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Caring Medical and Rehabilitation Services Oak Park IL 708-848-7789

Chronic Lateral Ankle Instability
Ross Hauser, M.D.

Most Ligament injuries do not totally heal. Even if the pain resolves, the ligament will not be as strong as it was prior to the injury. Since ligaments stabilize the joints, ligament injury then produces a loose joint. If the ligament never heals, chronic joint looseness or instability results.

The symptoms of chronic ankle instability are feelings of the joint giving way, swelling, pain, decreased range of motion or excessive motion, and recurring sprains. The pain is usually chronic or recurrent. Other symptoms include complaints while wearing high heels, increased symptoms after walking or sports, and, as stated, recurrent sprains.

If the ankle instability is not treated, cartilage deterioration with resultant degenerative arthritis develops. This sequence of events occurs everywhere in the body. If a ligament does not heal, instability of the joint occurs-and the end-result is arthritis with good prospects for fusion or joint replacement surgery.

Studies on injured ligaments show that at least one year is required before healing has been completed or the total amount of healing occurs. Injured ligaments do not entirely regenerate. Rather, they repair with scar tissue. Repair and regeneration begin at 48 hours to 72 hours post-injury, and continue maximally for six weeks.

From six weeks to 12 months the ligament tissue remodels, contracts, and gains tensile strength. After 12 months the ligament and scar tissue generally matures and achieves 50 to 70 percent strength of the original ligament. Do you understand the magnitude of this statement? On average, ligaments only heal to 50 to 70 percent strength when they are injured.

Pain relief is not a reliable sign that a ligament has healed; perfect function is the sign. A joint that is strong, without swelling or signs of weakness, is a better measure.

Do you have ligament irritation of the ankles?
To test for ligament irritation in the area of the right ankle, cross your right ankle over the left knee. Your right hand should be placed over the right ankle. The left hand then pulls on the toes of the right foot, inverting the ankle. If pain is felt in the right ankle with this maneuver, most likely injury to the ligaments on the outer part of the ankle has occurred. The same maneuver can be used for testing the left ankle.
 

An inner ankle sprain usually involves the deltoid ligaments. The test for this ankle sprain involves eversion of your foot (the opposite direction from inversion) by turning your foot out. If this causes increased pain on the inner part of your ankle, then there is a high likelihood of ligament injury to the deltoid ligaments. Unfortunately, many times the stability tests are negative, in that they do not reproduce pain. A better measure of ligament injury is by direct palpation. Often, when the stability test is negative (no pain), direct palpation over the injured ligament will be very painful. This is where the Prolotherapy is given.

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Ross Hauser, M.D.
Dr. Hauser received his M.D. from the University of Illinois, Chicago; completed his residency at Loyola-Hines VA-Marianjoy Hospitals in Physical Medicine and Rehabilitation; and received his Bachelor of Science degree from the University of Illinois, Urbana-Champaign. Dr. Hauser is the Medical Director and co-founder of the physician-run, comprehensive natural medicine clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy. He, along with his wife Marion, have written seven books on the topic of Prolotherapy, a comprehensive book on the natural medicine approach to cancer, as well as a myriad of articles and newsletters for the general public. Read more
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The information on this website is presented as information only and not a self-help guide NOR AS SPECIFIC HEALTH RECOMMENDATIONS. Never alter or change your health management or begin any new health plans without first consulting your personal health care provider. Some statements on this site regarding the value of nutritional supplements have not been evaluated by the FDA.

As with any medical technique, Prolotherapy may not be effective for every individual and there are risks involved, these risks should be discussed with your physician. Results achieved with some may not be typical of all. Please consult a physician. Please read Prolotherapy Risks

There is no known cure for arthritis. Prolotherapy and nutritional supplements can help alleviate, reverse, or end arthritic pain by treating an underlying cause that contributes to degenerative disease, ligament laxity. Strengthening ligaments and other connective tissue can help prevent bone on bone arthritis from developing.

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