Iliotibial (IT) Band Pain Causes & Treatment

Finally, you’re getting farther and farther along in your mileage and the longer runs are starting to feel a little better. You’re starting to break into your stride earlier into your runs and though the terrain may have been challenging, you finish the run and hardly remember suffering on the hills. The big race is still a few months out but your weekly training volume is on track to put you into a very advantageous position come race day. Then, on a particularly challenging volume week, you notice a slight pulling sensation in the outside of your knee towards the end of your long run. You shrug it off thinking it’s just a mild tweak, but then during the next week the sensation is still there but is present even on the shorter runs and during your next long run it becomes full-on painful. Then it hits you…

“Oh crap… this could be bad”.

Iliotibial band friction syndrome (ITBFS) to a training plan is like the Joker to Batman, the Night King to John Snow, Starbucks to every hipster coffee snob (guilty…). It takes the wind out of your sails and robs you of valuable training time when gearing up for a big race. Let’s delve into this condition to figure out exactly what to do in the event this arises. 

What is Iliotibial Band Syndrome?

Iliotibial Band Friction Syndrom (ITBFS) occurs as a result of the long rigid connective tissue band repeatedly rubbing over the lateral femoral condyle during the load-bearing phase of the gait. The IT band originates at the hip and is the tendinous portion of the Gluteus maximus and Tensor fascia latae muscles. It courses down the entire lateral thigh and inserts on the superior portion of the anterolateral tibia (the outside of the shin bone). Pain is most commonly felt directly over top of the lateral femoral condyle (the big bump on the outside of the knee) and comes on when the knee is being loaded.

During a single leg stance in running the hip muscles stabilize the lower leg which forces the IT band to be drawn tight and compress against the lateral knee and the tissues between it and the bone. The tendon repeatedly compressing and rubbing against the side of the knee during a run, especially a long or challenging run, will cause this area to become inflamed.  

What Causes IT Band Pain

There are a few things that may cause IT band pain such as the continuous compression and rubbing of the tissues in your leg. Due to muscle strains, the hip is unable to keep the knee from tracking over the toes during a run will cause the knee to “dive-in”, or during the stance phase start to track to the inside of the foot. This knee position is called “valgus” and lengthens the IT band, even more, thus magnifying its compressive quality. 

comparison photo of a knee that has collapsed inwards vs a normal straight knee alignment

The knee may also “dive-in” if the arch of the foot collapses. When this happens, the foot and ankle will over-pronate thus internally rotating the tibia and throwing the knee into the same valgus position as aforementioned. I talked about this phenomenon in this previous article. 

Iliotibial (IT) Band Treatment 

young male stretching his legs before a workout Since ITBFS is directly related to training volume, unfortunately, the first step in treating IT band syndrome does involve dropping your workout volume considerably. As a provider that strives to keep athletes continuing to perform this is really tough to do. The second thing is to circle a date on the calendar 2 months from the current date. By this date, considerable progress should have been made if not complete resolution of the condition. This is by far the hardest part of getting better but is pivotal in the quest for full resolution of knee pain

Now, just because we have dropped the training volume doesn’t mean that you don’t train. In fact, at this point, you train harder than ever, just differently. We first have to assess the athlete’s gait and foot to determine if weakness in the hip is causing the pain, dysfunction of the foot, or both. If the problem is with the foot there are a handful of go-to treatment options that is great at regaining function of the foot and ankle. I go into detail on some of these exercises in the article that I mentioned earlier. If the weakness of the hip is causing the knee to drop valgus then hip strength absolutely must be addressed. 

The knee is a “responder” meaning that it merely reacts to the forces put on it by the hip and by the foot. Therefore, assessing alignment and function through the entire lower kinetic chain is pivotal in Iliotibial treatment. If the pelvis is fixated in any way, the gait will be altered. The same goes for the foot and ankle. 

lastly, at the level of the knee, the tibia may be stuck in internal or external rotation and the fibular head may not be moving as it needs to. This is especially important as fascia from the IT band connects directly to the fibular head and lack of movement here will draw the distal IT band attachment even tighter. IT band chiropractors and Physical Therapists are uniquely trained to restore the function of these areas therefore, having the entire lower extremity assessed should be the starting point in dealing with ITBFS.

Why You Should See us at Knoxville Spine & Sports

As depressing as it to deal with a set back such as ITBFS, it really can wind up being a blessing. Injuries, especially this one, highlight your biomechanical flaws. If you have faulty biomechanics when running, something bad is guaranteed to happen at some point during your running career. 

The nature of the rehab for this condition forces you to become stronger and more stable than you ever were before the injury happened. In short, IT band syndrome is complex and therefore you must find care from a professional that addresses the root cause of your pain. Call Today to schedule an appointment with our IT band doctor at (865) 337-5574

Iliotibial Band Rehab Exercises

Plan: Strengthen glutes while mobilizing the soft tissue of the hip and quad. 

Mobilizing: Every day you should be spending 5-10 minutes mobilizing the musculature of the hips and thighs. This could be rolling, stretching, trigger point work, etc. It doesn’t matter what particularly you are doing, just be diligent about making it a small part of your daily regimen. Do it before or after the exercises. If it is particularly sore one day, roll before the exercises. 

*Sidenote – foam rolling should not be done on the ITB itself. Release out the tissue of the hips and when rolling the lateral thigh, stay just anterior or posterior to the ITB. When you’ve found a trigger point, slowly flex and straighten the knee. Grin and bear it… You’ll thank me later.

IT Band Exercises

group of people working out and squatting with a kettle bell Each series of IT band exercises is broken up into phases of healing. As you continue to heal, you can integrate harder movements into the plan. You can break it up into weeks, but it is variable as some phases of healing take longer than others. The ultimate determinate in the progression is pain and performance, i.e how does it feel when you are running or going through taxing movements.

  • Phase 1: Pick 4 of the exercises from Progression 1 to perform 1x / day.
    • Since you’ve been resting it since the race, this shouldn’t be more than 4-6 days
  • Phase 2: 2 exercises form Progression 1 and 3 exercises from Progression 2
    • This should last 5-7 days. Hiking should be tolerable and mild pain with beginning running before progressing.
  • Phase 3: 4 exercises from Progression 2 and 1 exercise from Progression 3 
    • 10-15 days. Extensive hiking without pain, 3-4 miles with only mild pain before progressing.
  • Phase 4: 1 warm-up exercise from Progression 1, 2 exercises from Progression 2 and 3 exercises from Progression 3
    • 10 -12 days. Running should be getting easier and miles should be increased before progressing.
  • Phase 5: 1 warm-up exercise from progression 1, 4 exercises from progression 3
    • Perform until running is painless.

Progression 1 drills:

  • Side-lying Clams – 2x 12 bilaterally 
  • Side-lying straight leg raise (abduction and slight extension) – 2 x 12 bilaterally
  • Quadruped donkey kicks (maintain slight knee bend) – 2 x 12 bilaterally 
  • Standing door jamb hip drill – 2 x 20-second hold (go longer as strength develops).
  • Star drill on an unstable surface – 2 x 5 rounds. 

Progression 2 drills:

woman performing a split squat with her sports training

  • Split squat (with or without valgus bias. Add weight as needed) – 2 x 12 bilaterally. 
  • Box step down (short box or stair step. Add weight as needed) – (IG @dr.jacob.hardin)
  • Banded monster walks – 2 x 15 steps. 
  • Glute bridge with a single leg lower – 2 x 10. (lower on 3 counts) 
  • Hip abductor side plank – 2 x 10. (IG video @rehabscience)
  • Dropdown Squat (From 12”-16”) – 2 x 15 

Progression 3 drills:

  • Single leg squat on the box (Add band with a valgus bias to make harder. These can be with weight as well) – (IG video @theperformancedoc)
  • Dropdown squat – single-leg landing (knee should bend to 50 degrees upon landing) – 2 x 15  
  • Split squat with 5 second holds at the bottom. Heavy dumbbells. –  2 x 8 (@strengthcoachtherapy)
    • Or Rear foot elevated split squat (about 6-10 inches) with lighter weight
  • KB goblet squats – 2 x 12. (IG video @theperformancedoc)
  • KB Deadlift – 2x 12

*Valgus Bias – Strapping a band around your knee to pull it in towards the other knee (genu valgus). This forces you to use your glutes more to keep your knee tracking properly during the movement. This can be added to any exercise as you progress.

* KB – Kettle Bell

Note: This is not an exact science. These progressions are estimations AT BEST. You may take shorter or longer to move through to the next phase and may be able to do more or less than what I wrote down before you move to the next set. You can also easily add weight, reps, or more exercises to each phase as needed. 

Make an Appointment with an IT Band Doctor

To learn more about how we can help you recover from IT Band Syndrome or other injuries call our office in Knoxville and make an appointment. Set up a consultation with our IT Band doctor at (865) 337-5574

 

Headache Treatment and Dry Needling

Headache Treatment and Dry Needling

One of the most common conditions we treat within our clinic using dry needling is headaches. There are many forms that range from tension headaches to chronic headaches to migraines. With the majority of headaches, including the various types of migraines, the musculature of the upper neck and back of the head is commonly involved and much of the time can even be the cause. If you are looking for headache treatments that work we offer a few options below. 

Headache Treatment Options

Female business woman holding her head

Chiropractic adjustment is an extremely powerful tool, especially in the upper cervical region. In fact, there are entire techniques and disciplines within chiropractic care that are built around the careful manipulation of this region. Restriction of these upper cervical joints will cause further spasm of the muscles and due to their proximity to the brainstem and cranial nerves can cause many of the nerves of the head and neck to become irritated and even entrapped. 

Adjusting this region to clear out the restriction of these joints is always the first step. Due to the severity and chronicity of the headaches, the musculature of this region may still be very hypertonic and irritated and thus, it is also important to address it individually. Dry needling is hands down the most powerful way to affect the musculature in this region. 

What is Dry Needling?

Dry needling utilizes a very thin metal filament without any injectable compound to penetrate a spastic muscle or trigger point in hopes of downregulating its tone. The needle is inserted into the skin, deep down into the inflamed area. This direct and profound stimulus is such a jolt to the mechanoreceptor that it can cause a hard reset of the entire control panel that is regulating its tone. This allows for a local relaxation of the tissue and thus the resolution of the painful trigger points. 

How is Dry Needling Administered

female patient receiving dry needling treatments

There are multiple different approaches to dry needling that vary strictly around the application. The type of application that we utilize at Knoxville Spine and Sports is the ‘Set it, and leave it’ approach. Patients with chronic headaches have the dry needles are inserted in the suboccipital region, a very thin filament is used to puncture the individual muscle in question. This is commonly a suboccipital muscle, levator scapulae insertion, or upper trap insertion. 

Most people are only vaguely aware of the needle going in and once it is in the muscle will hardly be aware of it at all. These needles will be left in from 3-5 minutes and moving or engaging that muscle is discouraged during this time. 

Why You Should See A Headache Doctor

Headaches are very complex disorders indeed with multiple layers. Therefore, it makes sense that to address them, you need a multifaceted approach. Address the joint mechanics by adjusting the area and treat the residual musculoskeletal dysfunction with the most effective trigger point therapy on the market, dry needling. This one-two punch is sure to help your symptoms. Call Today to schedule an appointment with our specialist at (865) 337-5574

Physical Therapy vs. Chiropractic: What’s the difference?

Physical Therapy vs. Chiropractic: What’s the difference?

Chiropractic or physical therapy… that is the question. And frankly, a good one when you get right down to it. The faces of both professions have continued to grow and develop over the years, largely, both for the good. However, the distinct lines demarcating the lanes of each profession have begun to blur over as of late. Is this a good thing or a bad thing? Well, that depends on who you ask.

What is Chiropractic?

chiropractor adjusting a female patient upper back

Chiropractic care is likely the most dynamically different between the two as they have, generally speaking, diversified the most within the profession. Similar to how medical doctors perform a variety of different roles from general medicine to plastic surgery to research, the styles of chiropractic also drastically vary. Both the best and worst thing about the chiropractic profession is the freedom that you are granted to practice how you would like. This is great for a provider with a unique niche in mind though it winds up being terribly confusing for the general public.

 When seeing the chiropractor, you don’t know if you will be manually adjusted, adjusted with a clicking tool (an activator or integrator), or with an elaborate machine. Will the whole body be worked on or just the upper neck? Would you see the doctor for 2 minutes or 2 hours? Would you be treated on the 1st or 4th visit? Will you be asked to hold crystals and sign up for an expensive and elaborate care plan? the list goes on. However, the same principle stands for all of chiropractic care, some type of adjustment or manipulation to the spine is performed in hopes of restoring function to the body and thus making the person better in some way. Unfortunately, that is about as clear and concise as it gets when defining chiropractic. No wonder people can’t make up their minds how they feel about the profession.

What is Physical Therapy?

physical therapist in discussion with a senior female patient

Physical therapy certainly has its differences within the profession as well but, generally, people usually have a pretty good idea what they’re getting themselves into when starting physical therapy. There will likely be some forms of exercise and/or stretching specific to the injury that they are attempting to overcome. It will likely be slightly more regionally focused (specific body region) than globally-focused as in traditional chiropractic. 

What Treatment Option is Best For Me?  

Man with shoulder pain and stiff neck sees chiropractor in knoxville for treatment

So, the most important thing to consider when attempting to find out what is best for helping your condition is to find out what type of doctor you are seeing. Some people claim that upper cervical chiropractic care can help with a lumbar disc bulge, but it is fairly few and far between that they are successful. A manual chiropractor or PT is probably best for that sort of thing. However, for headaches it may be a great idea. Or, if you are immediately post-op from surgery, PT is definitely going to be the place to start looking over almost all types of chiropractic care.  

It gets a little more complicated when attempting to figure who to see between a sports chiropractor and a manually focused physical therapist for general aches and pains. “Manual focused” means that the therapist will be doing hands-on soft tissue and low-grade joint mobilizations in addition to prescribing and overseeing stretches and exercises. There is a ton of overlap between the therapies that both professions provide. 

woman receiving a sports massage on her upper back

A sports chiropractor will typically favor the manual modalities before overseeing exercises and stabilization drills. They tend to spend a little more time assessing the joints and emphasizing the manipulation of fixed or restricted regions before moving on to the stability and strength phase of care. It’s important to note that this doesn’t just mean mobilizing joints. Soft tissue treatment via a number of therapies, ART, Graston, cupping, etc. are employed within the sports chiropractic realm.

Drawbacks to Be Aware of

A fairly considerable drawback is that many of the insurance companies don’t reimburse chiropractors for performing the necessary amount of exercise, strength, and stabilization work that is needed to adequately rehabilitate an injury. However, they will reimburse physical therapists fully for that same strength and stability phase of care. Thus, due to the restrictions placed on chiropractors with regard to reimbursements, the ratio tends to be 60-65% manual therapy and 35-40% therapeutic exercises. This tends to be the inverse for physical therapy. 

So, What Does This Mean for Me?

 The general flow of care for both sports chiropractic as well as PT is as follows:

  • Maximize mobility of the restricted or damaged tissue, joint or otherwise, and emphasize means to maximize tissue health.
  •  Stabilize and strengthen the now mobile joint through therapeutic exercise specific to that region.
  •  Increase motor control of the region through various proprioceptive challenges such as balance work and larger scale functional movements.

chiropractor adjusting a male patient lower back

Therefore, a loose strategy to follow, that of course varies depending on the condition, would lean towards seeing a chiropractor on the front end of the injury since they tend to focus slightly more on the number 1 listed above. For numbers 2 and 3, perhaps consider transitioning into physical therapy once improvements to the joints and tissues have been made since they will be able to spend the time needed to maximize stabilization and strength of specific regions. 

Unfortunately, it’s not a hard and fast science when deciding between sports chiros and physical therapists. But one thing stands, therapists (PT’s or chiros) that have respect for the other profession and are willing to refer back and forth will always achieve the best outcomes and get you better quicker.

 

How Can Sports Chiropractic help an Athlete

How Can Sports Chiropractic help an Athlete

There is a reason that nearly every professional sports team employs a chiropractor. Tom Brady, who is nearly 40 and just as sharp as ever has been known to talk about his relationship with chiropractic by saying, “As long as I see the Chiropractor, I feel like I’m one step ahead of the game”. In fact, all of the NFL teams and indeed many of the D1 collegiate teams have chiropractors on staff that work alongside the athletic trainers to ensure that their athletes are functioning at their fullest capacity.

 So what is it that makes chiropractic care so important to Athletes? There are a few important things to note first about human physiology to fully understand how chiro can have such a profound impact on performance.

Common Causes of Injury

Chiropractor adjusting a patients lower back

There are many reasons that joints may become stuck or restricted. Much of the time the problem is postural in nature, meaning that the way that you sit, stand, walk, etc. can put certain joints at a biomechanical disadvantage. Having these joints in improper positions for long periods of time causes the tissue around them to tighten up and bind down the joint. However, in the Athletic fields, it largely has to do with the joints constantly absorbing impact. This can be seen in the constant ground reactive forces being placed on runners, the collisions of football, the unilateral swings of tennis, are all common sports injuries that require continually pulling on muscles and joints are absorbing forces.

These joint restrictions can happen all over the body from the head to the toes. Chiropractors are known by the public primarily as back doctors but careful manipulation of places like the feet, hands, and shoulders can be just as impactful especially to the athlete.

How Our Bodies Pain Receptors Work

Tennis player holding his elbow due to pain

As Humans, we derive almost all of the information about where our limbs are in space from little pain receptors in the joint. The same way that a digital thermometer can give a readout immediately as the temperature changes, our joint mechanoreceptors do the same thing with movement. They give constant feedback to the brain that lets us know exactly how our feet, hands elbow, and indeed everything, is moving.

 When joints are restricted and are unable to move to their full capacity we lose our innate ability to perceive where our bodies are and how they are functioning in space. It’s like a thermometer that will only tell you the temperature between 50 and 70 degrees. Outside of that range, it’s useless and we no longer know how to prepare for the elements. It is much the same way with our joints. When our brain no longer knows fully how that joint is moving, it can’t recruit the proper muscle to stabilize the joint. 

This is when we see things like non-contact ankle sprains, ACL tears, and even craziness like rupturing a disc from a sneeze! When the brain can’t fire the right tissue to stabilize the joint against the movement, we pay for it in a big way.

illustration of the nerves in the human shoulder

This same concept can be extrapolated upon by looking at athletes returning from a mild ankle sprain. Trauma to the tissue will cause inflammation which leads to two separate ways that the body will try to stabilize the injured area, muscle spasm, and adhesions in the tissue. During the acute stage, these two mechanisms are important so that we don’t make the injury worse, however, they both will lead to the original topic of conversations, restricted joints. As stated above, this will change the neuromuscular control from the brain which, if not treated, leads us back to an increased likelihood of undergoing another ankle sprain due to a lack of motor control. 

Knoxville Sports Chiropractic Treatment

chiropractor helping patient stretch his shoulder

As Sports chiropractic proffesionals we address these restrictions head to toe. The chiropractic adjustment is one of the most important tools available for freeing up restricted joints which we utilize as the cornerstone of our practice. From there we use cutting edge tools and techniques for treating the soft tissue that ranges from Active release technique, Graston, dry-needling, cupping, and a plethora of other modalities to ensure that the adhesions and tight, spastic musculature are fully returned to its pre-injury state. 

From there, neuromuscular re-education through a series of therapeutic, functional exercises are absolutely imperative to ensure that you are once again able to move the way that you did before, and further, to decrease the likelihood of reinjuring yourself. The best part of all of this, you don’t need to be an athlete to benefit from this type of care. If you move, you need it!

Ankle Sprains and how to treat this condition from home

Treating Ankle Sprains from Home

A quick search on the internet for most common ankle sprains will show that roughly 75% of all ankle sprains are what is referred to as “Inversion” ankle sprains.  This injury occurs due to excessive rolling of the foot and ankle to the outside of the foot. Inversion is the foot position you would be in if you were to walk on the outside of your foot.  Eversion is the opposite foot position and eversion ankle sprains occur less often and will not be apart of this particular blog post; however, this might be a good topic for us to discuss another day.  

What Causes an Ankle Sprain

Almost all ankle sprains are due to an excessive force to the ankle applied in this extreme inverted foot position.  Most ankle injuries are sustained due to several factors which may include ballistic sports activities, walking or running on uneven surfaces, prior ankle injuries, improper shoe wear, and poor physical condition.   Ballistic sports are characterized as any sport needing quickness, explosive movements, and agility. With these quick explosive movements, the ground reactive forces applied to the foot and ankle are such that the ligaments of the foot and ankle may be overloaded or overstretched causing foot and ankle injury.

If you have ever walked on cobble stone streets in Savannah, Georgia you can testify to the negative effects of walking or running on uneven surfaces.  When I think of these type of surfaces, “trail running” comes to mind as well as playing on poor field quality with clumpy lumpy grasses. I can remember playing college soccer on uneven fields, thinking about each grassy clump as a land mine just waiting for some poor soccer player to come along and set it off.  It does not take much imagination to consider how uneven surfaces can negatively affect the foot and ankle.

Ankle Sprain Treatment in Knoxville

Within Knoxville Spine and Sports, we have treated many runners and athletes over the years for inversion ankle sprains and we have noticed many have had prior ankle sprains leading to loose ligament that predispose them to repeated sprain of the foot and ankle.  Every time we sprain a ligament or joint capsule, we deform those structures and make those joints looser. I can remember the first time I dislocated my right shoulder (playing baseball no less, #DontJudgeME) the pain was nauseating to say the least and yet each right shoulder dislocation I had was less and less painful and quite easy the next time around.

As a Sports Physician, I find myself walking around town watching other peoples gait and thinking to myself how poor their shoe wear is and what a difference good shoe wear would be to help restore the proper biomechanics of walking and running. This is a unique time in the life of footwear as now more than ever it is both at its best and worst. I am constantly assessing patients shoe wear for durability, stability, and motion control.  I could write an entire blog just on the necessity for good shoe wear to help maintain proper foot and ankle control while playing sports or walking down the street for that matter. Needless to say, footwear is crazy important when talking about inversion ankle sprains.

To this point, I can’t tell you how many times we have heard a patient say they were walking down the street or in the house and sprained their ankle.  Some of this is due to lack of physical condition or what we consider deconditioning due to lack of physical activity. I am thinking of the dad who is a desk jockey and wants to go outside and show his children that “Dad still has skills” and ends up with a grade II inversion ankle sprain.  This happens all the time!

How Our Chiropractors Grade Sprains to Assess Treatment of Sprained Ankles

Sprains are graded as I, II, III and are treated differently depending on the severity and number of structures involved.  A sprain is defined as a violent overstretching or tearing of a ligament or joint capsule. These sprains cause damage to the affected structures and sprains are graded based on severity of the damage and the number of structures involved.  We will briefly describe each grade and the clinical signs and symptoms of each.

Grade I:

Grade I Inversion ankle sprains are described as an overstretch of the affected structures having minimal swelling in and around the outside of the ankle joint as well as mild to moderate pain and tenderness with touching the affected area.  There will also be a 25% loss of ankle mobility due to pain and swelling. The foot and ankle in question will not tolerate fast walking and will exhibit pain with single leg toe raises and light single leg hopping.

The course of treatment will be to P.R.I.C.E. (protect, rest, ice, compress, elevate) the ankle for the first 48-72 hours.  There must be no pain with walking, or a brace or crutches will be needed in order to accomplish pain free ambulation/waking.  You must not walk on the affected foot until there is little to no pain with weightbearing. Mobility is key so after the first 48 hours and within a pain free range one should begin ankle mobility exercises such as using the toes on the affected foot to draw the alphabet in the air.  Sometimes we will ask the patients to write their name in cursive with the toes of the affected foot. This promotes increased healing with a full and free range of motion. Once you are able to weight bare pain free you must then start to strengthen the ankle and work on your balance.  Balance is the fastest and quickest way to rehab an ankle injury. These exercises should be safe yet challenging to the affected foot and ankle.

Grade II:

Grade II Inversion ankle sprains are described as having multiple ligaments involved with possible partial micro-tearing and moderate to severe pain with single leg toe raises.  Swelling will be pitting and full on the affected outside of the foot and may continue to the front and back side of the ankle. The foot and ankle will not be able to tolerate weightbearing nor single leg hopping.  Pain will be 4-8/10 on the pain scale and there will be a 50-70% loss of active mobility in the ankle joint. There will also be bruising around the outside of the ankle and foot over the course of the first 72 hours following the injury.  

The course of treatment for the first 72 hours will be the same as for a Grade I (P.R.I.C.E).  It is imperative that you be able to offload the foot and ankle with crutches or a walking boot until you are able to weight bare without pain.  This may take up to 2 weeks and then an additional 7-10 days in a stabilizing ankle brace. With a Grade II ankle sprain it is my professional opinion that seeking the help of a trained sports medicine specialist is appropriate to assess and speed up the healing process with the most effective means possible.  

A functional rehabilitative program will be needed for the patient to return to sport in a safe and supported way.  The Home Program will start with controlling pain and the inflammatory process, improve pain free range of motion and a range of motion that is freely accessible.  The next phase of Home care will be to increase balance work and strength of the affected joint.

Grade III:

Grade III Inversion ankle sprains are described as a complete tear of the ligament in question and or the joint capsule with possible fracture of the fibula or tibia.  This is an extreme injury and will need the expertise of a trained physician and possible diagnostic imaging to see the extent of the damage.

It is necessary to seek professional help in these cases and surgery may be required.  The key is to P.R.I.C.E for the first 72 hours and maintain good pulses in the arteries of the foot and ankle.  Seek treatment within the first 72 hours so that the extent of the injury can be assessed and measured appropriately.  Rehab will be necessary at the appropriate time which may very depending on the severity of the joint and ligament damage.  

Do You Have a Sprained Ankle?

If you think you have a Sprained Ankle, call us to find out. Sprained Ankle treament in knoxville is not far away. We have highly qualified doctors to help you with non surgical and drug-free treatment of your injury. If you have any questions about this please feel free to call us and we will be happy to speak with you in depth.  

-Dr. Bert