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Why do I sprain my ankle so often and how can I cut the risk of it happening again?

<p>Are you one of those people who seems to be forever spraining their ankle?</p> <p>To some extent, ankle sprains are <a href="https://meridian.allenpress.com/jat/article/54/6/603/420863/Epidemiology-of-Ankle-Sprains-and-Chronic-Ankle" target="_blank" rel="noopener">part and parcel</a> of being active.</p> <p>But if it’s happening again and again, here’s what may be going on – and how you can reduce your risk of recurrent ankle sprain.</p> <h2>One sprain can lead to another… and another</h2> <p>A large <a href="https://link.springer.com/article/10.1007/s40279-013-0102-5" target="_blank" rel="noopener">review</a> of ankle sprain studies in the journal <a href="https://link.springer.com/article/10.1007/s40279-013-0102-5" target="_blank" rel="noopener">Sports Medicine</a> found most people who actively play sport or train can expect to have a fairly low incidence of ankle sprain per 1,000 hours of training time. But it also said:</p> <blockquote> <p>Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity.</p> </blockquote> <p>The most frequent type of ankle sprain occurs if the ligaments on the outside of the ankle are stretched or torn when the joint moves beyond the normal range of movement. This is known as an inversion or lateral ankle sprain.</p> <p>Strong evidence from <a href="https://meridian.allenpress.com/jat/article/56/6/578/466668/Lateral-Ankle-Sprain-and-Subsequent-Ankle-Sprain" target="_blank" rel="noopener">studies</a> suggests once people sprain their ankle, they are more likely to re-sprain it. As one <a href="https://meridian.allenpress.com/jat/article/56/6/578/466668/Lateral-Ankle-Sprain-and-Subsequent-Ankle-Sprain" target="_blank" rel="noopener">review</a> of the evidence put it:</p> <blockquote> <p>a history of lateral ankle sprain is known to disrupt the structural integrity of the ligaments and sensorimotor function, likely impairing an individual’s ability to avoid injurious situations.</p> </blockquote> <p>Some ankle sprains might seem to be very minor, with almost no swelling or mobility problems. But some people can end up with what’s known as chronic ankle instability, where they tend to re-sprain their ankle again and again.</p> <p>Another <a href="https://link.springer.com/article/10.1007/s40279-017-0781-4" target="_blank" rel="noopener">review</a> looking at factors contributing to chronic ankle instability found</p> <blockquote> <p>feelings of instability and recurrent ankle sprain injuries (termed chronic ankle instability, or CAI) have been reported in up to 70% of patients. The subsequent development of CAI has adverse health consequences including reduced quality of life and early-onset osteoarthritis.</p> </blockquote> <p>Once an ankle fracture is excluded, busy hospital emergency departments often send patients home with instructions to ice the ankle and keep off it for a day or two. There’s often no advice to follow up with a physio for rehabilitation.</p> <p>This is unfortunate, as evidence suggests people with a history of ankle sprains will likely:</p> <ul> <li> <p>become progressively <a href="https://meridian.allenpress.com/jat/article/50/7/742/112426/Physical-Activity-Levels-in-College-Students-With" target="_blank" rel="noopener">less active</a></p> </li> <li> <p>have <a href="https://bjsm.bmj.com/content/50/24/1496.long" target="_blank" rel="noopener">higher</a> body mass indices</p> </li> <li> <p>report more general body <a href="https://bjsm.bmj.com/content/50/24/1496.long" target="_blank" rel="noopener">pain</a> and</p> </li> <li> <p>generally tend to have a lower <a href="https://bjsm.bmj.com/content/50/24/1496.long" target="_blank" rel="noopener">quality of life</a>.</p> </li> </ul> <h2>Even the other ankle may be at risk</h2> <p>Research suggests people who sprain their ankle may be more likely to have <a href="https://meridian.allenpress.com/jat/article/56/6/578/466668/Lateral-Ankle-Sprain-and-Subsequent-Ankle-Sprain" target="_blank" rel="noopener">injuries</a> to other joints on the same leg, or even the opposite leg. A review in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196323/" target="_blank" rel="noopener">International Journal of Sports Physiotherapy</a> noted “an ankle sprain is linked to both re-injury and subsequent injury to the contralateral side”.</p> <p>Why? It may have something to do with the brain’s tremendous ability to continually adapt.</p> <p>Just as <a href="http://www.ajnr.org/content/36/11/2048" target="_blank" rel="noopener">extended bed rest</a> or prolonged microgravity exposure in <a href="https://doi.org/10.1007/978-3-319-68201-3_3" target="_blank" rel="noopener">astronauts</a> can cause changes in the brain and the way it relates to movement, perhaps our brains subconsciously compensate after an ankle injury.</p> <p>That could be by, for example, via limping or a slight change in the way you walk; perhaps you subconsciously don’t want to challenge the ankle due to fear of re-spraining. This may put other joints or the opposite limb at heightened risk.</p> <p>This neuroplasticity adds new challenges to the assessment or rehabilitation of ankle injury, and to predicting who is likely to be at increased <a href="https://www.tandfonline.com/doi/abs/10.1080/00913847.2020.1780098?journalCode=ipsm20" target="_blank" rel="noopener">risk of subsequent injuries</a>.</p> <h2>What can you do to reduce the risk of re-spraining your ankle?</h2> <p>If you’re getting recurrent ankle sprains, see a physiotherapist. They will be able to teach you how to reduce the risk.</p> <p>Currently the best evidence for reducing the chances of re-spraining your ankle sprain comes down to two main things:</p> <p>1) Protecting the joint with an ankle brace when active</p> <p>This could mean using a <a href="https://meridian.allenpress.com/jat/article/54/6/650/420871/Prevention-of-Lateral-Ankle-Sprains" target="_blank" rel="noopener">professionally fitted external support brace</a> (not an elastic sleeve). This is a relatively low cost and effective means of risk reduction.</p> <p>2) Using balancing exercises and ‘proprioceptive training’</p> <p>Examples of <a href="https://meridian.allenpress.com/jat/article/52/11/1065/112804/Proprioceptive-Training-for-the-Prevention-of" target="_blank" rel="noopener">proprioceptive training</a> include:</p> <ul> <li> <p>balancing on each leg, one at a time, while throwing and catching a ball against a wall</p> </li> <li> <p>balancing on an ankle disc or wobble board for three to five minutes daily.</p> </li> </ul> <p>These exercises can help strengthen the muscles and ligaments in your ankle. As one literature review put it:</p> <p>Proprioceptive training is a cost- and time-effective intervention that can benefit patients who have sustained a previous ankle sprain during physical activity and can subsequently reduce the risk of further complications.</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/why-do-i-sprain-my-ankle-so-often-and-how-can-i-cut-the-risk-of-it-happening-again-190751" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

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Queen Elizabeth II releases message after back sprain

<p><span style="font-weight: 400;">Queen Elizabeth has sent a message from Windsor Castle to be delivered by her youngest son, Prince Edward, at the 11th General Synod of the Church of England.</span></p> <p><span style="font-weight: 400;">Prince Edward represented the royal family at the event on Tuesday and delivered her address.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7845682/queen-elizabeth1.jpg" alt="" data-udi="umb://media/4ac63c624a7a437a9a0821dc28f4350d" /></p> <p><em><span style="font-weight: 400;">Prince Edward delivers Queen Elizabeth’s address to the General Synod. Image: Getty Images</span></em></p> <p><span style="font-weight: 400;">“It is hard to believe that it is over 50 years since Prince Philip and I attended the very first meeting of the General Synod,” she said in her speech, referencing her late husband, the Duke of Edinburgh.</span></p> <p><span style="font-weight: 400;">“None of us can slow the passage of time; and while we often focus on all that has changed in the intervening years, much remains unchanged, including the Gospel of Christ and his teachings.”</span></p> <p><span style="font-weight: 400;">The Queen’s comments come after her most recent health troubles - which saw her cut back on public appearances - and comments in her COP26 video message to world leaders that “none of us will live forever”.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7845683/queen-elizabeth2.jpg" alt="" data-udi="umb://media/ed00f75e16b446e6b132b81b41f73be4" /></p> <p><em><span style="font-weight: 400;">Queen Elizabeth delivering her address to the General Synod over the years. Image: @theroyalfamily (Instagram)</span></em></p> <p><span style="font-weight: 400;">“It’s interesting that during a time when the Queen has been unwell we have had two addresses from her which have included lines that remind us that no-one is immune to the ageing process,” a royal insider told </span><em><a rel="noopener" href="https://honey.nine.com.au/royals/queen-elizabeth-message-windsor-castle-back-sprain/7e297191-1274-40cb-93fb-aeec0dcf68e1" target="_blank"><span style="font-weight: 400;">9Honey</span></a></em><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">“Her recent spate of ill health and her having to rest is a reminder that she is 95, and even though we have been so used to seeing her carry out her duties in a way that belies her age, of course that can’t go on forever.”</span></p> <p><span style="font-weight: 400;">Her Majesty also mentioned the “weariness” people have felt during the pandemic in her speech to the General Synod, noting how many have relied on their faith during this period.</span></p> <p><span style="font-weight: 400;">“Of course, in our richly diverse modern society, the wellbeing of the nation depends on the contribution of people of all faiths, and of none,” she said.</span></p> <p><span style="font-weight: 400;">“But for people of faith, the last few years have been particularly hard, with unprecedented restrictions in accessing the comfort and reassurance of public worship. For many, it has been a time of anxiety, of grief, and of weariness.”</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7845684/queen-elizabeth3.jpg" alt="" data-udi="umb://media/62b8eebabf4b4015bd5366ce94d1fad8" /></p> <p><em><span style="font-weight: 400;">Camilla, Duchess of Cornwall, and Catherina, Duchess of Cambridge, attend the Remembrance Sunday commemoration in London. Image: @theroyalfamily (Instagram)</span></em></p> <p><span style="font-weight: 400;">Though the monarch intended to attend Remembrance Sunday commemorations at the Cenotaph in London, she was forced to pull out on the day due to a back sprain.</span></p> <p><span style="font-weight: 400;">It is unknown whether her back injury has been the cause of her most recent rest period, hospital visit, and public use of a walking stick for the first time in 17 years.</span></p> <p><span style="font-weight: 400;">However, the palace has only confirmed that the Queen’s condition is not related to COVID-19.</span></p> <p><em><span style="font-weight: 400;">Image: @theroyalfamily (Instagram)</span></em></p>

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