May 5, 2024
We ushered in the beginning of the summer solar term
The graduation entrance examination is imminent
Comrades-in-arms at the same time as they went all out
Care should also be taken to avoid training injuries
And not only in the barracks
As the temperature rises
Many people choose outdoor sports close to nature
Increased activity inevitably increases the risk of injury
Follow Xiao Yin today
Let's learn how to prevent ankle sprains!
1. What is an ankle sprain?
Generally speaking, an ankle sprain is what we often call a "broken foot". From a professional point of view, an ankle sprain is a plantar flexion of the ankle joint when walking down steps or on uneven roads, and if the ankle is subjected to violence that causes excessive inversion or valgus, the ligaments around the ankle joint will be overstretched beyond normal range of motion [4], resulting in traction or laceration of the surrounding joints and soft tissues (such as joint capsule, ligaments, tendons). [2]
Depending on the location of the injury, we can divide ankle injuries into the following three categories.
Lateral ankle sprain
After the ankle is turned inward, the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament on the lateral side of the ankle joint are damaged. This type of injury is the most common ankle injury. [1]
Medial ankle sprain
The lateral collateral ligament of the ankle joint is relatively weak and susceptible to injury, while the medial collateral ligament of the ankle joint is thicker and the injury is relatively rare, accounting for only 5%~10% of ankle sprains. Medial sprains are mainly due to damage to the medial deltoid ligament or complex when the ankle is excessively valgus or pronated.
Inferior tibiofibular symphysis sprain
Also known as a high ankle sprain, it is an injury to the lower tibiofibular symphysis when the ankle joint is dorsially extended or valgus. Symphysis tibiofibular sprains can occur alone, but most often occur in conjunction with other types of ankle injuries. Because of the complexity of the injury, it can be easily missed or inappropriately diagnosed, leading to complications such as ankle instability, long-term chronic pain, and traumatic osteoarthritis [3].
2. Ankle sprain stage and clinical symptoms
Understanding the stages of sprains is an important guide for subsequent treatment, so let's learn together![5]
Early [4]:
Usually within 48 hours of an ankle sprain, it is characterized by severe pain and limited movement in the ankle and nearby areas, accompanied by mild or severe (mainly related to the degree of injury) swelling and skin bruising, and a feeling of local skin "hotness" to the touch.
Metaphase:
Generally, between 3~2 weeks after the sprain, the pain, swelling and skin bruising of the ankle joint gradually decrease, but the ankle joint still feels painful and difficult to walk.
Anaphase:
Generally, after 2 weeks of sprain, the pain gradually decreases to nothing, the swelling and bruising basically disappear, and the range of motion of the ankle joint is basically restored, but some patients still feel local pain and joint instability at this time, and are prone to repeated sprains and swelling.
3. First aid measures in the acute phase
When you have an ankle sprain caused by strenuous exercise or accidental tripping, you must rest in time and take corresponding measures, the earlier the treatment period, the better the prognosis and the better the recovery. So don't take it lightly in the event of an injury, deal with it as soon as possible, and keep in mind the "PEACE" tips.
保护（Protection）
Stop or limit exercise for 1~3 days to reduce bleeding, prevent swelling of injured muscle fibers, and reduce the risk of injury aggravation. However, it is also not possible to take long breaks, which can reduce the strength and performance of the tissue. Pain signals can be relied upon to remove the protective device and gradually resume movement.
抬高（Elevation）
This is to elevate the affected limb so that the ankle is as high as possible at the level of the heart. We can sit or lie down, using a footstool or pillow to elevate our ankles. This helps blood circulation and reduces swelling.
Avoid anti-inflammatory medications
（Avoid anti-inflammatory modalities）
A large number of studies have shown that inflammation has an irreplaceable role in tissue regeneration. For inflammation, it is also not recommended to control it blindly. Therefore, the use of anti-inflammatory drugs may be detrimental to the long-term healing of tissues.
加压（Compression）
An elastic bandage or a long towel can be used to compress the ankle inwardly. Wrap the bandage around the ankles and feet and secure it with medical tape, keeping the wrap dry until the swelling subsides. Be careful not to wrap too loose and too tight, and feel comfortable. Flip-up or pull-up bandages can also be used, which ensure that pressure is applied evenly without affecting the circulation of blood to the feet. The main purpose of compression is to reduce local bleeding and reduce edema.
教育（Education）
Medical staff should also do a comprehensive and correct education for patients. Good health education and load coaching will help avoid overtreatment, which increases the risk of medication injections or surgery, as well as increased medical costs due to disability compensation.
4. Rehabilitation in the chronic phase
Ankle injuries are not something that can be recovered quickly in a short period of time, and we need to "love" our body and persist in recovery.
Proper exercise (Load)
Being physically active and exercising is beneficial for most people with musculoskeletal disorders. We should increase mechanical stress as soon as possible during recovery and return to normal activities as soon as symptoms allow. Mechanical stimulation and appropriate weight-bearing (without pain) in the chronic phase can promote tissue recovery and speed up the repair of tendons and ligaments in the body.
保持乐观心态（Optimism）
A large number of research facts show that people's psychological state and psychological cues play a key role in the recovery after injury. Negative emotions such as fear and depression may affect the body's recovery. Pessimistic expectations are also associated with outcomes and worse outcomes, and in practice, healthcare professionals can increase the likelihood of recovery by encouraging patients to remain optimistic.
促进身体恢复（Vascularisation）
Physical activity, including aerobic exercise, is a cornerstone of musculoskeletal injury management. Painless aerobic exercise should be started a few days after the injury to improve motivation and increase blood flow to the injured structure. Early mobilization and aerobic exercise can improve function, work and reduce the need for painkillers in patients with musculoskeletal disorders.
活动有益健康（Exercise）
There is substantial evidence that activity can treat ankle sprains and reduce the probability of recurrent injuries. Activity contributes to the early recovery of motor capacity, strength, and proprioception after injury. However, it is important to avoid pain, and we should use the pain signal as a guide to the amount of exercise to ensure optimal recovery in the chronic phase.
I hope that my comrades-in-arms will train hard at the same time
Pay attention to the stability of your ankle joint in time
Make sure your training runs smoothly
Bibliography:
[1] Hu Dexin, Xu Yue, Wang Shentao, Wang Lina, Ni Guoxin.Interpretation of clinical practice guidelines for ankle stability and motor coordination disorders: lateral ankle ligament sprain 2021 edition[J].Electronic Journal of Foot and Ankle Surgery,2021,8(04):1-6+17+73.
[2] Xu Shaoting, Ge Baofeng, Lu Shibi, ed.Practical Orthopedics on the 4th Edition Revised Edition[M].Zhengzhou:Henan Science and Technology Press,2019,(1060).
[3] Sun Zhengtao, Sun Haiyu, Chen Bin, Zhang Yu, Li Shuo.Progress in the diagnosis and treatment of lower tibial-fibular combined injury[J].Practical Journal of Orthopedics,2019,25(06):537-541.
[4] Wu Mengchao, Wu Zaide, Wu Zhaohan presided over the review; Chen Xiaoping, Wang Jianping, Zhao Jizong, editors-in-chief; Qin Xinyu, Liu Yucun, Zhang Yingze, Sun Yinghao, Li Zongfang, deputy editors.Surgery, 9th edition[M].Beijing:People's Medical Publishing House,2018.
Massage and Rehabilitation Medicine,2020,11(09):20-21+24.
Youth League Committee of the School of Basic Medical Sciences, Air Force Military Medical University
Military doctor Xiao Yin's studio
Instructors
The Second Affiliated Hospital of the Air Force Military Medical University
Department of Orthopedics (Joint Surgery) Zhang Hongtao Attending Physician
Teaching and Experimental Center, School of Basic Medical Sciences, Air Force Medical University
Assistant Professor
Planner: Zhang Chengkai, Wang Hang, Zhao Yushun
Text: Li Yichen, Liang Zijing
Comics: Yan Mingyao, Guo Yilin
The People's Liberation Army Daily was released on WeChat
Editor: Liu Yan
Editor: Zhang Huajing