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Rolling an ankle impacts more than ligaments and tendons. The ankle joints (there are several) are obviously involved - and possibly the structures that get injured. Before I jump to the conclusion that pain and tenderness on the lateral (outer) aspect of the ankle is coming from the lateral ligaments, I move the joints to assess the effect. The joints of the ankle can create pain anywhere near the joints. If a joint is indeed the culprit, most will resolve rapidly with directional preference exercises. If a ligament is to blame, then traditional treatment of a ligament sprain is indicated. Looking for the problem that usually gets better the fastest not only makes diagnostic sense, but also benefits the patient. Who doesn’t want to get better as fast as possible? -- Laura
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When people twist or roll an ankle, the common diagnosis is that the ligaments are sprained. However, the joint itself is also affected! Here, a patient who twisted her ankle is treated successfully with simple repeated movements of the ankle JOINT. Therefore, the ankle JOINT was injured, not the ligaments. She was discharged with full recovery at visit number 2. Clinicians MUST assess joints as joints are injured far more commonly than soft tissues such as muscles, tendons, and ligaments. (I learned how to assess joints like this through my post-doctoral studies with the McKenzie Institute, not in school.) -- Laura If you have pain on the bottom of your foot, it is common that the source is a pinched nerve in your low back. As this image shows, nerves L4, L5, and S1 send signals to the foot. You can have a compressed nerve that does NOT create back problems, but instead creates pain, numbness, or tingling on the bottom of the foot. The plantar fascia is connective tissue on the bottom of the foot, which, when tight, can also produce pain on the bottom of the foot. A McKenzie clinical evaluation diagnoses the true SOURCE of the problem - which leads to an individualized treatment plan. -- Laura  |
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