Hatha Yoga Poses For Beginners
Throughout the Ankle No Specific Area
RECURRENT INVERSION SPRAINS AND ANKLE INSTABILITY
• Pain may or may not be present as the ankle rolls easily and often beyond the normal range. This is commonly the reinjury of a serious inversion sprain, years earlier, that did not fully heal.
• The instability of the ankle allows it to roll over easily – especially on uneven surfaces such as rugged trails. A more serious condition is noted when the ankle rolls over periodically on flat surfaces, with no cause.
• When an ankle has rolled many times, there may be very little pain because the ligaments are so stretched they no longer become aggravated.
• Those who stand or walk on the outer edges of their heels and feet are more likely to easily roll their ankles. Bowed legs can make this problem worse. Those who’ve had previous ankle sprains often have a more angled ankle with a reduced range of motion.
• During an inversion ankle sprain, the foot tilts inward under the leg bones. The top foot bone, the talus, fits inside a “pocket” made by the leg bones known as the tibia and fibula. The ankle ligaments hold the talus in this pocket. When the ligaments are stretched or torn, the talus tilts, allowing the outer edge to come out of the pocket. This also happens when the ligaments have been stretched permanently through recurrent sprains or from a serious sprain that never healed correctly. Pain occurs when the ligaments are injured. No pain occurs when the talus moves because the ligaments are permanently stretched out.
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• Recurrent sprains are caused by structural weaknesses, previous injury, weak muscles, shoes with no lateral stability, the inability to adapt to uneven surfaces, yoga form irregularities, and performing other sports that involve contact or extreme lateral motion.
• Conservative treatment begins with the proprioception balancing exercises (in the next section on ankle sprains).
• Three exercises can strengthen ankle support systems: 1) Walk on the heels without letting the forefoot touch the ground for 1 minute. 2) Walk on the outside of the feet without letting the big toe on each foot touch the ground for 1 minute.3) Walk on the inside of the feet without letting the little toe side of each foot touch the ground for 1 minute. These should be done while wearing shoes to avoid bruising the bones of the feet. These can be done every day for a while and then once or twice a week for maintenance.
• Some shoes help stabilize the footplant. Trail shoes generally have more lateral stability, and some models have cushioned midsoles that allow for road use. It’s important that the shoe be the right width for your foot. Stand straight with the shoe tied. Look down at the outside of the shoe. A small portion of the midsole and sole should be visible along the full outer edge. If the upper overhangs the sole, it is easier for the shoe to roll over. Get a shoe with a wider base.
• Custom medical orthotics can help in stabilizing the outer edge of the foot to prevent sprains. It is almost impossible to find an off-the-shelf orthotic that provides good lateral stability.
• If an elastic ankle brace is worn constantly for yoga/walking, the ankle can become weaker and less stable when it is not worn. This can be prevented by doing the proprioception exercises and the strengthening exercises mentioned in the next section on ankle sprains. These exercises should be mandatory for those with unstable lateral ankle ligaments.
• When people begin training and racing on trails, they often have ankle instability. A gentle introduction to uneven terrain, while avoiding over use, allows the leg and foot to adapt to this type of surface. Don’t give up if this feels difficult.
• yoga form changes can help decrease ankle sprains on uneven terrain. Most good trail runners have shorter strides with rapid stride frequency rates on rougher surfaces. Shorter strides are more stable.
• If the instability problems persist, consult a doctor, who can determine if the ligaments are permanently stretched or torn. This is important to know even if ankle rolling is infrequent. If the ligaments are torn, when the foot hits the ground, stopping the foot and talus, the ankle joint also stops. If the ligaments that stabilize the ankle are loose, the leg bone portion of the ankle joint can continue to move forward a few millimeters sliding on top of the talus. This friction can aggravate and damage the protective cartilage and eventually produce arthritis within the joint. This excess motion is reduced by the strengthening/balance exercises, stable shoes, and ankle brace components. The intensity of workouts and racing can increase the damage. A doctor can determine if the range of motion in the ankle is too great or there are anatomical flaws that need extra support. If it is determined that the ligaments are not tight enough, surgery is a viable option and is usually successful.
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