The "Wow" Factor in Sports Injuries

“Well the physiotherapist said it shouldn’t hurt.”  I blink twice and stare at the young man sitting in front of me who has just said this.  “Pardon me?” I ask a bit taken aback.  This young athlete had sprained his ankle pretty badly playing basketball when he jumped up for a ball and landed on someone else’s foot.  He went to a sports injury clinic where he had some physiotherapy treatment.  The treatment succeeded in getting the swelling in the ankle down and restoring his full range of motion, but he was still unable to run due to pain.  When he told his therapist that the ankle was still painful this is what he was told.

Given that he has already had treatment at a sports injury clinic I am a bit at a loss as to where to start, so I revert to the basics.  The ankle in fact is no longer swollen and moves quite well so I ask him to stand up and put his weight on one foot at a time.  When he stands on his good foot the ankle stays nicely lined up and stable.  When he stands on the bad foot the bone on the inside of his ankle nearly hits the floor.  Yikes.  I cringe.

“What?” he asks.  “Um, just let me get a mirror” I say.  I go and get the rolling mirror and put it in front of him.  When he sees how unstable his bad ankle is when he puts his weight on it his eyes bug out.  “Wow” he says.  “That doesn’t look good.”  “No, it really shouldn’t do that.  I think maybe that’s why it’s still hurting” I offer.  “Yeah, I guess so” he replies.

I ask him how it is no one noticed this so far.  It seems that the sports therapist never actually watched him stand on his ankle.  He just hopped up on the treatment bed with his feet dangling and had his ankle treated like that.  There is no doubt that getting the swelling down and regaining movement in the joint was very important, but it seems to me that the true dysfunction still remains.

As I always do, I conduct an assessment of his body as a whole.  What I find is that there is significant instability at the hip and pelvis on the side of his injury.  The instability here is in fact causing him to fall in on his ankle.  I do some hands-on work around the hip and pelvis on both sides and improve the stability centrally.  Then I have him stand up again.  I put the mirror in front of him again and ask him to stand on his bad ankle.  “Wow” we both say simultaneously, but this time it is a good “wow”.  His ankle is much more stable.

Over the next few visits we continue to work on the stability at the hip and pelvis and his ankle becomes more and more stable.  Soon thereafter he is very happily back to running and playing basketball.

This young man still comes to see me from time to time whenever he has an injury from the many different sports he enjoys.  He even came one time before running a 10km race, not because he was having any pain, but because he wanted to run faster.  We worked on improving the efficiency in the large muscles around his hips and the end result was that he took several minutes off his personal best time.  “Wow” I say.  “Wow” indeed.  It’s amazing what can be achieved when we treat the body as a whole.