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-   -   Ankle injury....riding with brace (http://www.snowboardingforum.com/slam-section/51352-ankle-injury-riding-brace.html)

Tech420 11-19-2012 04:40 PM

Ankle injury....riding with brace
 
I have bad ankles that have given me fits throughout my life. I tweaked it pretty good a few weeks ago and am still having a problem with it. Has anyone tried to ride with any additional ankle support whether it be a wrap, sleeve, brace...etc? I want to get out and ride this weekend, but would like some extra support. I was thinking of heading over to the local med supply store and picking up one of those sleeve/sock type braces to wear inside my boot.

gjsnowboarder 11-19-2012 05:32 PM

I have ridden with one of the lace up sock variety braces. I didn't notice to many issues with it in the boot. I would recommend dot some rehab exercises to help strength the ankle and lossen it up before and after riding. If you notice swelling practice RICE. And if if the pain becomes sharp feeling rather than a low dull throb stop riding.

DirtyD27 11-19-2012 05:55 PM

I am a physical therapist so I like to offer my advice to fellow riders in situations like this. You don't need a brace. Most boots are stiff and ridged enough to provide ampule support. If you've had numerous ankle problems e.g. sprains in the past and have not gone through the appropriate rehab then your going to have recurring ankle instability. I do not know the extent of your ankle problems but here is the gist of it in terms of ankle rehab. Keep in mind this is post acute, no gross swelling, fractures or ligament tears or ruptures. A little info in what actually happens with a ankle sprain. So a sprain is when you over stretch the ligament, ligaments hold joints together e.g. bone to bone. there are 4 main ligaments that hold the ankle 3 on the lateral side and 1 large on the medial side. Most ankle sprains are inversion sprains, when the foot rolls inward and pain occurs to the lateral aspect of the ankle. Generally followed by immediate swelling and bruising. There are several grades of a sprain determining how badly the ligament was stretched grades 1-4. feel free to Google the different grades if your curious to know the differences, basically 1 is least 4 is complete rupture. Moving on, Ligaments are elastic like tissue that is allowed to stretch to an extent within the ligament fibers there is what's called a muscle spindle. looks very much like a spring. These spindles are neuro receptors, basically they send a messages to the brain telling it how much the ligament is stretching. when the spindle is stretched out to its end range it sends a message to the brain to tell your foot to retract to prevent injury. With a sudden ankle sprain your body and can not react fast enough to make the correction, thus damaging the ligament e.g. a sprain. So when this happens the ligament is now permanently lengthened, or lax, causing instability. In minor sprains grade 1-2 not to bad, grade 2 and higher could be significant. With that being said rehab helps correct this problem by retraining the muscle spindles to how long the ligament now is so that re-injury does not occur as frequently. Additionally, its equally important to strengthen the supporting muscles to better support the ankle. This is all done through skilled, research based therapy. I can show you some exercises that would be beneficial for ankle sprain rehab.

1. Theraband resisted ankle strengthening (Google Theraband resisted ankle inversion, eversion, dorsiflexion and plantar flexion).
2. Functional strengthening, Standing heel raises/calf raises
3. (advanced in terms of ankle rehab) Plyometric line hops forward, backward, side to side. You can even be creative and spin jump line hops. doing 180's or 360's over the line.
4. (advanced) Box jumps from different heights. Focus on controlling how your feet, ,knees an hips absorb the impact, think of your legs as springs with out allowing your knees to dive in.
5. Balance and stability trainers (these retrain the spindles) Single leg balance with knee slightly bent, target time 30 seconds 5 times. Once that is easy single leg balance with eyes closed 30 seconds 5 times. Then Single leg balance on something soft stack of towel, throw pillow, couch cushion or you could buy balance training tools, personally I like the BOSU Ball, I own two and love them. Then next phase in this is to incorporate functional exercises with balance e.g. lunging on to a soft plat form so that front lunging foot lands on soft unstable platform do this in many direction forward, oblique, side ways. and finally jumping and landing on unstable soft plat form.

Remember this is a typical ankle rehab plan, plans vary between individuals injury and level of fitness and medical history. If you are uncomfortable doing something like this I would advise you seek out physical therapist to take you through this process and ensure your doing everything correctly. Additionally stretching is equally as important as strength, and stability. I believe too many people rely on supportive devices such as braces when all that they really need is to train there bodies correctly. I hope this helps. good luck.

gjsnowboarder 11-19-2012 06:02 PM

Quote:

Originally Posted by DirtyD27 (Post 541117)
Additionally stretching is equally as important as strength, and stability. I believe too many people rely on supportive devices such as braces when all that they really need is to train there bodies correctly. I hope this helps. good luck.

Damn straight, the brace for me was more of a mental crutch. Once I regained the confidence in the rehab of my ankle I ditched it and no longer ride with one.

BurtonAvenger 11-19-2012 06:35 PM

Stiff boots with a good liner/internal harness will help a ton. Other than that do what the doc said.

Tech420 11-20-2012 07:45 AM

Quote:

Originally Posted by DirtyD27 (Post 541117)
I am a physical therapist so I like to offer my advice to fellow riders in situations like this. You don't need a brace. Most boots are stiff and ridged enough to provide ampule support. If you've had numerous ankle problems e.g. sprains in the past and have not gone through the appropriate rehab then your going to have recurring ankle instability. I do not know the extent of your ankle problems but here is the gist of it in terms of ankle rehab. Keep in mind this is post acute, no gross swelling, fractures or ligament tears or ruptures. A little info in what actually happens with a ankle sprain. So a sprain is when you over stretch the ligament, ligaments hold joints together e.g. bone to bone. there are 4 main ligaments that hold the ankle 3 on the lateral side and 1 large on the medial side. Most ankle sprains are inversion sprains, when the foot rolls inward and pain occurs to the lateral aspect of the ankle. Generally followed by immediate swelling and bruising. There are several grades of a sprain determining how badly the ligament was stretched grades 1-4. feel free to Google the different grades if your curious to know the differences, basically 1 is least 4 is complete rupture. Moving on, Ligaments are elastic like tissue that is allowed to stretch to an extent within the ligament fibers there is what's called a muscle spindle. looks very much like a spring. These spindles are neuro receptors, basically they send a messages to the brain telling it how much the ligament is stretching. when the spindle is stretched out to its end range it sends a message to the brain to tell your foot to retract to prevent injury. With a sudden ankle sprain your body and can not react fast enough to make the correction, thus damaging the ligament e.g. a sprain. So when this happens the ligament is now permanently lengthened, or lax, causing instability. In minor sprains grade 1-2 not to bad, grade 2 and higher could be significant. With that being said rehab helps correct this problem by retraining the muscle spindles to how long the ligament now is so that re-injury does not occur as frequently. Additionally, its equally important to strengthen the supporting muscles to better support the ankle. This is all done through skilled, research based therapy. I can show you some exercises that would be beneficial for ankle sprain rehab.

1. Theraband resisted ankle strengthening (Google Theraband resisted ankle inversion, eversion, dorsiflexion and plantar flexion).
2. Functional strengthening, Standing heel raises/calf raises
3. (advanced in terms of ankle rehab) Plyometric line hops forward, backward, side to side. You can even be creative and spin jump line hops. doing 180's or 360's over the line.
4. (advanced) Box jumps from different heights. Focus on controlling how your feet, ,knees an hips absorb the impact, think of your legs as springs with out allowing your knees to dive in.
5. Balance and stability trainers (these retrain the spindles) Single leg balance with knee slightly bent, target time 30 seconds 5 times. Once that is easy single leg balance with eyes closed 30 seconds 5 times. Then Single leg balance on something soft stack of towel, throw pillow, couch cushion or you could buy balance training tools, personally I like the BOSU Ball, I own two and love them. Then next phase in this is to incorporate functional exercises with balance e.g. lunging on to a soft plat form so that front lunging foot lands on soft unstable platform do this in many direction forward, oblique, side ways. and finally jumping and landing on unstable soft plat form.

Remember this is a typical ankle rehab plan, plans vary between individuals injury and level of fitness and medical history. If you are uncomfortable doing something like this I would advise you seek out physical therapist to take you through this process and ensure your doing everything correctly. Additionally stretching is equally as important as strength, and stability. I believe too many people rely on supportive devices such as braces when all that they really need is to train there bodies correctly. I hope this helps. good luck.

Well I have noticed no swelling or bruising. This is a rather different ankle injury for me and I haven't had anything feel like this in the past. The pain is more-so in the front(outside front if it matters) on top of my foot. After a few runs I was in a fair bit of pain riding the lifts with my foot dangling (I ride regular so my left foot is strapped in on lifts). I am fine walking around but stretching my foot downwards or upwards far enough sends a slight shock of pain.

DirtyD27 11-20-2012 09:24 AM

Sounds like possibly two culprits to blame. My first thought is that you need to adjust your top strap so that it fits comfortably and there is no weird pressure being applied on your foot. The strap should distribute even pressure a crossed your foot.
Another possibility is that your strapping in to tightly on the top strap. At first you may feel fine but as the day wears on the applied pressure causes pain to your foot due to the lack of mobility at your mid foot.
As for the pain with riding the lift that is undoubtedly a strength issue. As your foot dangles with the the board attached the muscles supporting your ankle fatigue, thus applying more tensile forces to the ligaments causing the joint to stretch. This is most likely amplified if your broad begins to rotate in any fashion.
Most adult boards weigh in anywhere from 8-12 lbs. Depending on board length and type of material used in construction. If you were to sit with your ankle dangling over an edge with a 10 lbs weight on it all day you have to assume that eventually its going to hurt.
My suggestion is first, adjust your straps. Most bindings have multiple mounting positions find a position that allows the strap to apply equal pressure a crossed your foot.
Secondly, do not crank your straps down so tight that they are crushing your foot. Again, adjust the strap so that it only takes 3-5 clicks from the ratchet to give you the necessary level of tightness.
Lastly, strengthen your ankles. You can do this in the ways i suggested above. You may also want to practice this functionally buy strapping into your board and sitting on something that will allow your board to dangle much like on the lift. try to let it dangle for at least the same amount of time or slightly longer than your lift ride. Doing this will prepare and strengthen your ankle for the up coming season.

Tech420 11-20-2012 09:40 AM

My ankle strap is definitely not overtightened, if anything a tad loose. I do crank my toe strap tight. I am a very active mountain biker so I don't think its a strength issue. I'm in far better shape now than I was last year and haven't had these issues in the past.

DirtyD27 11-20-2012 09:57 AM

So, I had to step back a moment and re focus. You mentioned initially that you tweaked it pretty good a few weeks ago and that its still fairly sore. How did this happen?
Which direction did your foot roll?
Was there initial swelling and bruising and the time of injury?
Did you feel or hear a pop?
Where you able to walk on it at the time of injury?
What methods have you already used to try and make it better, and what was the outcome of said methods?
Have you had any sort of medical attention for this problem?
You also mentioned that you have had ankle problems in the past. Please if you don't mind sharing the information in this format describe type of injury and how often it has occurred.
If you do not wish to disclose this type of personal health information in this format I understand and wold suggest you seek out a local physical therapist.

Tech420 11-20-2012 12:16 PM

Quote:

Originally Posted by DirtyD27 (Post 541450)
So, I had to step back a moment and re focus. You mentioned initially that you tweaked it pretty good a few weeks ago and that its still fairly sore. How did this happen?
Which direction did your foot roll?
Was there initial swelling and bruising and the time of injury?
Did you feel or hear a pop?
Where you able to walk on it at the time of injury?
What methods have you already used to try and make it better, and what was the outcome of said methods?
Have you had any sort of medical attention for this problem?
You also mentioned that you have had ankle problems in the past. Please if you don't mind sharing the information in this format describe type of injury and how often it has occurred.
If you do not wish to disclose this type of personal health information in this format I understand and wold suggest you seek out a local physical therapist.

My ankle injuries have happened as a result of being so active in sports during my youth(I feel old at 23 with all my injuries). I would roll an ankle running the bases and such. I have had prescription ankle braces a few times, but nothing has felt like it currently does. Both of my ankles tend to crack/pop a little bit with full extension, but that is not out of the ordinary. I have been dealing with it for almost a month now and can't remember exactly how I did it. No swelling or bruising when it happened and I ice it when it is real sore. Walking and biking don't seem to effect it too much, but snowboard and full extension in either direction cause me a good amount of discomfort and pain. It is a very odd injury for me as it is more-so in the front of my ankle (if you understand what I'm even talking about). The pain seems to be any time the snowboard hangs....like on a chairlift or jumps. I really appreciate all the help you're giving me.


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