Injury Advice

[physio]

I had been meaning to post something for ages...........

Some of you might want to take notice of advice....... some might want to just carry on and ignore what they have done and get on with it. At the end of the day there are some fundamental rules that you should be aware of when getting injured.

There are 2 types of injuries I have found are the most common in trials through me working on the fair few riders that have been injured over the last couple years and I don’t really think there’s a great deal of difference between the risks of getting injured either street or natural.

1. Impact Injuries

With an impact injury you can

just bruise soft tissue (takes about a week or 10 days to de-sensitise)

damage or tear soft tissue (4 - 6 weeks to recover)

bruise a bone (just like bruising soft tissue like a muscle you can bruise a bone) can take up to 6 weeks to settle down pain wise

fracture (old school term - break) something (takes anything from 6 weeks to 12 months to heal fully depending on the severity of the fracture)

2. Twisting Injuries

these are the nightmare ones

generally if you twist something you stretch or tear ligaments, muscles or tendons

there are general rules of thumb that kinda give you an indication of what you done

- most severe soft tissue injuries are termed as sprains

dont be fooled by the term sprain! its not a namby pamby injury that you think it is!

what i'll do is talk about ankle sprains cause this is the most common form of sprain and what i seem to get asked more questions about

An ankle sprain is a common injury and usually results when the ankle is twisted, or turned in (inverted). The term sprain signifies injury to the soft tissues, usually the ligaments, of the ankle.

Sprains are classified into three types, based on how severe the injury is:

Grade 1 - the ligaments have been stretched but are still intact. There will be pain and a small degree of swelling but no difficulty moving the ankle and no bruising.

Grade 2 - a more severe injury, involving a partial tear of a ligament. Pain will be moderate to severe, the ankle will be swollen and difficult to move and there will be some bruising. Weight bearing will be painful but you can still walk on it cause its only affecting the outer ankle ligaments and not the ones that move the foot up and down.

Grade 3 - a complete tear through a ligament. There will be severe pain, swelling, loss of joint motion and inability to walk for about 3 days. The ankle is often unstable and bruising is more extensive.

Ligaments are tough bands of tissue that help connect bones together. Three ligaments make up the lateral ligament complex on the side of the ankle farthest from the other ankle. These include the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The common inversion injury to the ankle usually involves two ligaments, the ATFL and CFL. Normally, the ATFL keeps the ankle from sliding forward, and the CFL keeps the ankle from rolling inward on its side.

A ligament is made up of multiple strands of connective tissue, similar to a nylon rope. A sprain results in stretching or tearing of the ligaments. Minor sprains only stretch the ligament. A tear may be either a complete tear of all the strands of the ligament or a partial tear of only some of the strands. The ligament is weakened by the injury; how much it is weakened depends on the degree of the sprain.

The lateral ligaments are by far the most commonly injured ligaments in a typical inversion injury of the ankle. In an inversion injury the ankle tilts toward the inside, meaning the bottom of the foot angles toward the other foot. This forces all the pressure of your body weight onto the outside edge of the ankle. As a result, the ligaments on the outside of the ankle are stretched and possibly torn.

Initially the ankle is swollen, painful, and may turn ecchymotic (bruised). The bruising (usually a dark purple or reddy blue line from heel towards little toe direction) and swelling are due to ruptured blood vessels from the tearing of the soft tissues. Most of the initial swelling is actually bleeding into the surrounding tissues. The ankle swells as extra fluid continues to leak into the tissues over the twenty-four hours following the sprain.

People who have sprained an ankle often end up spraining the ankle again. If the ankle keeps turning in with activity, the condition is called ankle instability. Patients who have ankle instability lose confidence in their ankle to support them, especially on uneven ground. They often have swelling around the ankle that doesn't go away. Pain and swelling in a joint can cause a reflex where the body turns off the muscles around the joint. This can cause times when the ankle feels like it is going to give way, meaning it may have a tendency to twist again very easily.

The diagnosis of an ankle sprain is usually made by examination of the ankle and X-rays to make sure that the ankle is not fractured. A physical examination is used to determine which ligament has been injured. The doctor or physio will move your ankle in different positions in order to check the ligaments and other soft tissues around the ankle. Some tests place stress directly on the ankle ligaments to see if the ankle has become unstable and to find out if one or more ligaments has been partially or completely torn.If a complete rupture of the ligaments is suspected, your ankle is most likely to need to be immobilised.

The best results after an ankle sprain come when treatment is started right away. Treatments are used to stop the swelling, ease pain, and protect how much weight is placed on the injured ankle. A simple way to remember these treatments is by the letters in the word RICE. These stand for rest, ice, compression, and elevation.

· Rest: The injured tissues in the ankle need time to heal. Crutches will prevent too much weight from being placed on the ankle.

· Ice: Applying ice can help ease pain and may reduce swelling.

· Compression: Gentle compression pushes extra swelling away from the ankle.

· Elevation: Supporting your ankle above the level of your heart helps control swelling.

Healing of the ligaments usually takes about six weeks, but swelling may be present for several months. A physio will be good to help you regain full range of ankle motion, improve balance, and maximize strength.

If the ankle ligaments do not heal adequately, you may end up with ankle instability. This can cause the ankle to give way on uneven ground.

Small nerve sensors inside the ligament are injured when a ligament is stretched or torn. These nerve sensors give your brain information about the position of your joints, a sensation called position sense. For example, nerve sensors in your arm and hand give you the ability to touch your nose when your eyes are closed. The ligaments in the ankle work the same way. They send information to your nervous system to alert you about the position of your ankle joint.

Doctors will occasionally do surgery right away in people who seriously tear a lateral ankle ligament. In most other cases of torn ankle ligaments, doctors will try nonsurgical treatments before doing reconstructive surgery of the ligaments.

At the end of the day theres a load of information here just so you realise that a sprain isnt just a simple injury, especially if you have done it more than once in an ankle, knee or wrist as these explanations are typical for all 3 major joints you lot seem to screw up.

You know when you have fractured something and that gets dealt with at a&e with xrays and a cast for 6 or so weeks, then you need physio to regain strength and get back to riding

What you need to remember is that generally bones heal up stronger after a fracture in that area, so its very very unlikely that you will get the same injury in the same place twice.

However with "sprains" this is a very very underestimated injury and you should always get something looked at if you injure an ankle or knee etc when they look like these attached pics. As these are ligament tears typical swelling and must have rehab after the injury settles down!!

Torn ankle ligaments (must have rehab by physio after an injury like this)

[attachmentid=7710]

Typical Knee injury (must have rehab by physio after an injury like this)

[attachmentid=7711]

Ok so there's sooooooo much stuff to go through, but these are the most common injuries i have found through trials and at the end of the day, if you have any concerns then GO TO A&E!!! GET IT LOOKED AT

If you go and they say "its just a sprain - go home and rest it" then give me a shout

i can be contacted on this - just PM me or get me on msn or email me on silord@hotmail.com

Learn from the guys that have been suffering if any of you know who i been helping out, you know what im going on about!

but if you have any concerns or questions about an injury then feel free to drop me a line

laters

si

[Technical Tom]

I sprained my ankle 2 nights ago and that was a big help thanks

Tom.x

[Has anyone seen my shoe?]

Really intereting read, I twist my ankles quite alot (clumsyness) and im sure this will come to mind when I do especially that RICE thing.

[An_toin3]

woaah, nice post, Srpained my right ankle about 4 times, and now I think it's 90% healed

gonna take the RICE thing in mind

[Ali C]

cant say I have ever twisted, sprained or damaged my ankles, knees or wrists ever (touch wood) But if I do I know where to look for help

[spode@thinkbikes]

Me too!

[Walleee]

What a fantastic post. Si was very helpful when I had problem's with my wrist.

Definately one of the best post's i've seen yet. Really well thought out and just the time and effort that must have gone into that should be noted.

Thanks

[Synergy]

i was put of by the size of your post as im not a brilliant or even average reader but i went trhough it anyway and im totally glad i did.

the part where you said

"People who have sprained an ankle often end up spraining the ankle again. If the ankle keeps turning in with activity, the condition is called ankle instability. Patients who have ankle instability lose confidence in their ankle to support them, especially on uneven ground. They often have swelling around the ankle that doesn't go away. Pain and swelling in a joint can cause a reflex where the body turns off the muscles around the joint. This can cause times when the ankle feels like it is going to give way, meaning it may have a tendency to twist again very easily."

was interesting as i do twis my ankle a pretty high amount of times. i find myself having to get really stiff boots for ice hcokey as it can get sore then, i sometimes twist my ankle when im just walking (on straigh level ground ie in town).

any idea why that is i thought it might have been what you wrote and i quoted but i dnt have constant swellign around my ankle.

Edited October 22, 2006 by Synergy

[Ash-Kennard]

awesome topic and very helpful, ill think of you when im rolling around on the floor in pain.

[Tomm]

I'm sure you posted that a while ago? Either that or I'm having severe deja vu!

Can I just ask how you would distinguish (clinically) between the different grades of sprains that you mentioned?

[munkee]

I'm sure you posted that a while ago? Either that or I'm having severe deja vu!

Can I just ask how you would distinguish (clinically) between the different grades of sprains that you mentioned?

http://www.eorthopod.com/eorthopodV2/index...40ac065/area/19

There you go, that will give you even worse deja vu. Infact.. wack any of the post in to google and you will get deja vu. Amazing what you can find on the internet... lets just say plagiarism is a mother f**ker.

[Greetings]

http://www.eorthopod.com/eorthopodV2/index...40ac065/area/19

There you go, that will give you even worse deja vu. Infact.. wack any of the post in to google and you will get deja vu. Amazing what you can find on the internet... lets just say plagiarism is a mother f**ker.

What's written in this topic is one thing, how many people Si has apparently helped - another. So he might have copied it from another website just because he thought it's exactly what he'd want us to know.

[physio]

ok, this is gettuing stupid.

its just advice.

at the end of the day i'm recommending you go see someone if you have concerning symptoms.

The symptoms are in the post.

Yes a majority of it is copied (do you really think im gonna take that much time out to give you guys advice written word for word by myself?)

its the best advice that i could find in one place, so thought you'd be interesed in reading it.

[robster]

cant say I have ever twisted, sprained or damaged my ankles, knees or wrists ever (touch wood) But if I do I know where to look for help

Well done Ali you know whats gonna happen now don't you.

[THE trials commentator]

i personally think its nice of someone to take time to find all the relative info,even if it is copied,and put it into one place for us to read.saves us searching for it!

i wish it was on here when my knee got screwed a few years back,i ripped the crutiate (sp?) ligaments and ruptured the acl.opted not to go for surgery after spending time with a pro mx gp rider who advised against it.i just spent time building the muscle up around it,although i went for almost a year without knowing fully what to do.at least he's giving us something people can read up about.

Carl

[munkee]

What's written in this topic is one thing, how many people Si has apparently helped - another. So he might have copied it from another website just because he thought it's exactly what he'd want us to know.

So i post something relevant that tomm may have read and give the reasoning behind why he may have had the deja vu and then the trials forum crusaders come in on their horses to defend the honour of a bloke who i have met and has helped me out.

ok, this is gettuing stupid.

its just advice.

at the end of the day i'm recommending you go see someone if you have concerning symptoms.

The symptoms are in the post.

Yes a majority of it is copied (do you really think im gonna take that much time out to give you guys advice written word for word by myself?)

its the best advice that i could find in one place, so thought you'd be interesed in reading it.

Once again not a personal attack, just thought i was helping out tomm.

i personally think its nice of someone to take time to find all the relative info,even if it is copied,and put it into one place for us to read.saves us searching for it!

i wish it was on here when my knee got screwed a few years back,i ripped the crutiate (sp?) ligaments and ruptured the acl.opted not to go for surgery after spending time with a pro mx gp rider who advised against it.i just spent time building the muscle up around it,although i went for almost a year without knowing fully what to do.at least he's giving us something people can read up about.

Carl

Yea it was nice of someone to take the time to do it, good post. But at the same time i personally feel like this has all been taken out of context where certain members feel that this was some kind of personal attack? i have better things to do really.

[physio]

So i post something relevant that tomm may have read and give the reasoning behind why he may have had the deja vu and then the trials forum crusaders come in on their horses to defend the honour of a bloke who i have met and has helped me out.

Once again not a personal attack, just thought i was helping out tomm.

Yea it was nice of someone to take the time to do it, good post. But at the same time i personally feel like this has all been taken out of context where certain members feel that this was some kind of personal attack? i have better things to do really.

no worries chris

i was suprised considering i been helping you out a bit over the last year or 2.

thats the prob with these things sometimes theres no way of assessing context or emotion in posts and was def taken the wrong way

si

I'm sure you posted that a while ago? Either that or I'm having severe deja vu!

Can I just ask how you would distinguish (clinically) between the different grades of sprains that you mentioned?

its difficult to tell without assessing the ankle physically

there are several ways of doing this through stress tests, assessing the amount of "give" in the joint when its being stressed - putting one hand on front of the shin above the ankle and the other at the back of the heel and seeing if the ankle moves forward.

generally you can see through a stress xray as well if its a very very extreme case that is not so obvious just stressing the ankle normally, when a doc is holding the ankle in position or under stress and an xray is taken to see how much bone displacement occurs. this is used when the possibility of a bilateral tear has occured. double screwup!

to put into perspective, the amount of bruising gives a very basic guide. the pic in the post would be a general grade 2 tear moderate sprain with partial ligament tear

however as i said, if in doubt get it assessed professionally by either a physio or get your gp to refer you to an orthopod

si

[munkee]

Thats was mine around a week after doing it. Id deffo say a grade 3 cant even see my ankle bone. The cut that looks like a circle is where it rolled so far under me the bone pressed to the skin on the ground and cut it open was a puncture.

That was my other ankle after a small roll, bruised under the ankle bone.

Edited October 23, 2006 by Spacemunkee

[Lawnmowerman]

Simon's a genious about this stuff Came to my house and stayed for the weekend, sorted my knee and helped a few other people too. Thanks for that

[THE trials commentator]

Spacemunkee,that is one nasty lookin ankle man!

by the way,my post wasnt having a dig at you,sorry if it came across that way.just merely mentioning how i thought it was a good idea

Physio:

i bruised my hand today,i believe its the ulnar nerve area? it's pretty painful,and very very tender,any ideas how long before its rideable again?i've put some muscle rub on it,and its eased up a little.

cheers

Carl

[joe b]

Really useful post, mate. That had loads of relavent information in about sprains and stuff that we trials riders should know about. Thanks for taking the time to write all of that out.

This could probably help somehwere in my P.E Theory lessons at school, too . So, when i get an A* in P.E., i'll PM you thanking you. Hehe...

Cheers,

Joe.

[physio]

sounds and looks like a lot of you took some notice of what i put in here which is good. glad you lot are taking notice as it does make life so much easier to fix things when you have treated them correctly initially.

just gis a shout if you need any additional advice

si

[literocola]

Ouch buddy.

Bump more or less.

Edited November 4, 2006 by literocola

[Fixed Pants™]

I'm not sure if this is what this thread is for but i'll give it a go.

Today i was riding with a mate and i was going down some steps doing small pedal kicks and 2nd step my brake slipped and obviously you fall on your arse, and hurt the lower part of your spine, what can be done to help this heal quicker? and is there any special precautions i should take, it hurts, i also broke the step LMAO and it was a church, but my religious friend has confirmed that god will not smite me for damaging holy ground or something... Also got some minor scratches and its abit tender as if a bruise was there, but thats nothing to worry about as far as i know.

[Dan6061]

Not worried or anything..but when i like..twist my right ankle..it clicks..

Does anyone elses? Or is mine just weird...