help address the causes of knee valgus and provide exercises to minimize the symptoms and effects. This can be done through strengthening, stretching, and proper training of movement execution.

Home Safety Tips

Every year, there are many injuries and fatalities that are caused by a lack of home safety. There are many different ways you can modify your home and your daily routine to ensure safety. Here is a list of home safety tips:

1. Secure scatter rugs.

2. Have contrasting colors on transitions into different rooms, stairs, and different level surfaces.

3. Avoid using cleaners that make the floor slippery.

4. Always wear supportive shoes/slippers without an opening back.

5. Avoid walking in socks without grippers.

6. Have a night light to your bathroom.

7. Make sure steps have a non-slip surface.

8. Make sure you have proper lighting in all areas.

9. Make your bath/shower skid proof.

10. Purchase a non-slip bath mat.

11. Store heavy items below shoulder level.

12. Avoid wearing loose clothing while cooking on the stove.

13. Check expiration dates on food and medications.

14. Take your medication in a well-lit room.

15. If you have a medical history and or history of falls, invest in a medical alert system.

16. Remove clutter from your floors to avoid tripping.

17. Do not put too many electric cords into one socket.

18. Install a smoke detector.

19. If using a space heater, make sure it is 3 feet away from anything that could burn.

What is SI Dysfunction? How can Physical Therapy Help?

What is the SI Joint?

  • Sacroiliac joint
  • Lies at the bottom of the lumbar spine and above the coccyx (tailbone).  It connects the sacrum with the pelvis.  SI joints are strong and have very tight, strong ligaments connecting the bony surfaces.

What is the function of the SI Joint?

  • Acts as a shock absorber for the pelvis and low back.
  • It has minimal motion compared to other joints.
  • Transmits forces from the upper body down the pelvis and legs.

Why do I get pain at my SI joint?

  • Pain happens when the SI joint moves too much or too little.
  • Direct strain or trauma to the SI joint ligaments.
  • A fall on the buttox or mis-stepping a descending step.

Diagnosis

  • Can be difficult to diagnose because the symptoms can be diffuse and can mimic other common low back and hip injuries.
  • Assessing pelvic alignment, leg length, and palpating bony landmarks may help determine whether this joint is involved.
  • More advanced diagnostic tests like MRI, X-ray, CT scan can help with diagnosis but can also miss the correct diagnosis.

Treatment

  • Physical therapy can be very helpful with conservative management of SI joint dysfunction.
  • Assess pelvic alignment and use techniques to correct alignment.
  • Stretches to help with pain and lack of mobility.
  • Dry needling, massage, and heat can help with muscle spasms.
  • Ice can help with inflammation and irritation surrounding the SI joint.
  • Strengthening exercises to the applicable hip and core musculature will be given to help stabilize and normalize the proper pelvic alignment.

How to Exercise with a Foam Roller

A foam roller is a great tool to decrease muscle tightness, improve flexibility, and improve muscle strength/stability. It is inexpensive and easy to use anywhere in your home. Listed below are the benefits of using a foam roller and examples of foam roller exercises.

1. Decrease muscle tightness-  Place the foam roller on a trigger point.  You can either maintain pressure on the spot or perform gentle oscillations over the trigger point. Perform this self massage technique no more than 5 minutes per muscle.

2. Improve Flexibility- Laying with your back on the foam roller, elongate your arms to stretch your pectoralis muscles.

3. Improve muscle strength/stability- There are many exercises you can perform on a foam roller to improve muscle strength/stability. Laying with your back on the foam roller, alternate lifting your arms and legs. If you want a really challenging exercise, stand on a foam roller and perform a squat.

If you would like to learn more about how you can use a foam roller to achieve your exercise goals, give Harbor Physical Therapy a call.

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Foam Roller Squat
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Different Size Foam Rollers
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Pectoralis Stretch on Foam Roller

Playing Golf- Improper Form Leading to Injury

Golf is a strenuous sport on numerous joints throughout the body. This is due to the high impact on the ball, the quick acceleration/deceleration forces associated with swing, the pivot forces on your legs, and the rotational forces on your cervical, thoracic and lumbar spine.

Factors that can contribute to golf swing injuries:
• Overuse and over practice
• Poor swing mechanics
• Over swinging
• Improper warm up
• Rotational stresses associated with swing
• Improper set up/grip/club length
• Poor posture

If you continue to have pain while playing golf or are unable to play due to pain, please contact Harbor Physical Therapy for an evaluation. HPT will determine the cause of your discomfort and educate you on how to prevent a re occurrence.

Common Injuries At the Gym

1. Muscle Strain– There are different degrees of muscle strains from a minor overstretching injury to a tear. To avoid muscle strains, make sure you warm up appropriately and do not lift more weight than you can handle.

2. Tendonitis-is caused by a repetitive strain to the tendon of the muscle. If you overwork a muscle, you can develop tendonitis.

3. Bursitis– is inflammation to the bursa. A Bursa is a fluid filled sac that provides decrease friction and helps to give a fluid movement to the joint. Avoid doing the same exercises all the time; change it up to avoid overuse of one particular area.

4. Back injury– due to placing increase stress on your back muscles with exercises. Avoid forward bent over postures at the gym. Bend with your knees and tighten your abdominal muscles during exercises. This will help decrease the likelihood of a back injury.

5. Shoulder impingement injury– can occur when you overuse the rotator cuff muscles. The rotator cuff muscle can rub against the top part of the shoulder blade, producing pain. Avoid overhead weighted exercises.

If you experience pain while you are working out, you should stop and apply ice. If the pain persists for more than 3 days, contact your physician or your local physical therapist at Harbor Physical Therapy.