The clinic is located at 101-3151 Woodbine
Drive in Edgemont Village.
Michael White and Darryl Gjernes are the clinic
owners. Both Michael and Darryl have worked
in Orthopaedics and Sports Medicine for the past
30 years. They have both been Guest lecturers
in the clinical experts program at the
Physiotherapy Faculty at UBC since 1998.
For the first 48 hours after the injury it is
important to properly care for the sprain.
R.I.C.E. is the acronym to remember when
treating an acute injury. This stands for
Rest, Ice, Compression, and Elevation. This
treatment should be continued throughout
the day for the first two days after the injury.
The therapist will give you a home exercise
routine specific to the nature of the sprain.
These will include exercises for range of
motion as well as for strengthening. If there
is inflammation after the exercises are
completed, continue to ice the joint.
Michelle Edmison, Cheryl McNeight, and
Suzanne Rodzoniak, are associates at the clinic
with extensive specialization in manual therapy
and orthopaedics. Cathy Watson, our newest
associate has a strong background in Pilates
rehabilitation and osteoporosis education and
rehabilitation.
The Clinic is open 7 days a week. Hours on
weekdays are from 7:00 am until about 8:00pm.
On the weekends the hours vary but are usually
mornings.
Services offered at the clinic include spinal and
joint manipulation, orthotic and custom brace
fitting, Muscle Release Therapy, Intramuscular
Stimulation (IMS), Acupuncture, and
rehabilitation exercises.
A sprain is when the ligament is stretched
suddenly and the substance of the ligament
is put under stress. Most tears are not
complete. When the tears are complete they
are known as ruptures.
There are three degrees of sprain. Firstdegree sprains are more like runs in
pantyhose or a tear in your jeans.
In the second-degree sprains the amount of
the substance of the ligament is
compromised by 50% or more. This results
in a much longer recovery time. The
ligament is not the only structure affected.
The tendons and the surrounding tissues are
also compromised.
In third-degree sprains the ligament is
ruptured and occasionally the bone of the
fibula (the outside ankle bone) is avulsed
(broken off) the outside of the ankle. Even
though the tip of the fibula may be fractured
it is not always necessary to cast the ankle,
as the fibula is not a weight bearing bone.
Often a fractured fibula will heal faster than
the soft tissue (ligaments, tendons, muscle)
that is injured in a third degree sprain.
Physio Fact:
Heat can be used to reduce pain and
discomfort, and to increase mobility once
the acute stage of the injury is over.
Edgemont Village Physiotherapy
101-3151 Woodbine Drive
North Vancouver B.C 604-985-2629
All sprains are subject to the inflammatory
response of the body to injury. Each of the
three degrees responds in different ways.
First-degree tears (minor tears) are treated
by affecting the inflammatory response of
the tissues. The treatment then focuses on
promoting healing and subsequently
strengthening the surrounding muscles to
reduce the chance of recurrence.
Second-degree tears resolve using some scar
tissue. It is the goal of the therapist that the
scar tissue be of the same resilience as the
normal tissue. The use of ultrasound and
other modalities are standard in the
treatment of these conditions.
Third-degree tears often involve a chip
fracture of the fibular bone and are treated in
much the same way as the second-degree
tears after the immobilization period is over.
This period will vary from a day to six
weeks depending on the other damage done
to the surrounding tissues.
First-degree sprains may only require a few
treatments, second-degree tears may require
weeks of treatment and the third-degree
tears are often in treatment for a few
months.
Physio Fact:
Pain persisting over a bone on the outside
of the foot may be due to a displaced
bone called the cuboid.
This will obviously depend on the extent of
the injury but first-degree tears can often
compete at 90% or more with immediate
intervention, taping and bracing. The more
severe the injury is, the longer the
rehabilitation. Sometimes as much as six
months of treatment is needed for full
recovery.
In second-degree sprains the integrity of the
outside ligament has been compromised.
Thrusting with the foot planted firmly on the
floor can cause a bone on the ankle to shear
and pain and further damage can result. It is
important to tape and brace these ankles
prior to activity. The ligaments can
regenerate themselves but even though the
pain and swelling improve within a few
weeks the laxity of the ligament may take up
to a year to recover.
In third-degree sprains there is often less
ligament damage as the bone instead of the
ligament give way. Once bony union has
been achieved (8 weeks) the stability of the
ankle is often very good. Never the less
bracing will be required to return to activity.
Strengthening of the peroneal muscles on
the outside of the leg will help prevent
further sprains.
Balance training and strengthening of the
surrounding muscles is essential to prevent
further sprains. Neglecting treatment can
lead to scar tissue, instability and arthritis.
This is one of the joints in the body that
physiotherapy helps significantly.
Most of the severe sprains will need bracing
for early and safe return to activity. Where
the joint becomes completely unstable,
surgery may be suggested to tighten the
ligaments. Occasionally the bones may
need suturing or pinning. Antiinflammatory medication may speed up the
recovery in those patients who become
inflamed.
There are different braces that aid in
returning regular activity. The brace
recommended by the therapist will be
dependant on the individual needs. Some of
the most common braces include the ASO™
Ankle Stabilizer, The Active Ankle™
Brace, and the Aircast™ Brace.
Physio Fact:
Recurrent sprains can be due to
displacement of the talus (a bone at the
ankle). Ligament laxity may be the cause.
ASO™ Ankle
Stabilizer
Active Ankle™ Brace