The ankle is a robust joint. Provided it doesn't sustain any major injuries, it is actually very resistant to degenerative processes like osteoarthritis.
Unfortunately however, ankle injuries are very common. In fact in the USA the incidence is 2.15 per 1000 person-years, nearly half of which are caused during athletic exercise(Waterman et al., 2010).
Ankle sprains are often poorly managed. I have seen many people come to see me after several weeks of their 'ankle sprain' not getting better, only for them to clinically present with a high chance of fracture, later confirmed on X-Ray after I send them to the hospital. Yes, often people limp around until the pain gets better and then carry on with their lives. Perhaps this is a symptom because of how common they are. Everyone knows someone who has sprained their ankle, therefore it is assumed that your own ankle injury can't be too bad.
Above, a normal X ray of the foot and ankle.
Unfortunately this often leads to pain and stiffness long after the injury has healed. As ankle injuries heal, the ligaments often tighten and restrict normal movement. The most common loss we see is Dorsiflexion, the act of moving the knees over the toes.
The most simple test for dorsiflexion is the knee to wall test:
Comparing your right and left ankles with this text should reveal whether you have some deficiencies. More often than not, following an injury a significant reduction in the knee to wall test will be seen.
What's the problem with this?
Well, in day to day activities, it can start to cause an issue in several ways. If your ankle is stiff due to reduced ankle mobility you may notice coming down stairs is more difficult as you struggle ot lower your self down to the next step. You may find that your knee becomes painful as it works harder due to the lack of ankle mobility below it. You may find that your stiff ankle just tends to ache and feel generally like it can't be challenged as it once could.
And if you're an athlete?
Even bigger issues can be seen!
Athletes with reduced dorsiflexion are at increased risk of foot, ankle, knee and hip injury. You are more likely to develop joint pain when you run. You are more likely to suffer major knee injuries like ACL rupture. Your lower back may become painful when you squat. How do I know? Not only do I see it on an almost daily basis, but I developed knee and back pain following my own ankle injury and subsequent stiffness in 2019.
So how do we solve it?
As a Physiotherapist, we have long performed a simple yet highly effective treatment calle Mobilisation with Movement (MWM). These are possible around different joints of the body, but the ankle MWM is particularly effective in increasing ankle range of motion.
The idea is simple:
Support and fix the foot whilst assisting the glide of the talus bone underneath the shin to maximise movement at the talo-crural (ankle) joint, where the foot meets the shin.
If you compare the images above. You can see the bones of the ankle sitting beneath the shin bone (Tibia). With A-FLEX, the strap supports and fixes these bones, whilst the ergonomic base supports the foot and prevents arch collapse. The foot feels protected and cocooned whilst you lunge into the strap, and the strap helps to pull and glide the bones of the foot underneath the shin bone. This helps to maximise the ankle joint range of motion, and you'll often see immediate improvements in range of motion.
It really has to be felt to be believed. The immediate relief people feel after their first use, especially if they are suffering with a stiff ankle(s) following injury or trauma. Sometimes you can hear the satisfying *CRACK* as the scar tissue breaks down - that's what happened to me after my own injury back when we trialled our first ever prototype!
So the support at the foot and ankle and the glide from the strap combine to give an exceptional positive stimulus to the ankle. A-FLEX is rapid, easy, pain free and already used in physiotherapy rehab and elite sport!
https://journals.lww.com/jbjsjournal/Abstract/2010/10060/The_Epidemiology_of_Ankle_Sprains_in_the_United.3.aspx#:~:text=During%20the%20study%20period%2C%20an,per%201000%20person%2Dyears).
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