What you need to know about ankle sprains

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What you need to know about ankle sprains

 

To properly treat an ankle sprain it must be determined that the ankle is indeed sprained, and this requires an understanding of the condition.

What is an ankle sprain?

An ankle sprain is a common injury and usually results when the ankle is twisted or turned (inverted). The term sprain signifies injury to the soft tissues (usually ligaments) of the ankle.

What is a ligament?

It is a tough band of tissue that helps connect bones together. The specific ankle ligaments that are affected are the anterior talofibular, posterior talofibular and calcaneofibular ligaments. The inward movement of the ankle results in a stretching and tearing of the anterior talofibular and calcaneofibular ligaments. These two ligaments prevent the ankle moving forward or inwards.

Degrees of ankle sprains

A minor sprain is an over-stretch of the ligament/s and tenderness will result.

Next would be a partial tear of the ligament/s which can result in minimal bruising and swelling.

The last degree is a complete tear of one or more ligaments which will result in an inability to place weight on the ankle as well as acute bruising and swelling.

There is a condition which is the most severe form of an ankle sprain which is called ankle syndesmosis and it involves damage to the other supporting ligaments of the ankle and leg (shin area). This injury takes very long to heal.

Symptoms

Swelling, pain and bruising is to be expected. Swelling is a result of ruptured blood vessels and most of the initial swelling is blood leaking into the surrounding tissues. Continued swelling is a result of lymphatic fluid collecting in the area.

Treatment

Protection of the ankle via a brace or bandages while the ligaments heal.

Resting of the injured ankle is very important.

Ice can be placed on the ankle to decrease swelling and speed up healing.

Compression on the ankle must be applied as soon as possible to decrease swelling.

Elevate the ankle to reduce swelling.

Exercise the ankle once it has healed to prevent repeated injury.

Source

Camelot international sports massage manual (2013)

 

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What are knots?

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What are knots?

Knots are more specifically known as (myo-fascial) trigger points and can be defined as a hyperirritable lump in a tight band of skeletal muscle or fascia. These knots are painful when pressed and pain can be felt on, around and can even refer to the nearest joint.

Knots on the neck cause headaches and knots elsewhere cause limited movement of the joint and can reduce strength and flexibility of the affected muscle.

Theory on the causes of knots:

Over-activity of the muscles results in a prolonged release of calcium, resulting in a small cramp of the overloaded cells. This leads to a compression of capillaries within the cramp and results in localised loss of blood circulation and an increase in energy-demand. As the circulation decreases there is a buildup in metabolic by-products (toxins) and these are the cause of pain. The muscle is weakened by this ongoing cramp and so the surrounding muscles develop even more cramps in an attempt to compensate.

The causes of knots:

These are many. For example; repetitive micro-trauma, an injury, prolonged poor posture and emotional stress. Vitamin deficiencies, sleep disturbances, joint problems, poor biomechanics (problems with the skeleton), surgical scars and tissue under tension.

The alarm bell

Knots are a sign of overloaded muscles and an unbalanced biomechanical system that can cause a domino effect if not treated correctly. One set of tissue can break down which causes others to be overloaded and they can break down in turn.

Trigger-points start off by causing inflammation, followed by pain, weakness, nerve and joint dysfunction and finally a structural breakdown of tissue as in a severe injury.

Sources

Source: Camelot International sports massage manual (2013) pg.202.

 

When should I not go for a massage?

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When should I not go for a massage?

 

The following conditions are an absolute no-no for massage.

 

Having contagious or infectious diseases, especially if it is viral or bacterial (there is a high risk of cross -infection).

Respiratory tract infection, eg pneumonia, TB, bronchitis, sinusitis or a head cold:

The reason for this is that lying down will be uncomfortable and breathing will be difficult.

Fever:  Massage can accelerate the illness further by increasing the blood circulation, thus spreading the organism.

Cancer : No massage, especially if the cancer is still spreading.

Heart disease (severe): Massage improves blood circulation and blood pressure and this may affect the heart if it is weak.

Acute rheumatoid arthritis: The skin and joints will be too sensitive to massage and the increased circulation may cause discomfort.

Bruising/bleeding disorders: The skin will be too sensitive to massage and extreme caution should be taken with this disorder.

Alcohol or drugs: Anyone under the influence will be affected more because of the increase in circulation.

Local conditions:

These areas should be avoided if they present with the following:

  • Acute trauma (wounds, bleeding, bruising and sunburn)
  • Non-infectious skin conditions (eczema and psoriasis)
  • An undiagnosed lump
  • Inflammation
  • Phlebitis
  • Thrombosis

 

Precaution should be taken if the client has:

Varicose veins – massage may be painful.

If the client is pregnant:

Massage is not recommended in the first 16 weeks.

Diabetes: The skin and muscle is weaker and more prone to damage and the client has less sensation of pain. Massage itself may change levels of blood sugar.

Sources: 

Source: Camelot International sports massage manual (2013)

 

How to cope with an injury

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You have injured your muscle… now what?

Classify your injury

First degree muscle strain:

Excessive stretching or minor tearing of a few muscle fibres. Locialised pain with some stiffness and weakness.

Treatment: Rest, ice, compression (stocking/bandage) elevation, gentle stretching and pain-free exercise, progressing slowly back to normal exercise. Avoid sudden stop-starting types of exercise, eg. soccer.

Second degree muscle strain.

Moderate tearing of fibres with more generalised pain. Haemotoma (bruising) may occur due to bleeding and limping may result. See a medical practitioner.

Treatment: Same as above but progression should be slowed and recovery will take longer (2-3weeks)

Third degree muscle strain

A complete muscle tear with widespread bruising. This is a rare occurance. See your doctor immediately.

Treatment: Same as above but with extended rest time. 4-6 weeks to heal and walking aids may be required.

Understand what caused your injury

Most injuries are caused by the following:

Poor warm-up and fatigue.

A previous injury – injuries tend to recur in areas that have previously been injured.

Strength imbalance – Injured clients often have a strength imbalance within their muscles (one muscle is stronger than the other). This results in uneven contraction and the weaker muscle will often become injured.

Poor flexibility – When activities result in the muscles stretching beyond their normal range.

How to treat your injury -explained in detail

Rest: Once you realise that you are injured, stop immediately. You must cease the activity that caused the injury for some time afterwards. Do NOT exercise the injured part of your body or “work through the pain” this will only result in further injury. Only pain-free movements are allowed during exercise. If fitness maintenance is essential, then swimming is the best form of exercise, as no weight is carried.

Ice: This reduces swelling and inflammation. It is important to apply ice do as soon as possible after the injury. This treatment should be continued for two to three days.

Compression : Use a bandage, tape or brace to keep the area supported. This will reduce pain, swelling, bleeding and inflammation.

Elevate: Lift the injured area above the line of your heart. This will help with drainage and improve healing.

Rehabilitation: Stretch and strengthen the injured area once pain is reduced. Introduce stretching slowly and strengthening even slower.

 

Picture 1: http://www.physioanswers.com/2012/08/what-is-strain.html

Source: Camelot International sports massage manual (2013) pg.202.

 

Dealing with pigmentation.

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Skin pigmentation:

Appearance: Any colour other than the skins natural colour.

Possible causes: Genetic factors, hormones, post-inflammatory reactions, excessive sun exposure, medication and photosensitive skin.

Treatment recommendation: Regenerate skin and use peels.

Nutritional advice: Vitamin C and E, drink plenty of water and eat protein rich foods for collagen formation.

Home care advice: Use high value SPF skin creams and regenerating products and avoid the sun.

Source:

Camelot International Skincare study guide (2011)

Treating dehydrated skin.

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Dehydrated skin:

Appearance: Superficial fine lines, flakiness and tightness.

Possible causes: This skin lacks moisture and can be caused by lack of protective creams, incorrect use of products, change in temperatures, illness and environmental factors.

Treatment recommendation: Moisturise, regenerate and exfoliate skin regularly.

Nutritional advice: Drink plenty of water, increase intake of fresh fruit and vegetable, omega 3 and anti- oxidants.

Home care advice: Use a humidifier, lukewarm water and avoid harsh products.

Coping with mature skin.

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Lines, wrinkles and sagging skin:

Appearance: Lines between eyebrows, eyes, forehead, neck, mouth and loose skin.

Possible causes: Lack of sleep, worry and stress, excessive facial expressions, pressing on the skin, aging process, genetic, hormonal imbalance, improper cleansing, hyperthyroidism, illness, smoking and alcohol and environmental damage (air-conditioning).

Treatment recommendation: Moisturise, firm and tone skin regularly. Use regenerating peels, collagen injections and anti-aging therapy.

Nutritional advice: Follow a balanced diet, omega 3, increase vitamin C, P, calcium (collagen synthesis), and antioxidants and drink plenty of water.

Home care advice: Avoid soaps and use rich products and protective creams. Avoid the sun.