A Humdinger No Doubt Ankle sprains. Such a bugger to deal with. Ankle sprains are one of the most common injuries seen in basketball. The cutting, jumping, contact, fatigue, and poor footwear certainly don’t help matters. Damn near almost every game someone tweaks an ankle. Treating ankle sprains in-game provides quite a different perspective. Rarely in the clinic do we work with someone immediately post-injury. Instead, we deal with the cumulative effects of delayed treatment: acquired impairments, altered movement strategies, and reduced fitness. The pressure is lower and the pace is slower. You shed that mindset with the game on the line. You must do all in your power to get that player back on the court tonight, expediting the return process to the nth degree. I had a problem. Figuring out the most efficient way to treat an ankle sprain was needed to help our team succeed. I searched the literature, therapeutic outskirts, and tinkered in order to devise an effective protocol. The result? We had 12 ankle sprains this past season. After performing the protocol, eight were able to return and finish out the game. Out of the remaining four, three returned to full play in two days. The last guy? He was released two days after his last game. It’s a tough business. The best part was we had no re-sprains. An impressive feat considering the 80% recurrence rate¹. Caveats aside, treating acute injuries with an aggressive mindset can be immensely effective. Here’s how.
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The Sensitive Nervous System Chapter XIV: Management Strategies: Integration of Neurodynamics
This is a summary of chapter XIV of “The Sensitive Nervous System” by David Butler. The Big Picture Evidence Based Approach Here is the step by step patient care process that Butler advocates. 1) Identify red flags and manage accordingly. 2) Educate on the whole problem to include tissue health status, the nervous system’s role, and test results. 3) Provide prognosis and make realistic goals. 4) Promote self-care, control, and motivation. 5) Decrease unnecessary fear and manage catastrophization. 6) Get patients moving as early as possible. 7) Help patients identify success and sense of mastery of a problem. 8) Perform a skilled exam. 9) Acknowledge that biopsychosocial inputs combine with the nervous system to produce pain and disability. 10) Use any measures possible to reduce pain. 11) Minimize number of treatments and contacts with all medical personnel. 12) Chronic pain may need a multidisciplinary approach. 13) Manage physical function and dysfunction. 14) Assess and assist in improving general fitness. 15) Assess how injury affects creative outlets and assist the patient with regaining creativity and discovering new creative outlets. Incorporating Neurodynamics There are several ways to incorporate neurodynamics into the patient’s plan of care which will be outlined below. Reassessment. Explanation. Passive mobilization. Active mobilization. Posture and ergonomics. Reassessment There are many evaluation protocols that warrant constant reassessment after applying an intervention. Be it a comparable sign or audit, neurodynamic tests can be utilized well within these systems. A word of caution with instant reassessment, as quick changes could merely be
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