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Ankle / foot
Ankle sprains stretch or tear the ligaments that stabilize the ankle, most often on the outside after an inversion roll. Some people heal cleanly; others are left with recurring give-way.
Acute sprains bring lateral ankle pain, swelling, bruising, and trouble with push-off or uneven ground.
With chronic instability, people describe repeated rolling, hesitation on trails, or a sense the ankle is unreliable.
Lingering stiffness and weakness are common even after the original bruise fades.
The anterior talofibular and related lateral ligaments are the usual injured structures in inversion sprains.
Incomplete rehab of proprioception and strength is a major reason sprains become recurrent.
High ankle (syndesmotic) sprains and osteochondral injury are important variants we do not want to miss.
Mechanism, Ottawa-style fracture screening, ligament tenderness, and stress testing guide acuity.
We assess balance, strength, and mechanical laxity in people with recurrent give-way.
Imaging is used for suspected fracture, high ankle injury, or refractory instability planning.
Protected motion, swelling control, and progressive physical therapy are the backbone of care.
Bracing for sport return can help selected athletes while neuromuscular control is rebuilt.
Persistent mechanical instability may lead to surgical stabilization discussion after a real rehab trial.
Not always. We use clinical rules and exam findings to decide when imaging changes immediate care.
Ligament laxity, weak peroneals, and poor balance strategies often combine. Rehab targets all three.
When swelling is controlled, strength and hop testing look solid, and you trust the ankle under sport-specific demand.
Not as routine first-line care. Most sprains are managed with progressive rehab; biologics are case-by-case if discussed at all.
Dr. Adam Nessim, interventional spine physician, Westport Longevity, Pain & Performance.
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