Column: Ligament injuries need special care

Will a wobbly ankle ever heal? And, if it could be cured, what type of exercise helps?

The first line belongs to a doctor, the second part I may be able to answer. In any case, major joint instability resulting from a ligament injury can curtail your athletic future.

The most important part of the question of healing a ligament injury is the severity of the injury. My medical books list ligament injuries in three categories; a grade one injury being anything from a stretched ligament to a 20 percent tear of the ligament. A grade two, or moderate injury, can be anything from a 20 percent tear to a 75 percent tear. And the grade three injury takes in 75 percent to a total disruption of the ligament capsule. The medical field seems to like to grade things in 1, 2 and 3 levels. The treatment of these three levels of ligament injury are best handed out by your doctor.

Ligament injuries are incurred when they are stretched beyond the strength limit. Sprains are ligament injuries, which result in joint instability. A completely ruptured ligament will require surgery to reattach and return stability to the joint.

Four stages of healing occur with a sprain. First the ligament swells with blood and tissue, then a blood clot forms. The blood clot, or weak scar tissue, becomes stronger scar tissue. And finally damaged nerve endings in the injured ligament regenerate. This is just a thumbnail sketch of the whole process of healing for your twisted ankle. It takes time and lots of it, with your doctor directing the rehabilitation, to get you back on your feet again.

Then it is time for the reinsertion of your body into your fitness world. Here is where I come in - in answer to the beginning question. When you have healed to your doctor's specifications, work the muscles in the rest of your leg to keep strength levels up. Bike when you feel you can manipulate your ankle without stress. Walk and then lightly jog if you can. Work your way up to your prior level slowly maintaining no stress to the injury. It may take weeks or months of slow effort to achieve original status. Two more suggestions ss; protect the ankle with a pull-on, double strap bandage before your begin your workout, and stay away from irregular ground when you walk or jog as log as you feel inadequate in your balance and ankle strength.

(Jerry Vance is certified by the American Council on Exercise and teaches fitness at the Carson City Community Center and for the American Lung Association.)