Foot sprain or otherwise stroke

11/12/2019

An ankle sprain is called the traumatic rupture (cross-section) of various joints of the joint, but without fracture to the bones. Sometimes, however, an ankle sprain coexists with a bone fracture, so it is a minor traumatic injury. The word "sprain" is ancient Greek, derived from the verb "twist" (by + twist = twist, distort). In modern Greek, the word "sprinkle" is called "twisting" or "twisting" (Italian etymology from strambare and strangolare) and is incorrectly translated into dictionaries as "dislocation".

Springs degrees

If the problem is serious, exercise or walking should be stopped immediately and a flexible compression bandage placed on the ankle joint and the patient assured that there is no fracture. If in doubt, an Orthopedic examination should be performed. If a fracture is suspected, the foot should not be pressed to the ground until an X-ray is obtained. Behind an "innocent" sprain of the ankle joint may be: forearm fracture, ankle fracture, hammer fracture, tarsal fracture, metatarsal fracture, cartilage fracture not visible in x-rays, and bladder damage Salter), significant tendon or ligament ruptures, etc. Some of these require surgical treatment. In the past, some sprains of the foot, even second-degree sprains, were treated with heel plaster and crutches for a month. This method has been abolished because it has been shown to have many complications and significantly prolong the patient's recovery time. Likewise, several sprains of the ankle sprained undergoing ligament surgery. Swedish research in the 1970s proved that surgical treatment did not outweigh the conservative. So today the "pure" sprains of the ankles are treated with the so-called "rapid mobilization method", which has proven both effective and fast.Second-degree sprains are always treated conservatively with immediate stopping exercise and compressive immobilisation. A warm bath and gentle exercises from day two are allowed. Walking is permitted from the first day with restriction and partial charge (1 crutch) for 5-10 days and initiation of special editing and discharge techniques. If there is significant pain and edema (swelling) they are administered for 5-10 days anti-inflammatory non-steroidal drugs, and sometimes a plastic stabilizer is used. Some cases require physiotherapy, in addition to the hot bath and exercises. Generally, sprains of the second degree ankle are clinically restored within 15-20 days. Sport is allowed for 20-30 days.If an ankle sprain (fracture-free) is not fully repaired within 3-6 months and the patient complains of swelling, stiffness and difficulty in exercise, then one of the following problems may occur: cartilage fracture intra-articular, post-traumatic osteophyte, posttraumatic intraarticular scarring, free osteochondrial body, osteochondrial defect, scaling osteochondritis, aseptic bone necrosis, various arthritis etc. In these cases CT scan, MRI and arthroscopy are needed at a special Orthopedic Center.

The sprains of the ankle joint are clinically distinguished in three degrees according to their severity. The statistical distribution between the three groups is practically impossible, as patients with first-degree sprain usually do not go to the doctor and self-treat. However, it is estimated that 80% is first grade, 15% is second grade and 5% is third grade. Frequent ankle fractures are always accompanied by rupture of the joints. The classification of sprains is as follows:

  • 1st degree sprains: Slight rupture, extension of ankles (Ankle Strain)
  • 2nd degree sprains: Partial rupture of ankle sprains and ankle sprains
  • 3rd degree sprains: Complete rupture of joints (Ankle Ligament Tear, or Sprain).

Clinical picture

The clinical picture of ankle sprains varies depending on the stage of the injury, but also on how long the injury has passed. The simplest case of sprain is to "turn" one's foot lightly while walking and continue walking undisturbed, and the worst case is to make a total hematoma joint rupture, sometimes reaching 500ml. The patient is either an athlete who has a knee injury, a worker or a walker. The clinical picture includes pain, edema (swelling), hematoma, bruising, stiffness, and lameness (the patient cannot walk easily).

Approach errors at the ankle sprain

Initial treatment of a sprain of the ankle at the accident site is the most important parameter in the treatment of these injuries. There are also many mistakes or omissions. There, three strategy steps need to be completed and three questions answered:

  • First, what does the patient have? Fracture or sprain?
  • Secondly, do you need to stop or not?
  • Third, do you need a doctor and special treatment or not?

At this stage, there are a lot of mistakes due to half-learning, but also because - wrongly - the peduncle sprain is regarded by the people as something "simple". The case of a well-known AEK footballer in 1987, who played with difficulty in the ankle joint for two months, was widely regarded as a sprain. All non-specialists, except for an orthopedic doctor, had dealt with him, and when he finally decided to go to Accident Hospital, it turned out that he was playing with a Peron fracture, which most people think is unthinkable while it is happening. Strategy mistakes are often made by doctors and even orthopedists, while many diagnostic and therapeutic myths still remain in place, which should have been eliminated for years. For example, the sprain of the ankle is intertwined in everyone's mind with some therapeutic "cooling", "ice therapy" until frostbite, intensive, immediate "physiotherapy" rehabilitation, with plaster and crutches for 1-2 months, with surgery. Most of the above are errors. The sprain is a mild or severe injury, where the sole turns outward or inward, with parallel pruning or hypnosis, and causes rupture of some ankle joints. This rupture slowly or quickly causes local bleeding and edema. Then the body tries to heal the damage and it is caused by pain, bleeding and edema and inflammation, a stiffness of the joint that results in the patient being disabled. All therapeutic measures are aimed at preventing these complications and accelerating recovery.

First aid in the accident area

If the problem is serious, exercise or walking should be stopped immediately and a flexible compression bandage placed on the ankle joint and the patient assured that there is no fracture. If in doubt, an Orthopedic examination should be performed. If a fracture is suspected, the foot should not be pressed to the ground until an X-ray is obtained. Behind an "innocent" sprain of the ankle joint may be: forearm fracture, ankle fracture, hammer fracture, tarsal fracture, metatarsal fracture, cartilage fracture not visible in x-rays, and bladder damage Salter), significant tendon or ligament ruptures, etc. Some of these require surgical treatment. In the past, some sprains of the foot, even second-degree sprains, were treated with heel plaster and crutches for a month. This method has been abolished because it has been shown to have many complications and significantly prolong the patient's recovery time. Likewise, several sprains of the ankle sprained undergoing ligament surgery. Swedish research in the 1970s proved that surgical treatment did not outweigh the conservative. So today the "pure" sprains of the ankles are treated with the so-called "rapid mobilization method", which has proven both effective and fast.

  • 1st degree sprain treatment

This simple case is always treated with conservative treatment, which includes elastic bandaging for 5-10 days and massage techniques. This bandage is applied during the day and is removed at night. A warm bath and gentle exercises from day two are allowed. Walking is allowed freely from day one. Usually the first degree sprains are fully restored within about 7 days. Exercise is allowed approximately 10 days after injury.

In any case you should consult your Therapist and your Physician for instructions

  • 2nd degree sprain treatment

Second-degree sprains are always treated conservatively with immediate stopping exercise and compressive immobilisation. A warm bath and gentle exercises from day two are allowed. Walking is permitted from the first day with restriction and partial charge (1 crutch) for 5-10 days and initiation of special editing and discharge techniques. If there is significant pain and edema (swelling) they are administered for 5-10 days anti-inflammatory non-steroidal drugs, and sometimes a plastic stabilizer is used. Some cases require physiotherapy, in addition to the hot bath and exercises. Generally, sprains of the second degree ankle are clinically restored within 15-20 days. Sport is allowed for 20-30 days.

In any case you should consult your Therapist and your Physician for instructions

  • Treatment of 3rd degree sprains

The sprains of the third degree ankle are considered quite serious. In the past, two treatments had been suggested: first a ligament surgery and one a conservative plaster immobilization treatment. It is advisable for those who are professionally involved in sports to have a regular checkup of the foot to determine if there is any instability. Major - Severe instabilities tend to be managed in specialized centers. After many years of disagreement, it has been shown by large double-blind studies by Swedish Orthopedics that the end result is almost similar, whether the patient is operated on or treated conservatively. Thus, from 1990 onwards, conservative treatment with gypsum and crutches has begun to prevail internationally, even for professional athletes. For the last 15 years the "rapid mobilization method" has gained ground. The ideal treatment is as follows: in the first 10 days, elastic compression is used and at the same time a ready-made splint of either foot or other type is used. The patient walks with 2 crutches uncharged. A warm bath is allowed from the second day. After ten days, gradual walking is allowed and treatments begin. The patient can work after 15 days. Returning to sports is usually possible in 30-60 days. These patients usually present with some complications from this severe injury, the most common of which is recurrent instability due to instability. There are three solutions to this problem. One is the specific exercises to strengthen the dynamic stabilizing tendons and muscles. The second solution is to wear protective splints when practicing and the third solution is the fixation-tendonoplasty surgery.

Chronic ankle sprain pain

If an ankle sprain (fracture-free) is not fully repaired within 3-6 months and the patient complains of swelling, stiffness and difficulty in exercise, then one of the following problems may occur: cartilage fracture intra-articular, post-traumatic osteophyte, posttraumatic intraarticular scarring, free osteochondrial body, osteochondrial defect, scaling osteochondritis, aseptic bone necrosis, various arthritis etc. In these cases CT scan, MRI and arthroscopy are needed at a special Orthopedic Center.

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In any case, Konstantinos Vaitsaras, who has extensive experience in approaching the ankle sprains and specializing in Physical, Medical and Complementary Therapies, can give you all the information you need to deal with it.

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