Ankle sprain is one of the most common joint sprains and a very common disease in clinic. Ankle sprain, especially varus injury, causes strain, tear and even fracture of lateral collateral ligament. When walking and sprinting, the outer edge of the foot hits the ground or falls from a height, and the sole of the foot suddenly retracts, which may cause the lateral ankle ligament to be stretched and sprained, even partially torn, and may also be combined with the lateral ankle avulsion fracture.
When the ankle joint is sprained, there is a tearing feeling, local swelling and obvious pain. The affected foot can't walk with heavy load, limp, and can't land on the forefoot. If only the lateral collateral ligament is sprained and edema, the symptoms can disappear within 1 ~ 3 days. If there is a ligament tear, the pain will continue and the joint will be unstable. X-ray can show whether there is avulsion fracture, talus inclination increase or dislocation.
Early treatment after ankle sprain is very important, so it is advisable to stay in bed, hold crutches when going to the ground to prevent ankle from bearing weight, and don't exercise too early, and rest for more than two weeks. Cold compress should be used immediately after injury, not hot compress or local rubbing. Local sealing can be used to relieve pain. In order to stabilize the joint, the patient can sit in a chair with his calf drooping, and the fourth and fifth toes are wrapped with narrow bandages, which are pulled up by the patient himself, so that the ankle joint extends backward and everts. The doctor used three pieces of 4cm wide adhesive tape, which were overlapped by half in turn, bypassed the plantar surface from the upper part of the medial malleolus, went up through the lateral malleolus, stuck it under the fibula capitulum, and then bandaged and fixed it, and braked for several days. Fixed braking should be overcorrected, that is, the injured limb rotates in the opposite direction of the injury force, the eversion injury should be fixed, and the eversion injury should be fixed. Fix it with plaster or splint if necessary. After the acute phase, you can use hot compress and exercise the flexion and extension of the ankle joint, or massage the ankle joint, plantar flexion and varus, dorsal extension and valgus in turn, and press the affected area. The ligament is completely torn and can be repaired. A few patients are prone to sprain again after recovery.
Why does ankle sprain cause long-term foot pain?
After reasonable treatment, most patients can recover from ankle sprain, and some patients leave lateral foot pain after ankle pain disappears, which can last for decades and affect walking and labor. It is usually caused by simultaneous injury to the soft tissue of the tarsal sinus. The tarsal sinus consists of talus sulcus and calcaneus sulcus. The ostium of the sinus is located at the anterior lower part of the lateral malleolus, and there are calcaneal ligament, fat pad, synovium and calcaneal joint capsule in the sinus. Ankle sprain can cause damage to tarsal sinus ligament, fat pad and synovium, leading to aseptic inflammation. Scar contracture and ligament tension may occur after injury healing, resulting in dorsolateral pain of the foot and tenderness of the tarsal sinus, which may sometimes radiate to the toes. Autonomic nerve dysfunction caused by soft tissue lesions. Abnormal sensation, chills, weakness and involuntary trembling of the lower legs and feet.
The pain will disappear immediately after local sealing of the sinus. Attention should be paid to rest after ankle sprain, and local physical therapy and closed treatment can be used. The treatment effect is good. If conservative treatment is ineffective and the pain is stubborn, the soft tissue in the tarsal sinus can be surgically removed, and the gelatin sponge can be stuffed to stop bleeding and eliminate the dead space.
Prevention and treatment of ankle sprain
1. Causes and principles of ankle sprain. According to anatomical characteristics, the ankle joint is composed of the articular surface under the tibia and fibula and the articular surface on the talus (talus trochlea). Foot flexion muscle strength is greater than extensor muscle strength, varus muscle strength is greater than valgus muscle strength; In addition, the lateral malleolus is longer than the medial malleolus, and the medial malleolus triangular ligament is stronger than the lateral three ligaments. Therefore, the range of motion of eversion is larger than eversion. In addition, the talus body is wide at the front and narrow at the back. When the foot is extended, the talus completely enters the ankle point, and the ankle joint is stable and not easy to sprain. When the sole flexes, the narrow part behind talus enters the wide part in front of ankle point, so the ankle joint is relatively unstable and prone to sprain. The technique of ball games is complex, and the technical movements change frequently in practice, so it is necessary to constantly change the direction, make an emergency stop and get up. Especially in rebounding in basketball and spiking in volleyball. When students leave the ground in the air, their feet are in a state of plantarflexion and varus. If they fall to the ground with unstable center of gravity, lean to one side or step on other people's feet and balls, or on uneven ground, students lack the ability to protect themselves, they will use their feet.
2. symptoms. There is obvious tenderness on the medial or lateral side of ankle joint after injury; The swelling of medial and lateral ankles is obvious, local subcutaneous ecchymosis, limited ankle movement and difficulty in walking.
3. On-site treatment of ankle sprain. Immediately after the injury, give cold compress, pressure bandage, raise the affected limb, rest regularly, and apply new drugs externally.
4. Massage therapy. After 3 days, you can have a light massage: (1) massage Jiexi point (between extensor pollicis longus tendon and extensor digitorum longus tendon)1min; (2) Massage Kunlun point (the midpoint of the connecting line between the lateral ankle and achilles tendon)1min; (3) Massage hanging hours (3 inches above and below the lateral ankle tip and the posterior margin of fibula)1min; (4) Massage Yanglingquan point (the depression below fibular capitulum) 1min. The above acupoint massage is carried out according to the patient's feeling of acid swelling.
5. Practice after injury. After swelling and pain relief, you should walk on the ground or walk on crutches under the condition of fixing the adhesive tape support belt. 1 ~ 2 weeks later, you can do muscle strength and coordination exercises, jog in the sand or walk or jump on uneven slopes, and gradually enter regular exercises.
6. Strengthen preventive measures. An important cause of injury is lack of self-protection awareness and neglect of preventive measures. Therefore, it is necessary to make full preparations, do a good job in venues and facilities, cultivate and improve the ability of self-protection, improve the muscle strength of the ankle joint, improve the stability and coordination of the ankle joint, and wear protective support belts when practicing.