Are you tough enough? Can you walk it off?

In a conversation with a friend, she commented that she had recently twisted her ankle. As a physical therapist, immediately I was intrigued. I asked if she sought out medical attention. She remarked “for what... I just twisted my ankle! It should be good in a few days.” I then asked, “how long ago did you injury it?” Causally, she replied” two weeks ago.” “What?” I exclaimed contentiously. “ Two weeks!” I was shocked to hear that a middle school teacher would leave her health so causally unattended when there is a myriad of health professionals that could easily attend to her ankle. To illustrate my point, I compare a “healthy body” to a new car or cell phone. When these “vital” necessities malfunction, without hesitation, we take a trip to the Genius bar at the Apple store or the garage. Conveniently, most of us place a greater value on disposable necessities rather than being inconvenienced by our immediate health.

This commentary is not about your “mundane” ankle sprains, but the implications f when we devalue our health and the stark reality that follows. Common injuries are often dismissed as par for the course after exercise, or after stumble, and we try to walk it off. There are a multitude of reasons why we willfully neglect our precious health; ranging from old attitudes about health, immediate cost versus long term health benefit, to minimizing the issues and the list goes on. Consequently, a twisted ankle, pulled hamstring and tweaked back can balloon into major biomechanical breakdown. These common annoyances can lead to increased risk of chronic pain, preventable surgery, weight gain, depression, loss of wages and career­altering changes to mention a few.

Most of us generally know how a basic piece of machinery works. For simplicity, let’s use the components of a bike. When the chain starts to deteriorate, it make noises which we at first acknowledge but then blends into background noise. The “squeak” is oftentimes the first sign leading to mechanical complications before your chain breaks. Equally, while considering the human body as a machine, it is also subject to small “squeaks” that may ultimately lead to the occasional failure. Consequently, similar to machines, our bodies are constant under stress and strain are at premature risk of wearing out but unlike machines our bodies can modulate and repair itself. 

The bike chain example is analogous to common misconceptions concerning ankle sprains. Like the squeaky chain, it is acknowledged that your ankle has been injured. Common perception as it pertains to an ankle sprain is that a “real” injury has not suffered, since there are no broken bones so we walk it off. Nothing could be further from the truth. What’s worse, the pejorative insistence that a sprain is not a serious injury which can lead to bio-mechanical kinetic chain collapse like in our bike. Any untreated sprains will only weaken the joint creating more unstable. Other infamous misconceptions like “no pain, no gain,” which suggests toughening up an injured ankle will improve its function. Re­use will only result in re-­injury causing it to further deterioration. 

“The key to achieving zero breakdowns is not maintenance in terms of repairing broken down equipment, but rather “preventative maintenance” that treats the causes of breakdowns before the breakdowns actually happen." Hiroyuki Hirano

The bicycle mechanical chain of events led to the inoperative machinery. The same can be implied when you have a kinetic chain deficiency leading to improper biomechanics in the body. Recent research concluded that individuals with chronic ankle sprains had weak hip and less ankle range of motion. An intimate chain exists between the mechanics at the ankle and the proximal joints which include the knees and the hips. Postural stability and muscle recruitment patterns are compromised at the hip and ankle due to improper foot placement. Stability and strength at hips are essential for gait and posture. After ankle sprains, postural stability at the lumbar ­pelvic region decreases which can lead altered biomechanics to lower back (picture). A good assessment and treatment plan is vital to maximize rehabilitation potential and return of function. There are an abundance of research studies which revealed the deleterious effects of ankle sprain, which when managed by appropriate early medical intervention have positive outcomes. It is also essential that you visit the appropriate medical practitioner when dealing with injuries. A general practitioner may not have the orthopedic ( bones and muscles) background to correctly manage this type of injury, but could be an excellent resource. A practitioner experienced in orthopedics will have knowledge, insight and tools ranging from exercise prescriptions, manual therapy to taping, which will get you back to function. o sometimes, those little clicks, aches and pain are indicative of a potential problem which if left unchecked, can inevitable progress into inconvenient complications. We need to nullify and deconstruct these pervasive conditionings that lead to unnecessary health issues and treat our bodies as preciously as we treat our necessities because we aren’t tough enough.

by Garfield Andrews - MSc PT @COREStudio