ankle sprains

Ankle Sprain and Instability

You’ve undoubtedly seen it happen while watching a basketball game: a player jumps to grab a rebound and turns his foot as he lands awkwardly on his ankle. The player limps from the court, seeking help from the trainer. Ouch!

What the player has suffered is a sprained ankle. Everyone is familiar with the term, but what does it actually mean?

Ankle Sprains Explained

An ankle sprain is one of the most common injuries to the soft tissue of the ankle. It is estimated that approximately 100,000 Canadians suffer ankle sprains annually. In college and university sports, it is one of the most common injuries among both men and women.

An ankle sprain occurs when the ligaments, the bands of fibrous tissue that keep the ankle in place, are stretched or torn. It generally happens when the ankle is twisted, which can happen during an intense activity, such as a sport, or by simply losing your balance or stepping onto an uneven surface while walking.

A mild sprain results when the ligaments are simply stretched, a severe sprain occurs when the ligaments actually tear.

Sprained Ankle Symptoms

If you sprain your ankle, you can expect one or more of these symptoms:

  • Pain.
  • Bruising, resulting from ruptured blood vessels leaking into the tissue.
  • Swelling, resulting as fluid continues to leak into the tissue for 24 hours after the injury.
  • Tenderness when touched.
  • Joint instability, especially if the ligament is torn through.
  • A possible popping sound.

A severe sprain will exhibit symptoms similar to those of a broken bone and should receive immediate medical evaluation.


During a physician’s physical examination of your ankle she or he will:

  • Palpate. Gently press the area around the ankle to determine which ligaments are affected.
  • Test range of motion. Move the foot in various directions to see which movements are possible.
  • Use imaging. Images of your ankle may assist in diagnosis. X-rays can determine whether any bones are broken, while an ultrasound allows for observation as the ankle moves to see how much stability the ligament offers. Magnetic Resonance Imaging (MRI) may be used once swelling recedes to determine the extent of the injury.

ankle sprain diagnosis


Sprains are graded based on their severity – the amount of damage done to the ligaments. Grading is helpful to physiotherapists when they treat patients with sprains.

Grade 1 ankle sprain – mild

  • Ligaments are stretched slightly and there may be microscopic tears.
  • There is mild swelling, bruising and tenderness around the ankle.

Grade 2 ankle sprain – moderate

  • The ligament is partially torn.
  • Tenderness, bruising and swelling around the ankle are moderate.
  • Ankle is abnormally loose if moved in certain directions.

Grade 3 ankle sprain – severe

  • The ligament is torn through.
  • Swelling, bruising and tenderness around the ankle are severe.
  • With certain motions, there is substantial instability; unable to bear weight.

How to Heal a Sprained Ankle

Luckily for the injured, almost all sprained ankles can heal without surgery. However, healing will take time.

It is important not to treat a sprain lightly, because once an ankle has been sprained, it is more prone to further sprains. You may also experience stiffness and pain. Without proper rehabilitation, you may experience instability, which can lead other muscles to compensate. As a result, your gait may change, placing undue stress on your legs, knees or hips and making them more prone to injury.

Just as there are three grades of sprains, there are three basic steps to any ankle sprain treatment:

  • Step 1: Rest, protection of the ankle and swelling reduction.
  • Step 2: Restoring strength, flexibility and range of motion.
  • Step 3: Maintenance exercises and a gradual return to sports.

ankle sprains treatment

Physiotherapy for Ankle Spain

Initially, any sprained ankle can be treated using the RICE method: rest, ice, compression and elevation. However, once the initial swelling has receded, it’s time to turn to a physiotherapist for a rehabilitation program that focusing on rebuilding strength, restoring flexibility and range of motion and promoting stability.

In addition to a series of targeted exercises, your physiotherapist may employ a hands-on treatment called joint mobilization to restore the gliding motion to the ankle bones. Your exercises may also home in on your sense of position or proprioception. Nerve sensors inside your ligaments may be affected during a sprain and they may not give your brain an accurate reading of how your ankle is positioned. You may need to retrain your sense of position as you heal.

How Long Does it Take a Sprained Ankle to Heal?

Sprains generally heal in three to eight weeks if given proper treatment, so handle with care!

Take proper care of your Ankle Sprain!

neck pain and headaches

Coping With Neck Pain and Headaches

How many times have you thought of somebody to be “a pain in the neck”? Interestingly, however, a number of physical issues that affect the neck actually manifest themselves as “a pain in the head” – or a headache. There are many causes of neck pain and of headaches, so make sure you are informed before you decide upon a course of treatment – get a diagnosis from your physician or physiotherapist.

How to Relieve Neck Pain

Physiotherapists are trained to diagnose and treat neck joint dysfunctions and muscle imbalances. Your physiotherapist may employ some or all of the following techniques, depending on the individual diagnosis of your neck pain:

  • Gentle join mobilization and manipulation to loosen or unlock stiff neck joints.
  • Strengthening exercises for weak muscles, focusing on neck muscles and postural shoulder blades.
  • Stretching, massage, acupuncture, dry needling or other relaxation techniques to provide relief to tight or overactive muscles.
  • Deep neck muscle strengthening exercises for control, stabilization and limiting the joint movement of unstable joints.
  • Exercise, awareness, taping or a brace to correct poor posture.
  • Prevention advice regarding awkward postures to avoid in future.

In addition, if you have any type of nerve dysfunction, it will be addressed with special care. Depending upon the severity of your problem and its underlying causes, it should be resolved within a few days or a few weeks. Rehabilitation will be based on both treatment and prevention.

Why Does my Neck Hurt?

Although the physical problem originates in the neck, the pain radiates to the head, causing discomfort; the pain signals travel from your neck to the trigeminocervical nucleus in your brainstem and a headache results. Research has shown that neck headaches account for anywhere from 4% to 22% of all headaches treated clinically.

Various musculoskeletal or neurovascular structures in your cervical spine (neck) can be at the root of cervicogenic neck headaches when they are out of balance or malfunctioning. Your neck joints, neck muscles and nerves are the most likely culprits of your neck pain.

  • Your joints may be too stiff or too wobbly – unsupported because surrounding muscles are weak.
  • The joints may also be locked in an abnormal joint position, likely due to poor posture. Given the number of us who sit in front of computer terminals all day, this shouldn’t be surprising.
  • Problems with your cervical disks may also result in pain that radiates from neck to head.

Your neck muscles may work too hard if they are trying to protect injured joints. Over time the balance in your neck muscles changes, causing your head to feel heavy because some of the muscles that should be supporting your head have weakened, while the others have tried to compensate. Neck muscles work best when they have normal resting tension, length, strength, power and endurance.

why does my neck hurt

Common Neck Headache Symptoms

If you are experiencing one or more of these symptoms, you likely have a neck headache:

  • Tenderness at the base of the skull and top of the neck.
  • Neck stiffness or mild loss of movement.
  • Your headache pain radiates from the back of the head to the front.
  • Your headache is centred on one side of your head or the other and stays there.
  • When you apply pressure or massage the base of your skull or your neck, the pain eases.
  • Your headache is lessened or heightened by a sustained posture, neck movement, or sleeping on your stomach or with your head turned to one side.

Given that there are more than 300 known causes for headaches, your physiotherapist may determine that the neck isn’t the cause of your headache. If your symptoms indicate a different cause, they will direct you toward the proper source of treatment.

Is your neck causing you headaches?

shin splint

What are Shin Splints?

What do runners, ballet dancers and military recruits have in common? One trait they all share is a susceptibility to shin splints.

What are shin splints? A shin splint is  actually an inflammation of the tendons, muscles and bones surrounding your tibia, or shin bone. Generally, the pain occurs on the inside edge of your shin bone where your muscles attach to the bone. While any vigorous sporting activity can lead to shin splints, most people associate them with running.

Shin Splits Causes

Shin splints are caused when the leg’s muscles and bone tissue are overworked by repetitive physical activity. There are a number of physical reasons that can turn overwork into inflammation:

  • Excessive pronation of the foot;
  • Increase in strain on a muscle;
  • Overstriding;
  • Local fatigue of the surrounding structures, decreasing their ability to absorb shock and transferring it to the shin bone;
  • Inflexible calf muscles, lessening ankle flexibility;
  • Increasing intensity in training.

People who have flat feet or unusually rigid arches are susceptible to shin splints. In addition, running in worn-out shoes can bring on this unwanted inflammation.

Discuss your symptoms with your doctor. He or she may want to conduct some tests to rule out other shin problems, such as stress fractures and tendinitis.

Shin Splits Treatment

what are shin splints
Unfortunately, the treatment for shin splint requires rest from the activity that caused the inflammation – and that means no running for a while. Recovery can take three to six months.

For anyone working toward a goal, it can be frustrating, but you can substitute other aerobic activity such as swimming or using a stationary bike, to maintain your fitness while you recover. A physiotherapist can help prescribe a course of exercises that will keep you in shape without aggravating your injury.

You shouldn’t return to the activity that caused your shin splint until you are pain free for two weeks.

In the meantime, you should find these aids helpful in treating shin splints:

  • Flexibility exercises: Your physiotherapist can assist you in choosing exercises to stretch your lower legs and ease some of the pain.
  • Range of motion exercises: By exercising your ankles, knees, feet and hips, you can relieve pain, reduce inflammation and improve circulation, which aids healing. Ask your physiotherapist to suggest a course of exercise.
  • Ice: Apply ice packs to your shins for 20 minutes at a time a few times a day.
  • Compression: If you have swelling, a compression bandage may help keep it under control.
  • NSAIDs: Non-steroidal anti-inflammatory drugs such as ibuprofen or Aspirin help reduce pain.

How to Prevent Shin Splints

prevent shin splints
In addition to the discomfort they cause, shin splints put a cramp on your training schedule. If you’re preparing for a big race, there’s nothing more frustrating than delays or obstacles that could keep you from meeting your goal. With that in mind, here are some helpful hints on how to prevent shin splints:

  • Slow and steady. As you train, build up to longer distances gradually. Don’t expect to run five kilometres one week and be ready to do 10 the next.
  • Mix it up. Don’t make running your only activity, given the strain it puts on your joints. Combine it with other activities, such as swimming, cycling or rowing, that give you the same cardiovascular boost without the joint stress.
  • Short and sweet. A short stride length is better for your body and helps prevent shin splint. It also helps you increase speed, since quicker leg turnover leads to speed. Two benefits for the price of one!
  • Make it the middle. Landing flat on the middle of your foot prevents stress and injury. If you run on your toes, your calf muscles may become strained, while striking the ground heel first stretches your shin muscles.
  • Shoe cues. Give your feet the extra support they need by selecting neutral shoes or those that are designed for stability or motion control. Ask your physiotherapist for a gait analysis. If you are striking with your heel or overpronating (turning your foot outward), orthotics in your shoes may help keep you aligned properly by providing arch support. It’s an inexpensive way to keep other conditions, such as plantar fasciitis, at bay, too. In addition, make sure to replace your shoes every 500 kilometres. Worn out shoes are a major cause of shin splints, since the wear and tear erodes their support.

Prevent shin splints, but if you can’t avoid them, follow the proper course of treatment so you don’t do yourself permanent harm.

Are Shin Splints causing you discomfort?