Would you believe that even a banal injury in childhood can affect us and lead to further trouble in adulthood? Did you know that, for example, inguinal hernia surgery in the first years of life, a broken leg or repeated ankle sprains in puberty during football can have a major impact on the appearance of problems even several decades later? Our body has great compensatory abilities. The wound heals and you continue to live your normal life as before. Nothing limits you and you feel that everything is as before. But it doesn’t have to be this way. In a good case, if the injury healed well and you were treated conscientiously and, in addition, you have a good body image, that is, you can work well with the body, then you really could pass without losing a flower. However, such ideal conditions often do not prevail. The injury was either severe or untreated.The extent of the injury is also crucial, but there is no direct correlation that the greater the worse the consequences. The injury could have caused poor joint stability, failure of proper muscle control, or the surrounding muscles and later other tissues fixed it and reduced its mobility. After putting off the plaster, brace or crutches, the body must cope with your requirements for normal movement. He does not protest and prefers to look for a solution. If the segment is still in a protective spasm, i.e. less mobile, something else must move more. For example, after an injury or surgery in the hip area, the hip and ankle will have to compensate for the lack of movement. If the ankle is loose after repeated sprains, the calf must work harder to make up for the lack of stability when stepping on it.
Simply put, the body begins to have more work to do with the movement. However, compensation causes overload in the long run and these again cause additional compensation. It layers on top of each other and so it happens that the structure begins to hurt, which is overloaded, even if it is very far from the original place of difficulty. One would not connect the connection of difficulties at all and would solve a place that currently hurts. But if the therapy focuses on this place, the difficulties will still return. You will accept that the cervical or lumbar spine hurts with age and sedentary work. You will accept that it is normal to keep yourself in working order with regular massages and a sauna. But there is a key to all the troubles. And if you haven’t let it go too far into the form of major structural changes, then a complete cure is real. However, it is necessary to remove all layers of compensation, as with peeling onion peels. Great methods for such layering of problems are the method of dynamic neuromuscular stabilization of DNS and fascial manipulation techniques.

Článek How does the body cope with injuries? se nejdříve objevil na BeBalanced.

The issue of tennis and golf elbows is one of the so-called enthesopathy, which is a designation for inflammatory changes in the tendons, ligaments and joint capsules into the bone. These pains are referred to as tennis or golf probably because of the more frequent occurrence in athletes, but in fact they are at least as common, for example, in people working long hours at the computer with a mouse or after demanding manual work.
Pain can most often be felt by patients on the outer and inner side of the forearm, in the place where the muscles that stretch or bend the wrist and elbow joint are clamped. The first symptom is often pain when palpating this place, later it hurts when lifting heavy objects and loads or when grasping. In very acute difficulties, the place may also be swollen, reddened and have an elevated temperature. Characteristic for these problems is also that the pain at rest subsides and with effort returns again. Sometimes they can even shoot into the forearm, fingers or vice versa into the shoulder. It is especially important for the treatment of pain of this type to visit a physiotherapist as soon as possible, who will thoroughly examine not only the area of the upper limb, but also the whole body and can thus determine the true cause of the pain. It is very often not only in the place of pain, but can originate either in the area of the shoulder joints and shoulder blades or even in the cervical spine or ribs.Muscles are overloaded due to the fact that their tendons are not well stabilized. The stabilization disorder is usually transmitted from the center of the body along individual structures and manifests itself to the periphery, because it is very burdened. Treatment and therapy then proceeds according to the findings, but very effective at the beginning to relieve pain is targeted massage and relaxation of the forearm muscles, which are in higher tension, rest regime, icing of the affected area and kinesiotaping. Purely local treatment, however, is not effective and does not bring long-lasting relief. It is necessary to eliminate the cause, which is always outside the place of pain. Very effective is the method of dynamic neuromuscular stabilization, techniques of manual medicine and fascial manipulation.

Článek Tennis and golf (javelin) elbow se nejdříve objevil na BeBalanced.

Achilles tendon pain is one of the most common injuries not only of runners, but also of other athletes, mainly athletes, football players, cyclists. These difficulties can develop gradually or appear suddenly after a major workout or inappropriate sharp movement. The problem in the Achilles tendon often develops over a long period of time, long before you start to feel pain. The sharp, uncoordinated movement that triggered the pain in the Achilles tendon is often the last straw, when the pain until then subliminal, increases and you begin to perceive it.

Chronic Achilles tendon pain has been found to be accompanied by degenerative tendon changes, not chronic inflammation, as is often reported. Thus, anti-inflammatory treatment has no effect (drugs with anti-inflammatory effect, icing, etc.). The so-called sterile inflammation can accompany degenerative changes in acute microtraumatization of tendon fibers or overload of tendon sheaths. Around the Achilles tendon then appears swelling, possibly redness and local increase in temperature. In this case, of course, the suppression of inflammation makes sense, but such a phase usually lasts only a week.

Difficulties with the Achilles tendon are most often manifested by such symptoms:
• the feeling of a stiff tendon in the morning, within a few minutes or tens of minutes passes
•stiff Achilles tendon at run-up/at the beginning of training
•tendon pain, in lighter cases it appears only in the morning or at the beginning of the load, in the worst case it appears even after the load and in the most severe case it is even during normal daily activities or even at rest
• swelling of the tendon, most often in its middle third, which forms a ring around the tendon, or a thickened surface of the tendon in a certain part of it
• burning pain when pressing on the tendon, can be in its various parts

Of course, the Achilles tendon of runners or other athletes is very burdened. But why do only some of them have these problems, and why do non-sports suffer from these difficulties? The cause is not in the excessive load, training surface or shoes. The cause is in the musculoskeletal system itself and, moreover, often very far from the place of pain. If you want to solve the protracted problem with the achilles, you can not treat the achilles, but the place of the disorder.

We successfully treat Achilles tendon pain.

Certain functional disorders of the musculoskeletal system lead to an increased or uneven load on the Achilles tendon and thus predispose it to traumatization and the development of degenerative changes. The extent of these changes and difficulties is then probably due to functional disorders and other influences, such as the type of physical activity performed, shoes used, age, hormonal changes, etc., but these are secondary.

Let’s take the example of a recreational runner with age-old achilles pain. He hurts both of them, in the morning he is stiff that he can not go down the stairs, but within half an hour he breaks up. It hurts at the beginning of the run and then at the end. Running has to be a little restrictive. He has already tried everything – ultrasound, laser, shock wave, ice, compresses, anti-inflammatory drugs, exercises on the arch and on unstable surfaces. Some of it helped for a while, some of it was without effect. He already takes such troubles as a necessary part of aging, even though he is a fresh forty-year-old.

Then it gets into the hands of doctors for acute back pain. Problems with achilles do not even occur to him to mention, because he does not know that the two problems may be related. However, the physiotherapist reveals the problems with the achilles because he sees the connection. The master has a planted pelvis, overloaded loin, failure of the deep muscles of the trunk, on the contrary, overload of the superficial ones, unprimanded thoracic spine and very tight hamstrings and calves.The disorder in the posture of the pelvis and spine secondarily created tension in the lower limbs, namely on their back side, and the resulting tension is directed directly through the achilles to the heels.

In the body, by its coordination, it has created such changes that lead to overloading of the lower back. However, the body is able to compensate well for its shortcomings, so back pain has only now appeared. But long-term achilles pain tells us that the problem in the musculoskeletal system was long before that. In therapy, we do not focus on the achilles at all, but on the problem in the trunk.It is necessary to improve the position of the pelvis and spine, and in the next row to remove secondary changes in the lower limbs – that is, to relieve tension directed to the heels. And then just teach the runner to move a little differently – to straighten up while running, optimize the frequency of the step and learn how to use the feet. Running does not need to be changed immediately and from the ground up. It is enough to exercise before 10 minutes, sometimes remember a better style while running and practice it for a few minutes and after finishing he will work out a little again. The results will not be long in coming.

We can also help you effectively. Read more here.

We are preparing this series for you in cooperation with Sport.cz

Dagmar Lisá

Článek Achilles – Achilles‘ heel of runners se nejdříve objevil na BeBalanced.

Periostitis, Achilles tendon pain, foot pain and other inconveniences caused by suboptimal stepping

Inflammation of the periosteum – periostitis–most often it appears on the shin. The bone envelope, which is richly innervated, is overloaded by repeated and mainly impact work of the muscles that are attached to this bone. Like any overloaded structure, it gets into the so-called sterile inflammation, hurts, can turn red and swell. In the acute phase, it is good to ice, manually relax the relevant muscle and slightly stretch after the acute phase subsides. It is often reported that it is caused by running over a hard surface. But the culprit is not a hard surface, but an unideal and inconsiderate running technique.

Achilles tendon pain/inflammation – it is manifested by tendon pain directly during running, more often after it or only the next morning. As a rule, a ring is formed on the tendon – swelling. She is very sensitive to touch, stiff in the morning. Again, this is a sterile inflammation that develops for a long time. With an uneconomical and incorrect style, tendon wear occurs, and thus small cracks and degenerative changes in this area occur. Again, the cause of the problem is related to the running style. It often appears, for example, in connection with the incorrect function of the foot – reflection from the thumb, the work of the fingers or areas of impact on the sole of the foot. Therapy in the acute phase is identical to the therapy of inflammation of the periosteum.

Foot pain – plantar fasciitis– it is manifested by pain when the muscles of the foot (fascia) are attached to the heel. The pain increases with stretching of the fingers. It is an overload of the muscles in the area of the sole of the foot, their incorrect involvement during running, incorrect biomechanics of the foot. For example, difficulties can occur during a quick transition to minimalist shoes, when the foot is not enough to get used to a completely different run. The most risky group of runners is with the so-called pronation impact, but also those with a high arch and a very stiff leg.

The common denominator of the above mentioned problems is incorrect biomechanics of the foot, pedaling and posture when running. The images show three types of impacts.
The first is most common among novice runners. This is an impact far in front of the pelvic area (the center of gravity of the body) and on the heel. In the picture there is a better variant of this step, the worst is if the knee is completely stretched, so-called locked. In this case, the knee does not work to eliminate the impact on impact, and the likelihood of trouble arises. With such an impact, your heel collides with the ground, and the heel acts as a brake on this force. The impacts are then dampened by the heel or transferred to the tibia or knee. The exposed areas become overloaded, small cracks in the tissue are formed, and after further overloading, chronic inflammation.

The next picture shows a slightly better type of pedaling, but even this one still leads to trouble. This is what it usually looks like when the so-called.“ heeler“ wants to go into running over the toes. The length of the stride remains almost the same, or it has only been slightly shortened and the impact is on the stretched foot. The hull setting is the same, so the impact is still ahead of the center of gravity. The tip of the foot in this case must absorb the entire impact, it must be held by the calf muscle. He is then classically after such a run very strained and injured by rapid contractions with bumps. Also, the transverse arch may hurt. Often this occurs in people who put on barefoot shoes and began to run over the toe without changing the other parameters that barefoot running should have.

The last photo shows the optimal impact for injury prevention and the economy of running. This is achieved by increasing the tilt of the whole body. I mean the whole body, really the whole body, from the ankles to the head – so it’s not a break at the waist and pushing the pelvis back. The impact should be on the front of the foot, not on the toe. The tilt itself will already lead us to shorten the step and increase its frequency. A person unusual to the correct frequency of the step feels that he is twitching. It is only necessary to overcome the first phase of the habit before you fix the run as natural.

You can also get comprehensive information about running from the perspective at the all-day running workshop with Petr Soukup

Read on to find out the difference between stepping diagnostics and running diagnostics.

We perform analysis/diagnostics of running with training in proper running technique. After adjusting the run, the pain often disappears immediately.

Článek The most common running foot injuries se nejdříve objevil na BeBalanced.

Are you looking forward to training, running, but are you forced to interrupt or end it because again, after the same distance or time of running, your knee has sounded? It hurts externally under the patella, at about thirty degrees of bending and more. When running downhill, it gets worse. The paradox is that you do not have to have difficulties in other sports. It is likely to be a very common iliotibial tract syndrome (ITB syndrome).

Why a knee?
If you suffer a running injury, it will most likely be a knee joint. Difficulties in this area are confirmed by over 30% of injured runners. Interestingly, however, the root cause of the problem usually does not lie in the knee itself. Often there are problems from other parts of our body. For example, if we don’t use our foot and ankle to cushion bumps when stepping on, we’ll have a higher risk of knee pain after a long run. If we have back pain or poor posture, there may be an inadequate load on the knee and then subsequent difficulties. Therefore, although it seems paradoxical, we do not always have to work directly with this joint when treating the knee joint, but on the contrary, with other parts of our body, and the effect of the therapy will still come.

What is ITB syndrome?
The syndrome of the iliotibial tract is caused by excessive rubbing of this ligamentous strip against the bony protrusion on the tibia. Over time, sterile inflammation can occur here, which is a source of pain. Why does this phenomenon occur? The causative agent is usually increased tension of the iliotibial tract or muscle (thigh ligament tensioner), which is clamped into it.
This increased muscle tension occurs when our musculoskeletal system is out of balance. For example, the different length of the limbs may be to blame. Usually these are runners who have problems in the hip joint area and with pelvic stabilization. Poor pelvic stabilization can manifest itself externally in an abnormal running style. In a runner, for example, there may be a significant decrease in the pelvis in the vertical plane or an increased internal rotation in the hip joint. All these deviations can then increase the chance of overuse injury.

How do I deal with this?
The fact that I have increased tension of these tissues does not necessarily mean that I have already developed inflammation. In the thigh ligament tensioner, for example, there may be only a trigger point, which causes pain and higher tension of the fascia. The tension of the entire area of the outer thigh (from the hip joint to the knee) can be reduced, for example, by massage, stretching or kinesiotap.If the trouble keeps returning, it would be appropriate to diagnose why this phenomenon occurs and, based on this, to establish compensatory exercises. There are many ways to exercise, among the very effective is the method of dynamic neuromuscular stabilization (DNS), based on developmental kinesiology. This method will solve the cause of your difficulties, which is its advantage over other methods, such as classical analytical strengthening.

Postponing treatment does not pay off!
If you are one of the runners who are struggling with this phenomenon, you are in danger of developing inflammation. If, during the usual training doses, you feel the above-mentioned discomfort, which always somehow subsides on its own (or after a day off or massage), it means that it is your weak point. If there is any extreme load, there is a risk that you will not be able to compensate for your handicap and you will develop ITB syndrome.

An example would be a runner who has the symptoms described above during a standard workout. He decides to run a mountain run or ultramarathon. After the race, the attachment of the iliotibial tract is painful to the touch, has a higher temperature, pain is even when walking. In this case, it is probably an inflammatory reaction. It is advisable to indulge in peace, use tayping, manually release adjacent tissues, not be afraid to use nsaid anti-inflammatory drugs (brufen, ibalgin) for several days. The place can also be iced. After a few days, it is good to start compensatory exercise or perform physical activity that we know will not cause our pain. Start running only when the pain subsides, e.g. when walking.
If you do not treat this phenomenon and try to run with pain, then give yourself time off and run with pain again to no avail, there is a risk that the inflammation will go into a chronic stage.
If your problem persists for several months and you feel that exercise or a change in e.g. running technique does not help, it is advisable to see a doctor and consider, for example, the application of corticosteroids. Still, it’s important to exercise, corticosteroids will help remove inflammation, but not the cause that triggered it.

Článek ITB syndrome – pain on the outer side of the knee se nejdříve objevil na BeBalanced.

Foot diagnostics versus running technique diagnostics

• pain in the Achilles tendon, ankle, heel, shin
• knee pain when running
• ITB syndrome
• pain in the hips, groin when running and walking
• back pain, cervical spine
• herniation of the disc in the lumbar spine
• poor running efficiency

Mohlo by Vás také zajímat:

• Run Analysis and Diagnostics
• Disc herniation and sports
• How does the body cope with injuries?
• Tennis and golf (javelin) elbow
• Thoracic spine in cycling
• Sports Stress Test
• How to get started with running
• Center of the body, core, get to know each other! Can we really engage him?
• Ultramarathon from the perspective of a physiotherapist
• Leakage of urine during sports, a problem that is not talked about

Článek Pedal diagnostics versus running diagnostics se nejdříve objevil na BeBalanced.

As a rule, this happens during a faster run or during a race. Unbearable prickly pain in some part of the abdomen. Either it can be in the hypochondrium or in the middle part of the abdomen, most often in its upper part or around the navel. Pain comes from the abdominal muscles. You feel them being withdrawn and not being released. Even breathing itself hurts. You try to breathe it out or knock it out, but nothing helps.

What causes this pain and why does it regularly bother you?
We told ourselves that the pain stems from the contracted superficial abdominal muscles. Most often these are oblique abdominal muscles or a direct abdominal muscle. The classic stinging in the side probably has a different origin. Rather, it is a contraction of a certain part of the diaphragm. There are also theories that the stinging in the side comes from the shells of internal organs (liver or spleen), which do not manage to respond to the rapidly increasing load. But that’s another question, and we’re going to deal with cramps in the abdominal muscles. Further, abdominal cramp can be caused by the load of accelerated peristalsis, but you will soon know the origin of this pain, so there will be no talk about it either.

Why does this spasm of the abdominal muscles arise?
It is not a spasm originating from a mineral imbalance, such is usually on the muscles of the lower extremities, in which the metabolism is highest during the course. This pain arises from the suboptimal involvement of the muscles of the trunk and diaphragm and the suboptimal breathing stereotype. The muscles of the trunk should work so-called eccentrically, that is, in stretching. The opposite of such work is concentric contraction, that is, pulling inward.

If you’re running faster than your comfort zone and you have to exhale hard to breathe in as soon as possible, you’re just pulling your belly in, concentrically. On inhalation, the muscles should stretch, but if the muscles are permanently contracted and the diaphragm does not work fully, the muscles do not stretch even on inhalation. Thus, they remain still concentrically withdrawn. The more we withdraw them in this way, the sooner we will get to the spasm. And since we always have a certain asymmetry, the sheaves on one side are always pulled down more than on the other. Those who work more will be prone to cramps earlier.

READ ALSO: Running injuries – understand their cause and start from the brain
But it also depends on the position of the spine. If you are hunched in the thoracic spine, you have a pulled upper abdomen. This position of the spine alone prevents the front part of the diaphragm from breathing and the possibility for the abdominal muscles to stretch when inhaling. On the contrary, with exhalation, you pull the upper part of the abdominal muscles inside. Then there is a pain in the middle under the breast bone.

If you „squeeze“ at the waist while running, i.e. you rotate your shoulders a lot towards the pelvis, the oblique abdominal muscles will be contracted again, so you will get the spasm rather to the side.

The situation will be even worse if you suffer from allergies or asthma. In this case, the airways are narrowed and resist exhalation. This resistance must be overcome by greater work of the exhalation muscles, where the abdominal muscles belong. It can happen even if you are taking allergy medication, or you have only a very mild allergy, in fact, you do not even know about it, but under stress in nature, the airways swell and this causes resistance to exhalation.

What to do?
We have already discussed how the muscles of the trunk (a complex of abdominal muscles, diaphragm and back muscles) should be in the article Center of the body, core, get acquainted! Can we really engage him?

A FEW TIPS TO GET RID OF PAIN
• Two days before the race, do not strengthen the abdominal muscles, do not do would-be exercises on the center of the body (plank, etc.).
• Learn to breathe into your abdomen while running slowly, and try it gradually while running fast.
• Do not increase the load too much, or if it is a race, go rather slower and accelerate as the end approaches (there is nothing worse than going fast and creating a cramp, with which you will then run the whole race, albeit slower).
• If you get a cramp in the abdomen, it pays to stop for a while, lean forward and push intensively into the painful place and massage it, at the same time try to breathe through the abdomen, there is hope that this procedure will completely get rid of the pain.
• Do not underestimate allergies or asthma and rather take medication for them at least in connection with the load, because it is possible that you are otherwise unconsciously changing your breathing stereotype and muscle tension in the chest and abdomen.

We are preparing this series for you in cooperation with Sport.cz.

https://www.sport.cz/behani/ladime/clanek/827880-jak-na-krece-v-brisnich-svalech-pri-behu.html#section-artcl

Dagmar Lisá

Článek How to treat cramps in the abdominal muscles while running? se nejdříve objevil na BeBalanced.

Center of the body, core, get to know each other! Can we really engage him?

In all gyms, it offers us lessons focused on the center of the body. Everyone is now aware of the importance of the function of strengthening the center, but few people know what function it really is and an even smaller part of us can engage and use this function.

First of all, it is necessary to say that strengthening the core is not about pulling in the abdomen. If you pull in the abdomen and thus contract the abdominal muscles, you divide the upper and lower half of the body exactly in its center, which at that moment becomes the weakest link of your body. But you wanted to strengthen it, didn’t you?

Try!
Try to tighten your waist with a rubber band for exercise. Tighten the belt so that it grips you. This is how we often contract and feel that we are also strengthening. Now try to lean into the rubber, that is, squeeze it out. In addition, try to breathe into the rubber, this will stretch it a little. You will need to take a breath through the diaphragm and push it like a piston down. Then exhale freely. When you are sure in the first phase, i.e. filling the rubber and inhaling into it, try not to let go of the exhalation, not to let the rubber cut in half, constantly keep your belly actively filled against the pressure of the rubber that wants to chip you. This is the real involvement of the center. Your body center is firm at this moment, but at the same time dynamically flexible. Your spine is well supported from the front by filling – pressurization in the abdomen. Only now the foundation, the frame of movement, is formed. If you start running and keep the center of your body filled in this way, you will run easier, you will not sit in the run, but you will actually run upright. So, this is the first condition of quality involvement of the center, it can be trained anytime, anywhere.

IT WILL COME IN HANDY: Groin pain – Exercises

What muscles make up the Core/center of the body?

Core is not only the muscles of the abdomen, but the interaction of the deep muscles of the abdomen, pelvic floor and especially the diaphragm. The diaphragm is a key muscle here, without the involvement of which strengthening cannot be achieved. The diaphragm works like a piston that compresses the abdominal organs. The diaphragm, which is convex upwards at rest, flattens with a breath and presses perpendicularly down into the organs of the abdominal cavity until it leans against them. If the diaphragm pushes really perpendicularly (the idea of inhaling into the pelvis), the abdomen extends in all directions, not just forward. But the abdominal muscles gradually increase their tension, so the diaphragm can no longer push further down and begins to stretch the lower ribs to the sides. Thus, the pressure of the diaphragm down activates the abdominal muscles, especially the transverse ones, deeply stored. It also activates the deep back muscles. By pushing down, it presses against the pelvic floor, which also engages. With the exhalation, the walls of the fuselage come back a little, but a certain amount of pressurization is still maintained by the diaphragm. The abdomen must definitely not pull in with the exhalation!

When you imagine the hull as a barrel, you can see that all its walls are active and strengthened, but not pulled inward. The barrel is filled and pressurized. And this is precisely the desirable hardening. However, this involvement of the body center brings a number of other benefits. Good involvement of the diaphragm will ensure proper breathing and the use of full lung capacity. In addition, the pressure of the diaphragm down constantly massages the internal organs, and this contributes to their better blood circulation and work.

How to start with Core/Center body exercises?

This interplay of muscles must first be learned in simple static positions. It is ideal to lie on your back with your legs raised or sit down. In a standing position, the center of the body is harder to engage, due to frequent suboptimal adjustment of the pelvis. If the pelvis is tilted a little more forward, which it often is, the diaphragm cannot push perpendicularly into it, but pushes forward, creating pressure in the lumbar spine and there is no symmetrical involvement of all the walls of the trunk.

CORE EXERCISES FOR INSPIRATION
Climbing on fours. Perform kneeling on four like a cat. Check that the wrists are directly under the shoulders and the knees under the hips. Lean on your fingers and remove your knees from the mat. Lighten your arm and leg diagonally. Nothing else will move. Then take a step forward. Then replace your arm and leg and slowly move forward, but the priority is still a straight spine, a motionless torso and filling the center of the body.

Try the following in the car or while sitting at work: Put your hands on your hips, your thumbs back under your ribs, your fingers over your groin, and try to squeeze your fingers out of your belly with your breath. Be careful, it is not a clenching of the muscles under the fingers, but their displacement. Throughout the inhalation, you should feel this filling. The challenge will then be exhalation. The abdomen must not be pulled in. It may drop back a bit, but keep the filling in it. With a breath, fill the belly again.

Gradually, you can increase the difficulty of the exercise. The ideal is then to get to a dynamic movement, but in which you really keep the center of the body.

This series is being prepared for you by Rehabilitation BeBalanced Prague 6 in cooperation with Sport.cz.

Klára Komárková, Dagmar Lisá, Sport.cz

https://www.sport.cz/behani/ladime/clanek/818906-stred-tela-core-seznamte-se-umime-ho-opravdu-zapojit.html#section-artcl

Článek Center of the body, core, get to know each other! Can we really engage him? se nejdříve objevil na BeBalanced.

A sprained ankle is an injury that we often do not pay much attention to and consider it a banal injury. Some suffer from it very often, reducing the duration of treatment to a minimum. Unfortunately, we have no idea that even this common injury can have a big impact on our way of moving in the future. We will look at this problem in more detail. What actually happens with this injury?

Professionally, spraining the ankle is called ankle distortion. Most often it is an excessive deviation of the outer ankle outwards. On the outside of the ankle, the ligaments are weaker than on the inner. Excessive movement beyond physiological boundaries leads to a certain stretching or injury of these ligaments. This injury can be divided according to the weight into 3 degrees:

1st degree – minimal stretching of ligaments – ligaments have stretched more than physiological, but they have not been torn, in this case the ankle slightly swollen, the swelling disappears in 2-3 days.

Stage 2 – stretching of a larger number of fibers to their minor ruptures – there has already been a tearing of a smaller number of fibers, swelling persists longer, a significant hematoma is formed and the mobility of the foot is partially limited

Stage 3 – complete rupture – the ligament is largely torn, the leg is significantly swollen, the hematoma is large, on both sides and above the ankle and persists for more than a week, the hock is unstable

What are the consequences?
The greatest consequences arise in the case of severe sprain, despite the fact that if the therapy was conducted, that is, the ankle was fixed with gypsum or orthosis for a sufficiently long time. However, very frequent slight sprains can also have great consequences. You may not even feel the effects of an injury until many years later. The classic case is that of a man who played football or volleyball in his youth and ankle sprains were the order of the day. Then he didn’t do much sports for a long time and at the age of fifty he decided to start running. Repeated vertical load on the foot, however, will make visible the problem that the athlete carries with him from his youth.

The ankle becomes chronically unstable and is more prone to further injury. The work of the muscles in the leg area changes significantly, which is very noticeably reflected on other areas of the body.

First, by injuring part of the ligaments, the mechanical strength of the hock decreased. Secondly, the ligaments of the hock contain a large number of receptors that inform the brain, which thanks to this information controls the involvement of the muscles of the foot. The rupture of the ligaments reduced the number of receptors and the fixation of the hock also reduced the activity of functional receptors, so that the overall information of the brain was reduced and slowed down. Therefore, the activity of the muscles has changed. The muscles are less responsive and are unable to react quickly and keep the leg firm when stepped on the bump. And thirdly, by injury, swelling and irritation of the painful receptors of the foot, there was a malfunction of the function of the foot in its joints. The resulting blockages with subsequent stiffening of the ankle limit its mobility and this must be replaced elsewhere.

So how to properly treat a sprain?
After the injury, it is best to immediately ice the foot, immobilize it with a bandage fixation and put it in an elevated position. It is necessary to lighten the leg. If the swelling and hematoma are mild, you can heal the ankle at home. It is important to catch the first stage and strictly follow the recommendations above. After the most acute phase subsides, i.e. after about three days, it will greatly help to remove the swelling of the lymphatic drainage, relax the soft tissues of the foot and mobilize the joints of the foot. Very pleasant and very helpful is kineziotejp. The latter can help both to improve lymphatic drainage and to mechanically strengthen the ankle. Taping is advisable for quite a long time until you feel that the ankle is fully functional.
In the case of the second degree, it is necessary to lighten the leg longer and fix the foot with an orthosis. Lymphatic massage and joint mobilization will also help a lot. It is advisable to start practicing with the foot after three days – to pull and stretch the toe, move the toes, make pinches, lift objects with the help of fingers from the ground. All these exercises will help to remove swelling. Mainly, however, they keep the foot active, i.e. information is sent from it to the brain, which prevents functional depression of the foot.

In the case of the third degree of damage, it will be necessary to have a fixed fixation of three to six weeks with the need for full lightening. However, it is not good to overdo it on the other hand with fixation and lightening. It was found that the load helps to form the correct setting of regenerating collagen fibers. If you save the foot too much, the collagen fibers will not have a stimulus to properly arrange and so the resulting scar will not be strong and the ankle will not be strong enough.Therefore, it is good to fix the foot, but gradually begin to load it.

When to start to load fully, depends on the degree of damage to the ligaments. It can be in a light case immediately or only after the fixation is removed. However, you must not burden it so that it will swell. Slowly test what the foot can do without overloading. Exercise is a necessary component. Walking alone will definitely not break up and warm up your foot! It is necessary to restore the full function of the foot. Exercise with your fingers, practice toe straps, stretch your instep and ankle. It will help to practice various modifications of walking – walking on tiptoes, on heels, walking sideways by crossing the legs.

It is only during these actions that one discovers how stiff the leg is, how clumsy it is and how you have lost control over it. The foot also needs to restore its equilibrium functions. So start with lunges and weight transfers over the affected leg, gradually it is good to try on some unstable surface, lens or line. Balance exercises are important to stimulate the activity of receptors that are stored in the ligaments and ankle joint. The foot will then be able to react quickly to a sudden deflection. Do not rush with running too much, first restore the full function of the foot. Then slowly test what the leg can run without pain and subsequent swelling.

Dagmar Lisá (Mostecká)

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