Ankle sprain

　　When descending stairs or walking on uneven roads, the ankle joint is in plantarflexion, and it may be subjected to internal or external inversion violence, causing excessive tension of the ankle ligaments, leading to partial or complete ligament injury, or even ligament elongation, avulsion fracture, or subluxation or dislocation of the ankle or tibioperoneal syndesmosis. If the acute ligament injury is not properly repaired, the ligaments may become loose, leading to recurrent injury and chronic instability of the ankle joint.

　　The joint capsule fibrous layer thickens to form ligaments, mainly consisting of three groups:

　　1. The medial collateral ligament:Also known as the deltoid ligament, it is the strongest ligament in the ankle joint. Its main function is to prevent inversion of the ankle joint, originating from the medial malleolus and extending fan-shaped downward, dividing into bands that terminate at the navicular bone, talus, and calcaneus. According to the direction of the fibers and the different insertion sites, it is further divided into the tibionavicular ligament, talotibial ligament, calcaneotibial ligament, and posterior talotibial ligament.

　　2. The lateral collateral ligament:Originating from the lateral malleolus, it divides into three bands that terminate at the anterior and lateral, lateral, or posterior aspects of the talus, hence also known as the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament. It is the weakest ligament in the ankle.

　　3. The tibiofibular syndesmosis:Also known as the tibiofibular cruciate ligament, it consists of two ligaments that connect the front and back of the distal ends of the tibia and fibula tightly, deepening the anterior and posterior compartments of the ankle joint, and stabilizing the ankle joint. If the medial collateral ligament is injured, it will cause lateral instability of the ankle joint. If the lateral collateral ligament is injured, it will cause instability of the ankle joint in all directions.

　　If the disease is not treated properly in the early stage, the ligaments may become excessively loose, leading to ankle instability and an increased risk of recurrent sprains. It may even cause joint cartilage damage and traumatic arthritis, severely affecting walking function. The complications of improper prevention and treatment of ankle sprain generally include the following types:

　　7. Insufficient muscle strength, decreased motor ability.

　　6. Decreased range of motion of the ankle joint.

　　5. Long-term pain and swelling in the foot and ankle without a clear cause.

　　4. Ankle instability, feeling unsteady when walking. Habitual ankle injuries are more likely to occur.

　　Ankle sprain may cause pain, local swelling, subcutaneous ecchymosis, and increased pain when moving the ankle joint. Examination may reveal localized tenderness at the injury site, and increased pain when the ankle joint is plantarflexed and compressed, leading to inversion or eversion of the foot. There may be severe pain when moving the foot and ankle, making it impossible to stand or walk. The pain is felt in the bone, with a sound during the sprain. Swelling occurs rapidly after the injury, and X-ray examination can clarify whether there is a problem with the bone.

　　From literature and books, it can be understood that there are roughly two directions to prevent ankle sprains:

　　1. Appropriate equipment:Talking about equipment means wearing long boots, especially shoes with a shoe box height that can wrap the ankle, which can of course prevent ankle sprains. In practice, there are three common problems:

　　(1) Many players or friends do not tie the laces at all; without tying and wrapping the ankle, the shoes are not only easy to fall off but also cannot protect the ankle.

　　(2) Many players play basketball in short boots, and it is a joke to talk about preventing ankle sprains when there is no way to 'wrap the ankle' in the shoe box. Especially many people play basketball in fabric shoes.

　　(3) The shoes are too big, and some friends buy shoes worrying that their feet will continue to grow, so when buying, they do not follow the principle of buying one size larger, but aim for two sizes larger. As a result, the ankle cannot be completely wrapped, and the foot can slide inside the shoe, so there is no protection at all.

After discussing the above issues, readers should understand that to prevent sprains, it is a better choice to buy long boots, tie the laces properly, and not to buy suitable shoes with the thought of saving money, etc.; do not buy running shoes or canvas shoes used by track and field athletes, or short boots suitable for volleyball or badminton players, or show off and not tie the laces, etc., as these are self-inflicted wounds.

　　2. Appropriate ground:Taking basketball as an example, if the wooden floor is not properly maintained, the boards are almost as slippery as an ice rink; therefore, even if the outsole of the new sports shoes is perfect, players are still prone to sprains due to slippery conditions on the court. Of course, there are also some cement courts, especially those made by beginners, which have too much cement and too little sand and stone, which is what the cement workers call 'high weight'; as a result, the court is also very slippery. Then there is the PU plastic court, if it is old or after the rain, this kind of plastic court is also easy to cause people to slip or sprain; there is also outdoor plastic court, which always has a lot of sand and stone, so even if wearing new sports shoes with perfect soles, it is still difficult to stop quickly. Playing there, of course, is prone to sprains; therefore, avoiding playing in such places is the key to preventing sprains.

　　After an ankle sprain, pain, swelling, and subcutaneous ecchymosis may occur, and the pain of moving the ankle joint will worsen. Examination can find localized tender points at the injury site. When the ankle joint is in plantar flexion and pressure is applied, the pain will worsen when the foot is inverted or eversion, indicating that a diagnosis of ankle ligament injury should be made. The diagnosis of partial ligament injury, relaxation, or complete rupture can sometimes be difficult. An ankle anteroposterior X-ray film taken in the extreme inversion position under pressure can show a significantly widened lateral joint space, or on the lateral film, the talus can be found to be semi-dislocated forward, which is mostly due to complete injury of the lateral collateral ligament, and ankle anteroposterior and lateral X-ray films can show avulsion fractures.

　　1, Consume foods rich in protein, amino acids, high vitamins, and high nutritional value.

　　2, Eat more foods that are beneficial for detoxification and detoxification, such as mung beans, red beans, winter melon, watermelon, etc.

　　3, Eat foods with pain-relieving and anti-inflammatory effects, such as asparagus, lotus root, Chinese water chestnut, hawthorn, otter meat, heron meat, crab, sea cucumber, sea turtle, and sea snake.

　　4, Avoid eating foods containing carcinogens such as vegetables containing strong carcinogens such as nitrites, moldy foods, pickled, smoked, roasted, and fried foods.

　　5, Avoid smoking, alcohol. Avoid spicy and irritating foods such as scallions, garlic, ginger, Sichuan pepper, chili, cinnamon, etc.

　　6, Avoid fatty and greasy foods.

　　Treatment:For not very serious ankle sprains, immediate cold compress (soak in cold water for 10-15 minutes) can reduce pain, prevent excessive swelling, and help prevent internal bleeding of the tissue. If ice is used, it should not be directly in contact with the skin, otherwise it may burn the skin, and a bandage should be tied around the ankle. Hot water basin and cold water basin can be beneficial for treating ankle sprains, stimulating blood supply to heal as quickly as possible and reduce swelling. Place the heel in a suitable hot water basin for about 15 seconds, then transfer to a cold water basin for about 5 seconds, and so on.

　　For acute injuries, immediate cold compress (cold water soak for 10-15 minutes) should be applied to reduce local bleeding and swelling. After 48 hours and local physical therapy, promote tissue healing. For partial ligament injury or laxity, in the 90-degree dorsiflexion position of the ankle joint, extreme inversion position (when the medial collateral ligament is injured) or eversion position (when the lateral collateral ligament is injured), the foot-shaped plaster cast should be fixed, or wide adhesive bandages and bandages should be used to fix for 2-3 weeks. For complete ligament rupture combined with ankle instability, or for small avulsion fracture fragments, the foot-shaped plaster cast can also be used for 4-6 weeks. If fracture fragments enter the joint, the fracture can be reduced and fixed, or the ruptured ligament can be directly repaired. Postoperative fixation with a plaster boot for 3-4 weeks. For patients with recurrent injury and collateral ligament laxity, ankle instability, it is advisable to wear high-top shoes for a long time to protect the ankle joint. Due to chronic instability in the later stage, ankle dislocation may occur, cartilage degeneration leading to osteoarthritis, drugs such as sodium hyaluronate can be injected into the joint, or joint arthroplasty can be used for treatment.