(upbeat jazzy music)
- Hi, I'm Bob, physical therapist.
- And I'm Brad, physical therapist.
- And today we're going to talk about chronic ankle sprains.
Why are you, you know, there are people
who continually sprain their ankle.
I've had a person,
we had a patient,
that actually sprained his ankle over 20 times.
And we're going to go over some of the causes of that today.
So, we'll start off with number one.
And this is the serious one,
and this is only one to make sure
that you've had checked out.
Ankle sprains are generally graded from one to three.
And if you have a three,
where you actually tore the ligament,
Lindsay, you want to throw that foot out here?
(object clanks)
- All right! - All right.
- All right, cool.
- Yeah.
We got a foot here.
Do you want to zoom in a little bit, Lindsay.
And I'm not going to show you the actual ligament
that you might hurt when you sprain,
but ligaments hold bone to bone.
Okay?
They're just tough little structures that hold,
that link them together.
And if you, if that ligament is torn,
you can see where the it's not going to keep the foot
very stable and you can have a lot of movement.
Possibly in this, it'll be a good one.
- Yeah.
Look, maybe we should give them some reference here.
So they're clear on what the skeleton model is.
Here are the toes, obviously.
And then the,
the tarsals and then the metatarsals
and right here is actually your heel bone.
So if you're looking at your foot,
we're looking at it like this, okay?
This one's falling apart without any ligaments
to hold the muscles. - That's right.
- But that's the exact point.
Now, if you don't have secure ligaments and tendons
and muscles, they literally,
your foot becomes flacid and you lose stability.
- Exactly.
So that's one reason.
It's probably the least likely possibility.
You'd probably of known that right away when you injured it,
if that was the case.
A second more possible cause would be weakness in the ankle.
And Brad and I are going to do a video on that,
showing how to strengthen your ankle.
- Right, right.
- A third cause,
which is one that a lot of people don't know about,
or think about is there's actually little receptors
in the joints that you have of your ankle
and they are proprioceptive receptors.
And proprioception just means
it tells you where your ankle is in space.
So for example, Lindsay, if you can look down here,
right now without looking at my foot,
I can tell I'm turning it in
and I can tell I'm turning it out.
Now, when your receptors are affected with an ankle sprain,
it's not going to be so severe
that you can't tell which way you're turning it,
but it's going to be a subtle thing.
You're just not going to,
your ankle's going to start to turn when you hit
like an uneven surface and you won't know it's turning,
until it's too late and then you sprain it.
- Right.
- So it,
it's a major thing that we, you want be concerned about.
And it's something else that we're going to talk about,
when we talk about the use of a balance board.
But one simple way to,
to maybe measure whether, or not your receptors are out,
going out a little bit, Brad's gonna show you here.
- And I know when Bob's talking about proprioception,
don't get thrown off by that word.
You know, it's just knowing where your body is in space.
And particularly with weight bearing, you,
your mind knows where your foot is.
And it can tell if you step on a curb,
or tell if you step on a rock just by the angle in the foot,
not necessarily by the,
the feeling of it.
But it knows a position without looking at it
and your body will automatically adjust, so.
- That's a good point, Brad.
Because I mean, we're talking about joint proprioceptors,
which usually you have to have weight bearing on.
- Right.
- So, good.
Okay, so anyway,
a simple test would be close your eyes
and to balance on one foot for 30 seconds.
I'd try balancing on the good leg first.
It's not that easy, is it?
- Yeah.
And then close your eyes,
you'll notice if you look at my ankle,
I'm working much harder with my eyes closed,
than when I open my eyes.
There's a lot of balance involved with vision.
- Okay.
And then, you can go to the bad ankle.
I don't know.
Do you have a good ankle and a bad ankle, Brad or?
- Both my ankles are fantastic, Bob.
(Bob chuckles)
Okay, yeah,
but we'll pretend that this ankle is sprained.
I did sprain this one, but it, it's rehabbed well
because I had a good therapist help me out.
But when you see it in the clinic, I work,
I'm working with someone right now with a weak ankle
and she always falls to the left, to the opposite direction.
Okay, in her case, she's a right ankle,
but she goes to the opposite direction.
She goes like this and her ankle goes in.
In her case, I think it's actually weakness,
more than proprioception, but I'm not sure about that yet.
I still need to work with her a little closer.
But yeah, so if you got a weak ankle,
things are really working and you'll see the person do this,
and they need to close their eyes.
Oftentimes, there's not a prayer
that they're going to stand.
- Right, so that's two possibilities is the, you know,
the proprioception and the,
the weakness.
And those are two things that we'll cover in other videos.
A fourth possibility, (phone rings)
that was Brad's phone.
He got an emergency call from-
- It was my wife.
(Brad laughs) - His wife, called her back.
- I had to answer.
- So. - Okay.
- Going back, the last thing we're going to cover
is that,
the thing that a lot of people don't realize,
is if you have bad shoes with bad art support,
or even shoes that have wore out.
They can really promote ankle sprains.
- You want to show me that,
throw me that shoe, Lindsay?
We'll get an example of one,
this is obviously a work shoe,
but it's the same in a running shoe,
or any other type of shoe.
If you look, let's zoom right in tight here, Lindsay,
at the heel, it's wore right here.
So when the person steps on this,
it's actually going to start wearing the,
having the ankle twist in, we call it inversion.
That'll get worse and worse over time.
And I've seen people's shoes that are so wore out,
I'm surprised they don't sprain their ankle
on a daily basis.
- With every step. - Yeah.
- I've seen the same thing.
- It's just amazing.
So,
make sure your shoes are not wore out.
Catch Lindsay.
(shoe clanks) Thank you.