Lateral Ankle Injury

The ankle is one of the most common joints to be injured in an individual, especially those who engage in activities that require a lot of pressure around the lower extremity of the body, such as football, soccer, tennis or athletics. Most ankle injuries, such as sprains, respond more favorably to treatments that are non-surgical, such as those given by doctors of Chiropractic and physiotherapists. There have been a number of `journal articles, case study reports and clinical trials, that have attempted to prove the use of chiropractic practice in the diagnosis and management of different body parts, the focus of this assignment will be on the ankle, because, as was mentioned earlier, it is most likely one of the most likely occurring injury
in individuals. Firstly, to explain what an ankle is, and where it is located anatomically in the human body, it can be said that the ankle is a large joint, that is made up of three bones, the tibia (shin bone), the fibula (the thinner bone which runs next to the shin bone) and the talus (the foot bone that sits just above the heel bone). It is located in the lower extremity of the body. Ankles are prone to lots of different conditions the focus in this paper will be on:
-sprained ankle, which is the damage to one of the ligaments of the ankle, cause in most cases by an accidental twist or turn of the foot.
-Ankle fracture which is a break in any of the three bones in the ankle (tibia, fibula, talus). Most commonly on the lower bones of the leg, like the tibia or fibula.

The role of Chiropractic in the diagnosis of any ankle injury is similar to that of any different medical practice.
It can be explained in a few different points. The first point is that, radiographic imaging techniques can be used to rule out any possibility of of complete ligament tears, or fractures. For example, a case study that was published in the Journal of Chiropractic medicine (Battaglia, Craig & Kettner, 2015) highlighted the role of using an Ultrasonography (US) in the assessment of the lateral ankle ligament injury, its instability and anterior Ankle impingement. Using the case of a 28 year old male athlete who suffered from a history of an inversion injury to the left ankle. Using US, it was demonstrated suffered from a full thickness tear to the ligament of his left ankle, a partial thickness tearing of the calcaneofibular ligament on the laxity of the ankle. This case report held by Battaglia, Craig & Kettner demonstrated and exemplified the value and utility of using an Ultrasonography in the diagnosis derangement in the ligamentous, tendinous, articular and osseous injuries of the ankle. Also, considering that the images showed that the 28 year old male and a full tear to the ligament, it would in turn help with the treatment, as the treatment of a Chiropractic is depending on the severity of the injury, and whether it needs to be viewed by an orthopeadic, go through full rehabilitation or go through professional Chiropractic manual
manipulation.

Similarly, it can be said that the diagnosis of a injuries such as an ankle sprain is fairly easy, yet, assessing the degree of how serious the injury and the state of the involved tissues is more challenging. However, determining the severity of the issue or injury at hand is essential for a efficacious treatment. (Plaughter, 1993). The various diagnosis of ankle sprains comprises of fibular, proximal fifth metatarsal and osteochondral dome fractures, there are also osteochondritis dessicans of the talus, and sublaxation of the peroneal tendons.

Furthermore, it has also been proven that high velocity, low amplitude chiropractic manipulative therapy, can be applied when managing young athletes with functional chronic recurring, ankle sprains.
(Gillman, 2004). Although if an individual is looking for a normal quick healing treatment, it can be done through a simple chiropractic technique of manipulation of the subluxated talus bones. Although, if there is a fracture, then the chiropractic treatments would be irrelevant, which is the only negative about the treatment of chiropractic for ankle injury. Depending on how severe the pain and/or injury is, chiropractic treatment can be very effective in the treatment and prevention of ankle pain. Some of these techniques can also be applied at home by the patients themselves, like drawing the letters of the alphabet with the big toe, or using a wobble board for stabilization
trainings.

Another point with regards to the management of ankle injuries in the Chiropractic practice, a study was conducted by a Chiropractors and Physiotherapists at the National University of Medical Sciences in the United States of America to highlight the difference between the treatment of rehabilitation alone, compared to manual therapy (MT) and rehabilitation with regards to recurrent ankle sprain with functional instability (RASFI), to determine a short term out come. (Lubbe et al, 2014). The study showed that the addition of chiropractic MT resulted in a significantly reducing the pain and joint restriction when compared to rehabilitation alone, but not in disability. Therefore, the clinical implication is that Chiropractic MT may be useful in addition to rehabilitation in situations where pain and joint restrictions are the key clinical issues in the patient.

Subsequently, a chiropractic doctor can manage ankle injuries (mostly sprains) that are either Grade I or Grade II. Grade III injuries are viewed as the more serious types of injuries, and usually need to referred for surgical consultation. When treating an ankle injury or sprain, the first and most important thing to do, is to manage the inflammation. That can be done by giving instructing the patient to have hourly 20 minute ice baths along with compression and elevation, until the critical inflammatory phase passes, which is usually around 24 to 96 hours. For severe injuries or sprains, crutches may be required for the period of 2 weeks, and the patient must not bear weight until the pain is subsided. (Plaughter,1993) After managing the inflammation and the injury in general, the chiropractor would then give the patient strengthening exercises for the ankle, such as using wobble boards, heel/toe raises, manual resistance exercises etc (Wade, 1997)

In summary, the doctor of chiropractic plays a big role in modern therapy, and acts as the option for individuals to opt for when they experience common injuries such as ankle sprains etc. Since they are injuries that can be managed in ways that don’t include surgery, and that it has been proven, as was mentioned previously, that the doctor of chiropractic can manage almost all grades or levels of ankle injuries, that aren’t serious enough to be referred to surgery.