ANKLE

 

Rejuvenate Damaged Ankle Ligaments

 

Recover your natural maximum range of movement.

 

Problem:

Spraining an ankle means overstretching a ligament AND displacing that ligament, meaning ligament fibers were jerked out of their home locations & didn’t move back; of course both ends of the ligament are still attached to bones, but the middle fibers have twisted out of place. This typically occurs on either side of the ankle when ligaments that run from the knobby bone to the heel (calcaneotibial & calcaneofibular ligaments) twist forward and don’t twist back, and when ligaments that run from front of leg to top of foot (dorsal talonavicular & deltoid) twist-roll either right or left and don’t twist-roll back. But this is only the first part of an ankle injury, the part most people are aware of. Time passes, swelling goes away, pain disappears, movement gradually returns, you resume your activities, and . . . you think you’re healed? not yet—after injury seems healed, ligament fibers are still twisted, hard, inflexible, and calcium-glued where they don’t belong. This enduring trauma is the second part of an ankle injury. In this condition, not only is the ligament very susceptible to re-injury, but its decreased flexibility means that ligaments on the opposite side of the ankle (antagonists) are under more stress and thus are also more susceptible to injury. Without therapy, over time a series of minor sprains usually occur. The kind that keep you limping painfully for only a few days, but contribute to the gradual stiffening & instability of your ankle. [NOTE: some osteopathic-therapists would be more comfortable not saying a ligament twists-rolls, that what I am doing is restoring maximum blood flow and structural integrity to ligament tissue.]

 

Treatment:

Ligament fibers need to be loosened, de-adhered and repositioned, moved back into their home locations (anatomically correct positions). On the sides of the ankle this almost always means moving ligament tissues toward the back of the heal. On top of the ankle the hard, lumpish parts of ligaments move in whatever direction allows them to soften and flatten out.

 

Benefits:

  1. loosens, de-adheres and frees after-injury hardened ligament knot
  2. increases blood flow through injured tissues.
  3. ligaments return to their anatomically correct shapes & locations.
  4. decreases compression on fibularis & tibialis tendons.
  5. reduces stress on opposite (uninjured) side of ankle
  6. restores flexibility to injured area.
  7. allows Achilles tendon to gradually lengthen (heal-bone is more mobile).
  8. increases lateral foot speed.

 

Notes:

     Injured ankle ligament fibers rarely return to their home-locations without being physically manipulated by the hands of a therapist. I’ve never seen a soccer player over 16 years old without this problem—and most don’t even know it . . . often what feels bone-like is a calcified ligament knot.

     I’ve often seen ankles with repetitive injuries that caused people to give up all strenuous physical activity, even athletes to retire from their sport, restored to playing shape; even 15-20 year old injuries.

     High Ankle Sprain is a tear in the (tibiofibular) ligament on the front of the lower leg, just above the ankle, that connects the two lower leg bones (tibia, fibula). This area is often as dense & inflexible as hard rubber, and thus prone to tearing. The strong, knowing hands of a good therapist can loosen this, greatly reducing vulnerability to injury.

     Tarsal Tunnel Syndrome is when the nerve (posterior tibial) that passes beneath the knobby bone (medial malleolus) on the inside of the ankle becomes entrapped & compressed. In this condition, de-adhesion of this area is a must.

     Below the knobby bones on each side of the ankle, there are many ligaments and retinaculum that twist-roll forward when ankle is sprained. Each lies at slightly different angles, but in general all are moved toward back of ankle. Outside (lateral) include calcaneofibular & lateral talocalcanean ligaments, inferior & superior peroneal retinaculum. Inside (medial) include calcaneotibial & posterior tibiotalar parts of deltoid ligament.


     SOCCER PLAYERS: as an athlete's ankles age they become stronger and stiffer, don't rotate left and right as easily or as far as when younger. Every ankle sprain they have ever had contributes to this decrease in range of flexiblity. By loosening and restoring ligament suppleness much of this flexibility is restored. For a soccer player this means his plant-leg (Standbein) easily rotates to the proper angle needed for shooting. Thus, shot accuracy is drastically improved, or if you will, restored to what it was before ankle had become so stiff. Many soccer players think they have simple lost some of their ability, when in reality all they have lost is some of their ankle (or knee, hip) flexibility. A session or two of Fluidification Bodywork has restored many of my clients to their peak performance abilities.