Ankle Sprains

Sprained ankles happen to be one of the most common injuries among both athletes and non-athletes. The amount of movement that takes place at the ankle, coupled with numerous opportunities for missteps or awkward positions makes the area very vulnerable.

Sprains can occur on either side of the ankle, but the outer (lateral) side is injured most frequently. An ankle sprain occurs when the foot is turned excessively and abruptly enough to tear or overly stretch ligaments around the joint. Occasionally, the sprain can be severe enough to cause a fracture of bone that is attached to one of the ligaments (referred to as an avulsion). The severity of an ankle sprain can often be initially determined by the symptoms. Mild sprains will usually cause only mild discomfort and swelling, and very little or no swelling. More severe sprains will cause limping, greater swelling and often bruising within several hours.

Treatment of an ankle sprain will of course depend upon the severity of injury. With most ankle sprains, the initial treatment is often referred to as RICE: rest, ice, compression, elevation; which are meant to promote healing (rest), and reduce pain and swelling. Protect the skin from cold injury by using a small cloth between the skin and ice, or apply ice massage after proper instructions by a health care professional. Ice applications should not last more than about 20 minutes, but can be repeated frequently. Compression can be applied using an elastic wrap or an air splint. Care must be taken, to avoid too much compression, leading to swelling or numbness in the foot. Mild sprains will often require only a few days of home treatment, followed by a gradual return to usual activities.

Moderate to severe sprains will not respond quickly to the treatment described above and will exhibit more pain and swelling than mild sprains. Any sprain that does not respond within a few days to the RICE treatment or leads to persistent limping should be evaluated by a professional. X-rays may have to be done if a fracture or severe ligament damage is suspected. Along with RICE treatment, crutches and/or a cast may be needed. In very severe cases, surgical repair may be required. Full recovery from severe or persistent ankle sprains often involves strengthening, balance, and carefully prescribed agility exercises, to regain normal function and prevent reinjury. At Oliveri Physical Therapy, we provide all of the exercises needed to properly rehabilitate injured ankles. In addition, we provide modalities such as ultrasound, electrical stimulation, and infrared energy to promote and speed healing.


Tony Oliveri is a licensed physical therapist and owns Oliveri Physical Therapy and Sports Training in Rochester.

Back Pain

By Tony Oliveri, DPT


Back pain is one of the most common reasons for visits to the physician or physical therapist. The causes of back pain are too numerous to list here, but most cases are caused by poor posture, repetitive minor strains or awkward movements or positions.

Doing an activity you are not accustomed to can easily cause back pain, even in a very fit person. A fair weather example is gardening, or yard work. Bending or stooping repetitively, or for prolonged periods often leads to back pain. Repetitively rotating, even slightly, such as while raking can also lead to back pain. It is the repetitive nature of the activity, not the force, that generally causes the back pain. Stretching prior to getting into the activity, just as in sports, can help prevent problems.

Apparantly simple activities such as those mentioned above can lead to back pain either because the movement is unfamiliar (you are “out of shape for it”), or the position itself causes muscle or joint stiffness. Since muscle and joints thrive on movement, holding a position or posture for a prolonged period of time leads to stiffness and pain. Learn to interrupt the activity, even briefly, to avoid the stiffness. A non-activity that can lead to back pain is slouching. When slouching becomes a habit, the relaxed muscles become weak, and other muscles become tight. Eventually, back pain can develop, since the muscles are not holding the vertebrae of the spine in proper alignment.

Although you may not be able to totally prevent it, you can reduce the frequency, duration, and intensity of low back pain. Along with many types of pain-relieving treatments, physical therapists can provide instructions on improving posture, proper lifting techniques, and specific exercises and stretches to decrease and help prevent back pain. When the back pain is associated with sciatica, or leg pain, a careful evaluation by a health care professional should be done prior to initiating back exercises. The wrong exercises can easily make the problem worse. Regular exercise, such as walking, swimming, and weight training has also been shown to reduce the occurrence of back pain.