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The greater majority of athletes have experienced a sprained ankle at some point in their career. Mechanism of Injury: Most lateral ankle sprains occur from a rolling inward movement that causes excessive inversion (moving sole of foot toward body) and plantar flexion (toes pointing partially downward).
Bones most specific to a lateral (meaning outside or away from center of body) ankle sprain include those that help form the talocrural joint or ankle mortise:  tibia (shin bone), fibula (outer leg bone), talus (bone that sits on top of your heel bone). Ligaments (which connect bone to bone) specific to lateral ankle sprain include: anterior talofibular ligament (ATF), calcaneofibular ligament (CF), and posterior talofibular ligament (PTF). Muscles most often compromised include the fibularis longus and fibularis brevis (also known as peroneals).
Grade 1: Overstretching of ligament – microscopic damage, minimal impairment, minimal tenderness and swelling. Sub-Acute Treatment: Once an athlete can bear weight and initial symptoms are subsiding, the following steps should be taken under the guidance of a physical therapist. Return to Function: Once athlete has full ROM, full weight bearing, and absence of swelling the following activities should be incorporated into daily rehab. With that in mind, a brace in poor condition or poor fitting well may be less effective than a proper ankle taping.
Primary lateral ankle ligament injuries including Grade 3 sprains are usually managed very effectively without surgical intervention with appropriate physical therapy. About the Author: Julie Eibensteiner PT, DPT, CSCS is a physical therapist and owner of Laurus Athletic Rehab and Performance LLC, an independently owned practice specializing in ACL rehab and prevention in competitive athletes.
As a guy who had to quite playing because I was constantly rolling my ankles and tore ligaments several times, I can tell you that a lace up brace in nearly impossible to play soccer in Steve. There are 20 muscles in the foot that give the foot its shape by holding the bones in position and expand and contract to impart movement. There are elastic tissues (tendons) in the foot that connect the muscles to the bones and joints.
Skin, blood vessels, and nerves give the foot its shape and durability, provide cell regeneration and essential muscular nourishment, and control its varied movements. After all, sprained ankles are the most commonly injured joint in athletes accounting for approximately 34% of all injuries and 80% of all injuries in soccer players according to a 2007 study in Sports Medicine.

In fact, it is the vicious cycle of spraining it again and again and AGAIN that victimizes athletes.
These 3 ligaments along with the deltoid ligament on the medial (inside) aspect of the ankle work to keep the two lower leg bones together to a form a mortise with the talus bone underneath, providing your ankle with both stability and mobility. These muscles allow you to evert (turns sole of foot outward) and often become strained or overstretched when the ankle is rolled inward. The more the unstable the joint, the more bones crash into one another resulting in arthritis in the future and poor performance at present. Female athletes have a 6.5 times greater chance of lower extremity injury with a score of less than 94% according to a 2010 study in the Journal of Orthopaedic and Sports Physical Therapy. Stop the first injury: Train the body to protect itself with an appropriate strength and conditioning program or dynamic warm-up that incorporates elements of balance and neuromuscular training. Don’t rush back from an ankle injury: The #1 reason individuals have recurrent ankle injuries is because they rush back to play once the pain and swelling are gone, but completely ignore the range of motion, strengthening, and neuromuscular control pieces.
In addition to being a regular contributor to IMS on topics of sport injury and prevention, Eibensteiner holds a USSF A License, coaches a U18G MRL team for Eden Prairie Soccer Club, and assists with the Men’s and Women’s soccer programs at Macalester College.
The largest and strongest tendon of the foot is the Achilles tendon, which extends from the calf muscle to the heel.
The longest of these, the plantar fascia, forms the arch on the sole of the foot from the heel to the toes. Chronic Ankle Instability or tendency toward repeated ankle sprains and recurring symptoms such as poor postural control, decreased joint awareness, and joint instability are estimated in up to 80% of athletes who have experienced a prior ankle sprain. Or in the case of Lady Gaga….wearing shoes that put your ankles in excessive plantar flexed positions. The ATF is the most commonly injured ligament in a lateral sprain followed by the CF and rarely the PTF. As a result, their ability to produce timely and appropriate muscle contraction is compromised and must be relearned. Now, I’m not advocating everyone let their ankles blow up to the size of balloons just yet. Not to mention they just feel unnatural in soccer shoes.  However, ankle bracing and taping are appropriate for short term protection of the joint while an athlete is returning to play and have both been proven to offer some joint stability and increased proprioception to reduce future injury.

Part of my U18 team’s warm-up includes jumping and hopping as well as volleys while hopping on one leg. After a ligament injury, bones can shift preventing full range of motion and the body loses its ability to defend itself unless relearned. Its strength and joint function facilitate running, jumping, walking up stairs, and raising the body onto the toes. By stretching and contracting, it allows the arch to curve or flatten, providing balance and giving the foot strength to initiate the act of walking.
This article will discuss what really happens when you sprain your ankle, the proper treatment to stop the cycle of repetitive injury, and how to determine when you are ready to return to play. Excessive swelling does contribute to pain as well as muscle inhibition and also restricts full range of motion. We get in about 1620 hours of injury prevention work this year via our daily warm-up and had no major knee injuries, just 1 new ankle sprain, and 1 minor hamstring injury in total for the year. Medial ligaments on the inside and lateral ligaments on outside of the foot provide stability and enable the foot to move up and down. However, some swelling in the early stages of an injury may be OK and consider ditching the use of anti-inflammatory medications like ibuprofen (Advil) and use acetaminophen (Tylenol) for pain instead.
Lace up braces and ankle taping offer some benefit in terms of increased muscle activation with some motion restriction versus no support at all. Chronic ankle sprains that go untreated lead to early arthritis, compensations by neighboring joints, and long term joint laxity….and more injuries.
Steering clear of ibuprofen is a common practice in the management of stress fractures to help promote healing and your GI tract will thank you as well. Kinesiotape (the stretchy black tape you often see in the Olympics) offers no significant benefit in terms of support or muscle activation specific to the ankle.

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Comments to “Tendons in foot and ankle”

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