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What is Chronic Ankle Instability?
Chronic ankle instability is a condition characterized by a recurring “giving way” of the outer (lateral) side of the ankle. The ankle can give while walking, running or doing other activities,. Ankle instability can affect athletes and non-athletes alike.
The symptoms of chronic ankle instability include:
surfaces or when participating in sports
Nurontogenic principles and ankle instability
While the conventional view (left) is not untrue, it misses what may be the major factor in the treatment of ankle instability.
Examination of an unstable ankle will always show muscle aberration - some muscles too tight, some to lose, and many with aberrant muscle tests, some inhibited, others over-facilitated, all of which indicate problems with proprioception - the sense of joint position, muscular and ligament stretch. Problems with proprioception are thought to be the primary cause of ankle instability.
Following any injury, ankle sprain/strain included, a series of adaptations occur to the injured body part. These adaptations may do the following:
Healing of the tissues may not restore function to it’s pre-trauma state. Adaptations that remain past their time of need become a maladaptive. The presence of muscle inhibition or over-facilitation, as determined by muscle testing, indicates the presence of maladaptation and ankle instability.
According to neurontogenic principles, maladaptation, causing altered proprioception and muscle imbalance, constitutes a major piece of the cause of ankle instability. While this does not remove damaged ligaments as a factor, treatment using neurontogenic principles often rapidly, effectively and lastingly improve ankle instability.
Initial treatment of ankle sprain/strain - the generally accepted view.
In addition to RICE - Rest-Ice-Compression-Elevation, the latest research has shown that functional treatment is superior to complete immobilization even for severe ankle sprains with torn ligaments. Functional treatment includes, as tolerated, use of complete range of motion and early resistance work and weight-bearing as well. Exercise and joint motion stimulate healing and influence the strength of ligaments after injury. (1 left)
Surgery, with it’s risk of side effects, can be applied at any time after the injury if conservative measures are not sufficient.
Neurontogenic view of early treatment of ankle sprain/strain
When treated with NeurOntogenics®, the immediate pain and resistance to weight-bearing and movement of mild to moderate ankle sprain/strain is fairly easily treatable. The recommendation of the use of ice following injury is a nod to the understanding of neurontogenic principles; the body is understood to overreact to trauma. Pain we find, is a part of the adaptation process along with muscle imbalance and proprioceptive changes. Adaptation begins immediately following an injury, and much of the adaptation seems to be overreaction, as inhibited muscles will strengthen, pain-free range of motion will be restored, and weight-bearing tolerated immediately following treatment of a freshly sprained ankle.
NeurOntogenics® Neuromotor Deprograming and ankle instability
As mentioned earlier, muscle imbalance, including inhibition over-facilitation, all of which indicating altered proprioception are the main findings from a neurontogenic evaluation of an unstable ankle. As stated in neurontogenic principles such imbalances are the result of adaptation to previous stress and trauma that never reverted to normal function thus becoming maladaptive. NeurOntogenics® Neuromotor Deprograming - treatment to eliminate residual maladaptation - is very effective at restoring stability to the unstable ankle.
Depending on the integrity of the ligaments, ruptured or severely stretched ligaments will of course compromise stability to some extent, we find stability to be significantly enhanced within four to eight visits.
As long as the basic integrity of the ankle is sufficiently intact to prevent the body from going back into adaptation, the result of neurontogenic treatment is generally lasting. Some individuals will, if their ankle injuries were severe enough, still benefit from some kind of taping or support following treatment, but many ankles go on to lasting normal function.
Standard physical therapy treatments and ankle instability
There may still be benefits that can be gained from more standard physical therapy applications. Once muscles are freed to return to their normal function by eliminating maladaptation, the benefits of appropriate exercises will be attained much more readily. When adaptation is no longer confusing proprioception, practice with balance and stability should achieve faster and more lasting results. Trying to attain peak conditioning with maladaptation in place is like replacing your auto tires that have been warned unevenly without first fixing the alignment; an imperfect solution.
Neuromotor Deprograming - speed recovery from pain and dysfunction
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