How Does Andy Murray Go About Treating His Twisted Ankle?

 

This is the second article about tennis injuries. The Roland Garros tournament is currently taking place in Paris and Andy Murray has qualified for the semi-finals and he is due on court tomorrow against Rafa Nadal. Incidentally, they have met head to head 14 times with Rafa leading 10:4. So it looks like the odds are in Rafa’s favour.

Andy Murray is playing some great tennis and he is moving very well. This is surprising since he sustained a nasty twisted ankle in the game qualifying him for the quarterfinals. Maybe this injury has fired him up or maybe he knows he has to play better tennis so he doesn’t have to run about more. Or maybe he is being shown a bit of charity by his opponents, this does seem a bit unlikely! You would have thought he would have been tested more with drop shots so lets see what Rafa does tomorrow.

 

Twisted ankles are extremely common and not just in athletes. You only have to remember what the pavements were like along Upper Street before they were replaced to realise how easy it is to go over on your ankle. So it is no surprise that amongst athletes twisted ankles are the most common injury. These inversion injuries (turning the ankle in and spraining the outside ligaments) comprise 40% of athletic injuries.


There are three ligaments that provide the stability to the lateral or outside of the ankle. The anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL) and the posterior talofibular ligament (PTFL). The fist two are the most common to be injured in a twisted ankle and the PTFL is the least likely unless you dislocate the ankle joint!

There is a classification system to ankle injuries and this dictates the treatment:

• Grade I is an injury without macroscopic tears. No mechanical instability is noted and pain and tenderness is minimal.
• Grade II is a partial tear. Moderate pain and tenderness is present. Mild to moderate joint instability may be present.
• Grade III is a complete tear. Severe pain and tenderness, inability to bear weight, and significant joint instability are noted.

The initial treatment of all joint sprains involves RICE. Rest, ice, compression and elevation. The ice should be applied for about 20 minutes three to four times a day and a compressive bandage should also be applied to help control the swelling. Weight bearing she be avoided initially but encouraged as soon as it can be tolerated.

Grade III injuries are obviously a lot more serious and initial treatment should include an ankle brace to immobilise the ankle joint. Once the patient can tolerate weight bearing the brace should be removed and rehabilitation can commence approximately 48 hours after the injury.

The rehabilitation of a severely twisted ankle should be gentle initially with simple range of motion exercises. Stretching of the Achilles tendon and cycling on a stationary bike can then follow this.

As strength and mobility improve, isometric exercises for ankle dorsiflexion, plantar flexion, inversion, and eversion are implemented. The isometric exercises are followed by resistance exercises (we use Thera-Bands at the clinic) and then heel and toe raises.

Once the pain and inflammation has gone down and there has been a return to gentle exercise a lot of patients get complacent about the treatment of their ankle. Patients dont realise that they still need treatment to get them back to 100% fitness. Our physiotherapist is eperienced in this rehabilitation process and will aid your recovery by providing specific taping techniques to the damage joint to aid it's stability and to help with the proprioception re-education process using a 'wobble board'.

At the Angel Wellbeing Clinic our physiotherapist takes things further and motivates patients to move on to proprioceptive and balance exercises so the weakened ankle returns to full function and this minimises the chance of a recurrence.

Taping by our physiotherapist can aid stability as well as provide a feeling of security when returning back to sports followng a twisted ankle.



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