Issue link: https://www.massageandbodyworkdigital.com/i/72312
In any case of ankle sprain, the individual should immediately stop strenuous activity, elevate the leg, and ice the ankle. FRICTION THERAPY AND MASSAGE Friction therapy stimulates healing of a ligament while removing adhesive scar tissue. Combining friction therapy with massage makes treatment even more effective. Massage applied directly to the foot and leg can reduce the swelling and help speed the healing process. Gentle effleurage may begin soon after the injury occurs. FRICTION OF THE ANTERIOR TALOFIBULAR LIGAMENT With the client lying supine, gently supinate the foot with one hand and use the thumb of the other hand to feel the lower edge of the lateral malleolus. Go to the base of the lateral malleolus and then work your way around toward the anterior portion of this bone. The anterior talofibular ligament is located slightly medial to the distal aspect of the lateral malleolus. When the ankle is sprained, it is not difficult to locate this ligament, because it is very tender. Keeping the ligament stretched by holding the foot supinated, friction in either direction with your thumb or forefinger. FRICTION OF THE CALCANEOFIBULAR LIGAMENT The calcaneofibular ligament is located directly below the lateral malleolus and runs vertically down and slightly back to the calcaneus. The tear may occur anywhere along the length of the ligament but is usually just inferior to the malleolus. Frictioning is done by pressing the ligament up under the inferior edge of the malleolus or against the calcaneus. Sometimes both this ligament and the anterior talofibular ligament are sprained. In these cases, alternate a minute or so on each ligament and come back to each place two or three times. EXERCISES To increase the stability of the ankle and prevent the development of poorly formed scar tissue, clients should perform the following exercises daily during the rehabilitation phase of therapy. Give them the following instructions: ANKLE CIRCLES. While sitting in a chair, cross the injured leg over the uninjured leg. Rotate the foot in as wide a circle as you can, both clockwise and counterclockwise. Begin with ten circles in each direction and build up to fifty. ANKLE FLEXION. Sitting in a chair with the injured leg crossed over the uninjured leg, flex the ankle so the toes come toward the knee. Hold the flexion for one or two seconds, and then point your toes and hold that position for one or two seconds. Begin with five repetitions of flexing and pointing and build up to thirty, taking rests as you need them. FRICTION OF THE POSTERIOR TALOFIBULAR LIGAMENT With the client lying supine, use one hand to rotate the foot medially. Place the index finger of your other hand directly on the posterior aspect of the lateral malleolus and friction in a superior-to-inferior direction at the ligament's bony attachment. massagetherapy.com—for you and your clients 115