Ankle Sprains

This blog comes about due to the recent slippery conditions, resulting ankle sprains. Ankle sprains are one of the most common joint injuries, most people have experienced at least one during their life. Some people have had repeated ankle sprains whether due to sport or as some people will tell me they have “ weak ankles”, more on that comment later.

The ankle joint is formed by the two lower leg bones, the tibia (shin bone) and the fibula (the smaller bone on the outside of your leg) and the bones beneath that are part of the ankle and the heel.

So you’ve just twisted or rolled your ankle, what now? Ankle sprains or any injury to the ligaments ( tough connective tissues that connect bone to other bones) are graded from 1-3.

Grade 1 being the least severe, only some stretching of the ligaments, there may be some swelling and obvious at the end range of movements but no real damage to the ligament. You will be able to stand on your toes and may have a limp for a couple of days. Recovery takes 1-2 weeks.

Grade 2, is more common and involves some partial tearing of the ligaments, here there will be obvious swelling plus some bruising will also appear around the ankle and then into the bottom of one side of the foot. You will limp for up to 2 weeks, you will be unable to hop, run or stand on your toes, there will be pain with most movements. Recovery takes 1-2 months.

Grade 3 is more severe, complete tearing of the ligament, there will be bruising on both sides of the foot, weight bearing is impossible and nearly all movements will be painful and severely reduced. This may require surgery and months of treatment/rehab.

Ok, so when do I need an x-ray, should I go to the hospital? To determine need for an x-ray we follow the Ottawa Ankle Rules. These rules developed by the Ottawa Hospital Research Institute are designed to reduce unnecessary x-rays and reduce unnecessary hospital trips. In short the rules recommend x-ray if there is pain on touching the bones of the ankles and foot or there is an inability to bear weight and take 4 steps ( 2 with each foot) both right after the injury and at presentation to the health care provider’s office.

So what now, Grades 1-2 will respond well to conservative care including chiropractic care. Grade 3 will require a specialist consult, but if no surgery is necessary a conservative route can be taken but will require more time.

Initial home care will be for inflammation control (icing 10minutes/hour), rest ( including crutches), protection /compression of the joint ( some form of tensor bandage or brace) and elevation. Regaining mobility early is important, so moving the foot as much as possible in a non-weight bearing position, i.e. spelling the alphabet with your toes.

In the office we can use electrotherapy, ultrasound and hands on mobilizations to improve range of motion and decrease swelling.

As mobility improves and swelling decreases we will begin with strengthening exercises, initially non-weight bearing and then weight bearing.

Lastly, if you recall at the beginning of the blog, some people will say they have weak ankles or sprain them frequently. The reason for this is they have not retrained the ankle’s proprioceptive ability, or simply the ankle and the brain are not communicating properly and your balance is affected. To train for balance we need to stress the affected ankle alone, with one legged standing, hopping and balancing on an unstable surface.

I hope that this gives you a better understanding of ankle sprains and what to do about them. As always if you have any questions give me a call, send me an email, tweet or find me on Facebook.     info@drkevinfinnca @drkevinfinn 905-831-3939

Seniors and Chiropractic

I am often asked who should see a chiropractor, to this I answer everyone. Everyone should have a chiropractor as they have a family physician, dentist and optometrist.

One group of people who would particularly benefit from chiropractic care are our seniors. There are 3 major reasons seniors benefit from chiropractic care.


  • Pain reduction

– As we age the prevalence of chronic neck, back and joint pain increases typically due to more wear and tear related osteoarthritis. Chiropractic care has been shown to reduce neck and back pain.


  • Improved range of motion

– By using manual chiropractic treatment movement to the spine, hips, shoulders and knees can be improved enabling you to lose the stiffness in your joints that prevent or hinder you from performing the daily tasks you need to do and the recreational or social activities you enjoy doing.


  • Reduce your risk of falling
  • As we age we have an increased risk of falling and suffering serious injury as a result. Things like reduced leg strength, flexibility and co-ordination can increase our risk of falling.

As a chiropractor I will assess your fall risk using a 14 point test, provide strategies to prevent falling and provide treatment that helps to improve your balance. Lastly there are particular exercises that can easily be done at home that can improve balance, increase leg strength and thus reduce the risk of falling


As a chiropractor I will also help to manage/monitor other co-existing conditions that are more common as we get older.

For my senior patients who have high blood pressure I will periodically check their blood pressure and report to their family physician should something be amiss.

For patients who are diabetic, I will regularly assess their lower limb neurological function to monitor for neuropathy and the presence of emerging musculoskeletal conditions.

For patients with chronic obstructive pulmonary disease or COPD(Chronic bronchitis/emphysema) chiropractic treatment of the mechanics of breathing ( rib cage, back, chest and neck musculature ) may improve breathing function and overall sense of well-being related to their condition.

Did You Know That November Is Osteoporosis Month?

I have decided that the topic of this blog should be osteoporosis. For one November is Osteoporosis Month. Secondly, after being in practice for 17 years a number of patients who started care with me at the beginning when they were middle aged are now seniors, retiring looking forward to travel, increased leisure time, time for hobbies and continued physical activity. For some however osteoporosis or decreased bone density may limit what they would like to do.

Osteoporosis which often gets mistakenly used interchangeably with osteoarthritis, is most commonly a condition related to aging and most commonly in women, men and those in younger age ranges can also be affected however.

With osteoporosis the amount of bone is diminished, this occurs without any symptoms until a fracture occurs which results in a great deal of pain and disability. If you imagine the inside of your bone looks like a sponge you might use for cleaning, there is a framework of sponge material with a lot of holes. Your bone is obviously a stronger, harder framework than sponge but the appearance is similar, now imagine an osteoporotic bone, there would be less sponge and bigger holes, thus a weaker structure more prone to fracture.

Areas typically fractured are the hips, wrists and mid/upper back. So who’s at risk, women of Caucasian or Asian heritage, slight build, early menopause, diabetics, those on corticosteroid medications for inflammatory lung conditions or bowel conditions. Those are factors that are hard to modify, avoidable risk factors, things that can reduce your bone quantity are things like; smoking, alcohol use, caffeine use, soft drinks and inactivity.

So what can you do? You can’t change being a senior woman of Caucasian ancestry, you can ensure that you have adequate calcium intake ( 1500mg/day), Vitamin D intake 1000-2000iu/d be active performing regular weight bearing activity, walking is great, but don’t forget things like resistance training or weight training and balance exercises like Tai Chi or yoga. Limit falling risks around the home, wear good footwear use walking sticks (like cross country ski poles).

This is all reasonable once you get to be older and at risk, my challenge is not only to my senior patients but also their daughters and granddaughters. Why? Simply the amount of bone you acquire prior to the age of 30 is your peak bone mass, the more you acquire by that age the more you have to lose as you age before you’re at risk. Bank not only your savings for retirement, but your bone. Encourage our younger women to be active and build their bone mass.

Links      for more osteoporosis information     for fall prevention strategies

The Truth About Compression Garments


You may have noticed watching a sporting event, whether it be basketball or a running event, the athletes seem to be returning to longer socks. This most likely is not a fashion choice but one of performance enhancement.

Previously compression garments were worn by people who were having poor venous return, i.e. poor circulation in the legs causing reduced blood return resulting in bulging varicose veins, swelling in the legs and feet. Compression socks or hose are graduated elastic garments that have stronger compression at the feet and reducing as they go up the leg or thigh, this acts to push the blood up the leg and return it to the circulation, reducing swelling and blood pooling in the veins. Older individuals, people who stand for long periods, pregnant women and pilots/air cabin personnel are those who typically are prescribed these garments.

Recently there has been a large increase in athletes wearing these types of garments, whether they are socks, compression hose, sleeves or shorts and tights. The rationale for the use of these garments in athletes is similar however the mechanism is not well understood. Athletic use of compression garments appears to improve such things as; jump performance, joint awareness thus improved performance of a sport movement, increased blood flow to the muscles, joint warmth and reduced post exercise soreness. There may be a role in compression garments in injury recovery as well.

At the office we carry a number of compression garments for both scenarios: poor circulation, those who have standing occupations ( assembly line workers, General Motors, warehouse employees, Costco, etc) and for athletes looking for a boost in performance or exercise recovery.

If you are interested in learning more about compression garments, feel free to contact me at, 905-831-3939, on Twitter @drkevinfinn, Facebook drkevinfinn