There are many forms of fractures, each causing a dilemma in our lives and requiring the help of a physiotherapist in order to heal safely and properly. One of the most common types of fractures seen in sports medicine today is called a “hairline” or “stress” fracture. Hairline fractures are caused by repetitive strain and excess training. Hairline fractures are minute cracks on the bones, which can become severe if not immediately treated. The main causes of a hairline fractures are:
- Traumatic Incidents
- Repetitive Stress
- Pathological
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Basically, hairline fractures are caused by the depressed response of the bone with the ground reaction forces that are applied to the bones during certain activities such as: running, jumping, or walking. Symptoms may include pain and tenderness to the affected bone. Repetitive stress or a sudden fall or strike to the area can also cause hairline fractures.
The best way to treat a hairline fracture is to refrain from any activities that can aggravate the injury. Recovery time can span from two weeks to a month and a half. Once the bone is healed from its minute cracks, you can gradually resume normal activities. In extreme circumstances, the affected area must be put at rest and must be immobilized by casting or bracing. The stages of healing a fracture through physiotherapy are as follows:
- Muscle Assessment
- Joint Mobilisation
- Massage Therapy
- Heat and Electro Therapy
- Gait Education
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Shoe inserts like supportive orthotics and walking crutches may also be recommended by your physiotherapist. Treatment through physiotherapy is advised through strengthening exercises that are non-weight bearing like swimming. Luckily, hairline fractures rarely need surgery because they can easily be mended with just two weeks of rest. However, the injury can worsen if not given the proper medical attention.
If you happen to suffer from a hairline fracture and you are looking for a way to relieve pain, and recover from an injury, adding physiotherapy to a routine wellness plan can maximize recovery time and optimize your healing process. Our physiotherapists at Triangle Physiotherapy can be a powerful ally when combating daily stress, muscle pain, and general health issues when it comes to hairline fractures. Not only does physicaoherapy relieve pain, increase energy levels, and improve overall physical and mental performance, it prevents further injuries. The experienced, professional physiotherapists at Triangle Physiotherapy are available at five convenient locations: Etobicoke, Oakville, Mississauga, North York and Toronto. At Triangle we customize your physiotherapy sessions to address your individual needs.
Amyotrophic lateral sclerosis (ALS) is the most common type of adult- onset motor neuron disease. Neurological disorders are characterized primarily by progressive degeneration and loss of motor neurons. ALS involves upper and lower motor neurons and presents as an idiopathic , progressive degeneration of anterior horn cells and their associated neurons, resulting in progressive muscle weakness, atrophy, and fasciluations.
ALS is a gradual onset disease. The first initial symptoms of ALS varies person to person. One person may have trouble with their grip, such as holding a cup or pen, while another person may experience change in pitch in their voice while speaking. The rate at which ALS develops also varies person to person, with the mean survival time ranging three to five years. Although there are cases in which people have lived five, and ten or more years. Onset symptoms can begin in the muscles that control speech and swallowing, or in the hands, arms, legs or feet. Not all people who suffer from ALS experience the same symptoms as others or the same sequences or patterns of progression. Although, universally progressive muscle weakness and paralysis is experienced.
ALS is a somewhat difficult disease to diagnose. There is not one test or procedure to instantly establish the diagnosis of ALS. Through the use of clinical examination, and a series of diagnostic tests, often ruling out other diseases that mimic ALS, that a diagnosis can be established. A comprehensive diagnostic check-list includes most, if not all, of all the following procedures:
- Electrodiagnostic tests- Electomyography (EMG) and Nerve conduction velocity (NCV)
- Blood & Urine studies
- Spinal tap
- X-rays including MRI
- Myleogram of cervical spine
- Muscle and/or nerve biopsy
- A thorough neurological examination
These tests are done at the discretion of the physician, usually based on the results of other diagnostic tests and the physical examination. There are several diseases that have some of the same symptoms as ALS, and most of these conditions are treatable.
Treatment of ALS can be done with physiotherapy, focusing on stretching and daily range of motion (ROM) exercises. Our physiotherapists at Triangle will focus on the emphasis of energy conservation and teach patients and caregivers methods for performing safe, efficient transfers. Our therapists at Triangle can also provide instruction for strengthening exercise programs. In one study, individualized, moderate-intensity, endurance-type exercises for the trunk and limbs performed 15 minutes twice daily was shown to significantly reduce spasticity as measured by the Ashworth scale. At Triangle, we may have to recommend wheel chairs to anticipate the patients future needs. Initially, a lightweight wheelchair should be rented, with future plans to purchase a heavier chair when the patient is no longer able to ambulate. Modifications will be recommended on the basis of the patients condition and tolerance for gadgets.
An ankle sprain refers to tearing of the ligaments of the ankle. The most common ankle sprain occurs on the lateral or outside part of the ankle. This is an extremely common injury which affects many people during a wide variety of activities. It can happen in the setting of an ankle fracture (i.e. when the bones of the ankle also break). Most commonly, however, it occurs in isolation.
Causes of ankle sprain
Any movement that suddenly twists the foot beyond the natural range of motion can cause an ankle sprain such as:
- Landing wrong when jumping or running on to an uneven surface.
- Stepping off a curb wrong
- Slipping on ice
- Tripping on a hole in the ground
Consequence of ankle sprain
When an ankle is sprained, the ankle bone itself is uninjured. It is the ligaments surrounding the ankle bone that suffer. Ligaments are structures in every joint in the body that help control the joint’s movement. The ligament will become injured if it is stretched too far and could result in a partial or complete tear. There are two different types of an ankle sprain.
- The inversion ankle sprain is the most common type of sprain and occurs when the foot falls inward and stretches the outer ligaments too far. Pain occurs on the outside of the ankle and not on the inside of the ankle.
- The eversion ankle sprain occurs when the foot is twisted outwards and the inner ligament is stretched too far. Pain will occur on the inside, and not the outside, of the ankle.
THE SEVERITY OF THE ANKLE SPRAIN
First degree symptoms – a first degree ankle sprain is when the ligaments have been stretched but not torn. Symptoms include:
- Mild pain
- Some swelling
- Some joint instability
- Mild joint stiffness
- Difficulty jogging or jumping
Second degree symptoms – a second degree ankle sprain is the most common of ankle injuries and is a partial tearing of the ligament. Symptoms include:
- Significant swelling
- Bruising
- Moderate pain
- Some loss of motion or use of the ankle
- Trouble walking
Third degree symptoms -– a third degree ankle sprain is the most severe of ankle injuries. With this sprain, the ligament has been torn completely. Symptoms include:
- Severe swelling
- Severe pain
- Instability of the joint
- Extreme loss of motion
- Walking can be quite painful
TREATMENT FOR ANKLE SPRAINS
Rest – especially in the first 24 to 48 hours
Ice – for the first 48 hours for 20 minutes at a time
Compression – wear a brace or a wrap that is snug, but not cutting off circulation
Elevate – above the heart as often as possible
Physical therapy is a mainstay. Patients should learn to strengthen the muscles around the ankle, particularly the peroneals. An ankle brace can be used in an athlete until a therapist believes that the ankle is strong enough to return to play without it. Surgery is rarely indicated but may be needed in a patient who has cartilage damage or other related injuries. Ligaments are only repaired or strengthened in cases of chronic instability in which the ligaments have healed but not in a strong fashion.
Frequently Asked Questions
What is a high ankle sprain and is that different from a regular ankle sprain?
A high ankle sprain refers to tearing of the ligaments that connect the tibia to the fibula (this connection is also called the syndesmosis). These are different and much less common than the standard lateral ankle sprains, meaning those that occur on the side of the ankle.
Do ankle sprains ever need to be repaired acutely?
Ankle sprains rarely, if ever, needed to be treated with surgery. The vast majority simply need to be treated with rest, ice, compression and elevation followed by physical therapy and temporary bracing.
I have sprained my ankle many times. Should I be concerned?
Yes. The more you sprain an ankle, the greater the chance that problems will develop. For example, turning the ankle can lead to damage to the cartilage inside the ankle joint. You should see your doctor if this is occurring.
To get your ankle assessed, schedule a consultation with a physiotherapist at Triangle Physiotherapy and Rehabilitation!
Written by: Puru Chattopadhyay, Resident Physiotherapist
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