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Photo source: pxhere only sprained his ankle zero and countless times?

Ankle sprain is probably the most common joint injury in humans.

For many people, this is a very ordinary part of life. Sometimes, when people with sprained feet rest for a day or two, they will feel that they are all right, so they feel relieved to walk around and jump around, and even begin to exercise violently. But in fact, the recovery of ankle sprain is not as simple as people think, pain-free does not mean that the ligaments have been fully recovered, let alone safe and free movement.

These seemingly healed ankles may have become more fragile than before. Scientists surveyed freshmen at three military academies in the United States and found that students who sprained their ankles in the six months before enrollment were 3.4 times more likely to sprain their ankles during the two months of basic training after enrollment. In other words, after an ankle sprain, the likelihood of another sprain increases.

In addition to affecting one ankle, a sprained ankle may also change the fate of the other ankle. So, what happened when we sprained our ankle?

How is our ankle made up of three bones: the tibia, the fibula and the talus. The tibia and fibula are the two long bones on the calf, and the talus is located in the hind foot, connected to the two calf bones. This bone has a special shape. Perhaps you have heard the elders talk about the "sheep crutches" played in childhood. This kind of toy is often made of sheep's talus.

There are ligaments between bones and bones. For example, the lateral ankle has the anterior talofibular ligament (ATFL) and the posterior talofibular ligament (PTFL), which connects the talus to the fibula, and the calcaneofibular ligament (CFL), which connects the calcaneus to the fibula, while the medial ankle has the triangular ligament (deltoid ligament), which consists of four ligaments that connect multiple parts.

The existence of ligaments maintains the stability of the ankle. But when a person's foot (relative to the ankle) rotates beyond the normal range, the ligaments are prone to overstretch or even tear, which is when the ankle is sprained.

When the ligament on the outside of the ankle is injured, varus will occur. If the ligament on the inside is injured, the ankle will valgus. The ligaments on the outside of the ankle are fragile (especially the anterior talofibular ligament), and the main position of human ankle spraining is varus. By contrast, the medial triangular ligament is usually stronger and the ankle is less likely to valgus.

Varus (photo: pxhere) walking on a rough road, wearing a pair of inappropriate shoes, or moving from side to side on the tennis court. A variety of factors may increase the risk of sprained ankles. Among these risk factors, the most striking one is probably the "last sprained ankle".

As mentioned at the beginning, in the study of military freshmen, students who had sprained their ankles in the first six months of the semester had more than twice the risk of sprain after the start of the semester. You may suspect that even if it is not a sprained ankle, other injuries to the leg will increase the chances of sprained ankles. The researchers found that students who did not suffer any lower limb injuries in the first six months of school had a similar risk of ankle sprains during basic training compared with students who did not sprain their ankles but had other lower limb injuries. In this way, the risk of sprained ankle does not seem to increase significantly after other lower limb injuries.

In that case, the more important factor of spraining one's ankle may be that he sprained his ankle before. When the ankle is sprained, the ligaments are microscopically torn, resulting in weaker strength-which can lead to ankle instability. If you do not get timely treatment, or do not wait for the ankle to fully recover before starting exercise prematurely, it is possible for the ligaments to heal in a stretched state, and the probability of sprain will increase.

Michael Fredrickson (Michael Fredericson), a sports medicine physiotherapist at Stanford University, said: "the main reason people repeat foot sprains is that they never get rehabilitation."

Photo: arlowskay via Tenor tens of thousands of humans may have been accustomed to belittling the harm of ankle sprains. It is estimated that about 40% of ankle sprains in the population eventually lead to chronic ankle instability (chronic ankle instability,CAI), which makes people feel "give way" and rickety from time to time. In addition to repeatedly spraining the ankle, such patients may also experience persistent discomfort and swelling, pain or pain during compression, and so on.

And these ankles have been unable to return to peace for a long time, and not just because of structural instability.

Humans have a skill called proprioception (proprioception). Proprioceptors in muscles, tendons and joints can help us sense position and speed, let people know what to do next without thinking, and know how to adjust their movements to avoid falling on uneven surfaces. Studies have shown that chronic ankle instability is also associated with decreased proprioceptive sensation. Patients may suffer from damage to the proprioceptor of the ankle joint, making it difficult to protect themselves in time, so they are more likely to sprain their ankles.

After the ability to maintain balance in real time is impaired, the quality of daily life of patients will be affected, and they may also suffer from exercise phobia. In addition, chronic ankle instability may also lead to traumatic osteoarthritis. It sounds like a lot of money, but it's just the misfortune of one foot or one leg.

Will the other foot become unlucky, too? In a study published in 2002, a team of scientists from Denmark followed 648 patients with sprained ankles for seven years. They all went to the hospital because of an ankle varus in one foot. 28% of the ankle sprains developed into chronic ankle instability during follow-up.

And 85% of these long-term troubled patients reported that there was no injury to the contralateral ankle, followed by problems, such as pain or swelling or repeated sprains, and so on: some people had relatively mild symptoms of the contralateral ankle (46%). Some people's contralateral ankle symptoms are similar to the original sprained ankle (30%), and a small number of patients have more severe contralateral ankle conditions (9%).

Perhaps, the weakness of one ankle will really bring greater risk to the other ankle. A study published in 2020 showed that patients with flabby lateral ankles were more likely to varus than people with both healthy ankles. This may have something to do with postural control at the neural level. Some scientists have found that when the signal input from the mechanical receptor (mechanoreceptors) of one limb is defective, the other side is also affected.

Whether it is repeated sprains on one ankle or further involvement of the other ankle, it is not the result we want to see. So, with a sprained ankle, we need to try to avoid the next sprain.

After an ankle sprain, it can usually be treated according to RICE's principle: r stands for stopping movement to rest the sprained ankle; I stands for Ice at a swollen or painful area, 10-20 minutes at a time, every 2 hours; C stands for pressure bandaging (Compression); E stands for raising the affected area (Elevation) so that it is higher than the heart, helping to return the veins.

Photo Source: pixabay and after the pain dissipates, appropriate rehabilitation exercise may also help people reduce the risk of recurrence. Rehabilitation exercise may include joint activity, strength training, balance training and so on. However, these activities must be carried out under the guidance of professional doctors.

If there is unbearable pain or swelling or congestion after a sprained ankle, please seek medical help directly.

Reference:

Https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868773/

Https://www.nytimes.com/2022/05/02/well/move/exercise-ankle-injury.html

Https://www.ncbi.nlm.nih.gov/books/NBK560619/

Https://www.ncbi.nlm.nih.gov/books/NBK459212/

Https://pubmed.ncbi.nlm.nih.gov/33017672/

Https://meridian.allenpress.com/jat/article/56/6/578/466668/Lateral-Ankle-Sprain-and-Subsequent-Ankle-Sprain

Https://www.sciencedirect.com/science/article/abs/pii/S106725161400249X

Https://bjsm.bmj.com/content/50/24/1496.short

Https://pubmed.ncbi.nlm.nih.gov/12135444/

Https://pubmed.ncbi.nlm.nih.gov/30291398/

Https://www.nytimes.com/2009/07/28/health/28brod.html

This article comes from the official account of Wechat: global Science (ID:huanqiukexue), written by: chestnut, revision: clefable

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