Proprioception, best ankle sprain ally.

“Propiocepci贸n, la mejor aliada del esguince de tobillo”

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驴What does “ankle sprain” really mean?

When we run our body is under constant movement. Maybe it seems monotonous, but in fact everything becomes impredectible when doing trail running or other outdoor activities. Terrain turns into something unstable, irregular or slippery.

A sprained ankle occurs when a person performs an exaggerated and sudden movement of this joint (articulation) in a forced manner. At that time, the ligaments, which are the soft parts that have the function of joining and keeping the joints stable, suffer an over stretching or breakage.

Ankle sprains have 3 possible degrees of rupture. We must know that each of them involve a greater number of crippled ligaments, being the 3rd degree the most problematic causing a rupture of the lateral ligament.

驴How do I know I suffer from sprained ankle?

The symptoms are mainly the following:

  • Joint pain
  • Joint stiffness
  • Inflammation of the ankle
  • Sensation of instability
  • A bruise may appear if the lesion is 2nd or 3rd degree.

*Remember, the test of choice is never an X-ray, to know what degree of injury we suffer is essential a MRI (Magnetic Resonance Imaging) or CT (Computed Tomography scan).

photo: beyerfisio.com

The treatment of an ankle sprain

– Treatment can be divided in 3 steps:

Step 1 (first 3-4 days) – Try to reduce pain and inflammation with the application of ice or contrast baths. It is important to know that if the pain and inflammation is not excessive we will not apply anything, it is at that moment when the body is in the process of regenerating damaged / affected tissues.

Step 2 – Both the patient and the physiotherapist, will be in charge of trying to normalize joint stiffness through specific mobilizations of the ankle joints. The duration of this phase will vary depending on the degree of injury.

Step 3 – This is the most neglected phase by the patient, once he has gained mobility and his pain has decreased believes also he is recovered from the sprain. He is not aware that a ligament after suffering a sprain suffers an increase in laxity (less ability to stabilize the articulation) that will obviously cause an easier rupture in the future and will repeat every time you make a bad gesture with your ankle. It is the job of the physiotherapist to make the patient aware that the work of strengthening the ankle is vital for the long time to avoid new episodes of ankle sprain.
Here, proprioception comes into play.

The patient will have to perform a series of exercises to work 4 basic aspects

  • Joint mobility
  • Strength muscles
  • Muscular elasticity
  • Proprioception

La propiocepci贸n, our subject of debate

Proprioception is the ability of our body to locate its parts without the need to use sight. We will perform it when the ankle is practically recovered and it is identified as a tool to prevent future injuries.

The proprioception work will allow the ankle a greater capacity for movement and response to unexpected situations, such as a loss of balance or an irregular tread, causing an increase in the activation of the musculature. This work will help us counteract the possible ligamentous laxity that has been caused in the past with the ankle sprain.

How to work proprioception properly?

Proprioception is effective by doing a series of exercises with material that provides us with some instability, so we will be able to work the proprioceptive receptors of our ankle that together with our vestibular system (this is, our system of balance and orientation) and our visual system will give us a better response in our ankle under situations of possible sprains.

What benefits can I obtain with proprioception?

  • To guarantee the static and dynamic stability of the joints (articulations)
  • To improve proprioceptive sensitivity
  • Prevent recurrence sprains.
Running down from Rysy (2503m), the highest peak in Poland

驴How to train it? 驴When?

  • First of all, we must say that proprioceptive work is much better done barefoot to increase the sensitivity of the ankle receptors.
  • It is important to train proprioception without muscular/joint fatigue, as the quality of training will reduce. We know from experience that doing it before physical activity seems lazy, because we still do not feel “activated”, but the body will thank us.
  • Performing from 1 to 6 exercises per session with 2 or 3 sets each exercise and always from least to greatest strength involvement, we will start with the easy exercises and finish with the more complicated ones. Gradual training!
  • With subsequent training? It does not matter if you are accompanied by a few kilometers or a session of weights, in any way, it is a type of exercise that we can do without having to do another one later. The training itself already constitutes a training session.

All the information published in this blog is informative. Injuries are like the races, they look similar but no two are alike, so we should consult it with a professional. We hope we have helped to understand a little bit more this passion. Thank you for reading!

This post has been offered thanks to the experience and training of our friend and physiotherapist Xavier Pedr贸s. Visit @xpedrosboria on Instagram to learn more about the world of trail, cycling and physiotherapy.

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驴Qu茅 es, realmente, un esguince de tobillo?

Cuando salimos a correr, nuestro cuerpo est谩 sujeto a un movimiento constante y, aunque parezca muy mon贸tono, es impredecible si hablamos de trail running o actividades f铆sicas donde el terreno es inestable, irregular o resbaladizo.

Un esguince de tobillo se produce cuando una persona realiza un movimiento exagerado y repentino de esta articulaci贸n de manera forzada. En ese momento, los ligamentos, que son las partes blandas que tienen la funci贸n de unir y mantener estables las articulaciones, sufren un sobre estiramiento o rotura.

Los esguinces de tobillo tienen 3 posibles grados de rotura. Debemos saber que cada uno de ellos implican un mayor n煤mero de ligamentos lisiados, siente el 3er grado el m谩s problem谩tico provocando una ruptura del ligamento lateral externo (principal estabilizador de la parte externa del tobillo).

驴C贸mo saber si sufro un esguince?

Los s铆ntomas son principalmente los siguientes:

  • Dolor articular
  • Rigidez articular
  • Inflamaci贸n del tobillo
  • Sensaci贸n de inestabilidad
  • Puede aparecer un hematoma si la lesi贸n es de 2.潞 o 3.潞 grado.

*Sobre todo, la prueba de elecci贸n nunca es una radiograf铆a, para saber qu茅 grado de lesi贸n sufrimos es imprescindible una Resonancia Magn茅tica o un TAC.

photo: beyerfisio.com

El tratamiento de un esguince de tobillo

– El tratamiento lo podemos dividir en tres fases.

Fase 1 (primeros 3-4 d铆as) – Intentar disminuir el dolor y la inflamaci贸n con la aplicaci贸n de hielo o ba帽os de contraste. Es importante saber que si el dolor y la inflamaci贸n no es desmesurada no aplicaremos nada, es en aquel momento cuando el cuerpo est谩 en pleno proceso de regeneraci贸n de tejidos lisiados/afectados.

Fase 2 – Tanto el paciente como el fisioterapeuta, se encargar谩n de intentar normalizar la rigidez articular que pueda haber a trav茅s de movilizaciones espec铆ficas de las articulaciones del tobillo, la duraci贸n de esta fase variar谩 en funci贸n del grado de la lesi贸n.

Fase 3 – Esta es la fase que m谩s descuidada por parte del paciente, una vez ha recuperado la movilidad y su dolor ha disminuido cree estar recuperado del esguince, no es consciente que un ligamento despu茅s de sufrir un esguince sufre un aumento de laxitud ( menos capacidad de estabilizar la articulaci贸n ) que obviamente provocar谩 que en un futuro sea m谩s f谩cil sufrir esguinces cada vez que realice un mal gesto con su tobillo. Es trabajo del fisioterapeuta concienciar al paciente que el trabajo de potenciaci贸n del tobillo es vital para la larga evitar nuevos episodios.
Aqu铆 entra en juego la propiocepci贸n.

El paciente tendr谩 que realizar una serie de ejercicios para trabajar 4 aspectos b谩sicos

  • Movilidad articular
  • Potenciar musculatura
  • Elasticidad muscular
  • Propiocepci贸n

La propiocepci贸n, nuestro tema de debate

La propiocepci贸n es la capacidad que tiene nuestro cuerpo de situar sus partes sin necesidad de utilizar la vista. La realizaremos cuando el tobillo est茅 pr谩cticamente recuperado y se identifica como una herramienta para prevenir futuras lesiones.

El trabajo de propiocepci贸n permitir谩 al tobillo una mayor capacidad de movimiento y respuesta ante situaciones inesperadas, como podr铆a ser una p茅rdida del equilibrio o una pisada irregular, provocando un aumento de la activaci贸n de la musculatura. Este trabajo nos ayudar谩 a contrarrestar la posible laxitud ligamentosa que se ha provocado en un pasado con el esguince de tobillo.

驴C贸mo trabajar correctamente la propiocepci贸n?

La propiocepci贸n la trabajamos realizando una serie de ejercicios con material que nos proporcione una cierta inestabilidad, de esta forma conseguiremos trabajar los receptores propioceptivos de nuestro tobillo que junto con nuestro sistema vestibular (este es, nuestro sistema de equilibrio y orientaci贸n) y nuestro sistema visual permitir谩n una mejor respuesta de nuestro tobillo ante situaciones de posibles torceduras.

驴Qu茅 beneficios puedo obtener con la propiocepci贸n?

  • Garantizar la estabilidad est谩tica y din谩mica de las articulaciones
  • Mejorar la sensibilidad propioceptiva
  • Prevenir esguinces de repetici贸n.
Bajando del Rysy (2503 m), el pico m谩s alto de Polonia.

驴C贸mo se entrena? 驴Cu谩ndo se entrena?

  • Antes de nada, decir que el trabajo propioceptivo es mucho mejor realizarlo descalzo para aumentar la sensibilidad de los receptores del tobillo.
  • Es importante entrenar la propiocepci贸n sin un estado de fatiga muscular/articular, ya que la calidad del entrenamiento se reduce. Sabemos por experiencia que realizarlo antes de la actividad f铆sica nos resulta m谩s perezoso, porque aun no nos sentimos “activados”, pero el cuerpo nos lo agradecer谩.
  • Realizando de 1 a 6 ejercicios por sesi贸n con 2 o 3 series cada ejercicio y siempre de menor a mayor implicaci贸n de fuerza, empezaremos por los ejercicios f谩ciles y acabaremos por aquellos m谩s complicados. Entrenamiento gradual!
  • 驴Con entrenamiento posterior? No importa si le acompa帽an unos kil贸metros o una sesi贸n de pesas, de cualquier modo, es un tipo de ejercicio que podemos realizar sin necesidad de hacer otro despu茅s. 脡l mismo ya constituye una sesi贸n de entrenamiento como tal.

Toda la informaci贸n publicada en este blog es de car谩cter informativo. Las lesiones son como las carreras, se parecen pero no hay una igual, as铆 que debemos consultarlo con un profesional. Esperamos haber ayudado a entender un poquito m谩s esta pasi贸n. Gracias!

Este post ha sido ofrecido gracias a la experiencia y formaci贸n de nuestro amigo y fisioterapeuta Xavier Pedr贸s. Visita @xpedrosboria en Instagram para conocer m谩s sobre el mundo del trail, el ciclismo y la fisioterapia.

When did all begin?

Less than 3 minutes-reading

I remember myself running barefoot from one point to another in the garden of the village. We used to do races with my brothers just to discover who could be able to run over the tiny sharp stones as long as possible. Evenings always ended with red feet. It was a mad way to spend a childhood, but I really never appreciated objects -outdoor activities were always a better plan than TV or computers.

Running the mountain marathon of BUFF Epic Trail in 2017

Sometimes people ask me since when I run. At the beginning I used to try to figure out an exact moment of my life -that’s because humans we usually need distances, exact dates, places or bib-numbers just to verify a story. Then, I understood that running has always meant a way of expression.

The fact is, my parents never took me to the mountains, or campings, or nature at all. We were 10 brothers and sisters so logistics always put us on troubles to do road trips. I was too young to take a car and no trails surrounded the area. Unfortunately, I am not the personification of natural human that was born in a valley. I am more a village-city product with the desire of discovery and run, meet the mountains and their beauty.

However, from young ages to adolescence I played football in several teams. It was an easy and accessible way to burn my energy. But the need to run (yeah, it was something quasi-animal) became evident, a football field was already small. Things got in troubles when my aunt (who always used to run) said: – hey, would you be able to run a marathon someday? After one week, I bought a pair of shoes and I told my mum that I would run a marathon. I was 16 years old. I promised my aunt to finish in less than 4 hours (Why? No fucking idea, 4 hours sounded good). At that moment we were training 3-times + 1 match per week. That, with 3 days of running, meant no rest at all. But the coach did not know that, so the 0 experience together with silence led me to a marathon line.

Before running my first marathon with 16 years old in Donostia, Basque Country.

I was 16 so I had to race with an adult bib-number (I definitely do not recommend that but I can be really persistent). I did not have too much money so I ran with a 10 euro watch from Decathlon. I wrote some pace times in my arm. I finished the 42km with 3h and 56min. Of course, the photo above is before the race. After the event, I kept that big smile but with the particularity of having 2 legs less during 3 days. I do not regret at all.

By the way, when did all begin? Before my first marathon? After? That’s the idea, will we stop being runners when we stop racing?

See you soon!!