Snowboarder’s Ankle Treatment & Rehab

Best Snowboarder’s Ankle Treatment in Delhi

What is Snowboarder’s Ankle ?

“Snowboarder’s Ankle,” also known as a lateral process of the talus fracture, is a common and often misdiagnosed injury among snowboarders. It is a fracture of a small bone in the ankle, the talus, specifically its lateral process.

Causes of Snowboarder's Ankle

This injury typically occurs due to the high-impact nature of snowboarding, especially during jumps, tricks, or awkward landings. The mechanism of injury often involves a combination of forces:-
- Forced Dorsiflexion and Eversion: The foot is forcibly pointed upwards (dorsiflexion) and rolled outwards (eversion). This can cause the lateral process of the talus to be compressed against the calcaneus (heel bone) and the lateral malleolus of the fibula (outer ankle bone), leading to a fracture.
- Inversion with Axial Loading: Less commonly, the foot may be twisted inwards (inversion) with significant axial loading, which can also result in the fracture.
- Sudden Changes in Terrain: Catching an edge or landing on uneven snow can lead to awkward twisting motions of the ankle.
- High-Speed Falls: Falling at high speeds generates significant forces that strain the ankle bones.
- Snowboard Boot Characteristics: Snowboard boots are generally softer than ski boots, offering less rigid ankle support, which can make the joint more susceptible to such injuries. The feet are also positioned cross-wise to the direction of travel, placing more stress on the subtalar joint.

Symptoms of Snowboarder's Ankle

Pain on the Outside of the Ankle: This is typically felt over the lateral side of the ankle, just below the outer ankle bone (lateral malleolus), and worsens with weight-bearing activities. It can be extremely tender to touch.
Swelling and Bruising: The affected area will likely show swelling and discoloration (ecchymosis) due to the trauma.
Difficulty Walking and Weight-Bearing: Bearing weight on the injured foot can be painful or even impossible, depending on the severity of the fracture.
Tenderness: Significant discomfort when pressing on the lateral side of the ankle.
Reduced Range of Motion: Difficulty moving the ankle through its normal range.

Advanced Physiotherapy for Snowboarder's Ankle (including Manual Therapy)

Initial Stages (often with immobilization – cast or boot, and non-weight bearing):

Pain and Swelling Management:
- RICE protocol: Rest, Ice (cryotherapy for 10-30 minutes, several times a day), Compression (bandage), and Elevation.
- Modalities: Therapeutic modalities like ultrasound therapy and Transcutaneous Electrical Nerve Stimulation (TENS) may be used to reduce pain and inflammation. Laser therapy (LLLT) can also aid in accelerating healing.
- Gentle Range of Motion (ROM) Exercises: As pain allows, passive and then active range of motion exercises are initiated to prevent stiffness and promote joint mobility within pain-free limits. This includes dorsiflexion, plantarflexion, inversion, and eversion.
- Non-Weight Bearing Exercises: Exercises like pool running with a buoyancy belt (hydrotherapy) can help maintain cardiovascular fitness and allow for early movement without putting stress on the fracture.

Intermediate to Advanced Stages (as healing progresses and weight-bearing is allowed):

- Progressive Weight-Bearing: Gradually increasing the amount of weight placed on the injured foot, guided by the physiotherapist.

Strengthening and Stability Exercises:
- Muscle Strengthening: Exercises for the ankle and surrounding muscles (e.g., calf muscles, peroneal muscles) using resistance bands, bodyweight, and eventually weights. This helps regain stability and support the joint. Examples include calf raises, ankle inversions/eversions with bands.
- Proprioception and Balance Training: Crucial for preventing future injuries and improving ankle awareness. This progresses from stable surfaces to unstable ones:
  - Single-leg standing (eyes open, then closed).
  - Wobble board, balance disc, or Indo Board exercises.
  - Progressing to sport-specific drills that challenge balance in dynamic ways.
- Functional Training: Once pain has decreased and mobility improves, exercises are introduced that mimic daily activities and eventually sport-specific movements. This could include walking, jogging, jumping, and cutting motions.
- Cardiovascular Conditioning: Maintaining overall fitness through activities like cycling or swimming.

Advanced Physiotherapy Techniques (including Manual Therapy):

Joint Mobilization: The physiotherapist manually applies gentle, oscillatory movements to the ankle and subtalar joints to improve range of motion and reduce pain. This can involve:
- Talocrural Joint Mobilizations: To improve dorsiflexion and plantarflexion.
- Subtalar Joint Mobilizations: To restore inversion and eversion movements, which are crucial for adapting to uneven terrain.
- Accessory Glide Mobilizations: Small, specific movements of joint surfaces.
- Soft Tissue Mobilization: Techniques to release tension and improve flexibility in muscles and fascia surrounding the ankle. This includes:
- Myofascial Release: Applying sustained pressure to release fascial restrictions.
- Trigger Point Therapy: Addressing specific tight bands or “knots” in muscles.
- Passive Release Stretches and Active Release Techniques: To lengthen shortened muscles and improve tissue extensibility.
- Neuromuscular Re-education: Techniques to improve the communication between the brain and the muscles, enhancing coordination and control around the ankle. This often involves specific exercises performed with precise movements.
- Dry Needling : May be used to address pain and muscle tightness.
- Shockwave Therapy: Can be used for persistent pain or issues with bone healing.

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