Pictures of badly sprained ankles. Third-Degree Ankle Sprain: Symptoms, Treatment, and Recovery
What are the symptoms of a third-degree ankle sprain. How is a severe ankle sprain diagnosed. What are the best treatment options for a grade III ankle sprain. When is surgery necessary for an ankle sprain. How can you prevent chronic ankle instability after a severe sprain.
Understanding Ankle Sprains: Grades and Severity
Ankle sprains are common injuries that can occur from various activities, ranging from everyday mishaps to sports-related incidents. To effectively address and treat ankle sprains, it’s crucial to understand their severity levels, known as grades. Let’s explore the different grades of ankle sprains and their characteristics.
Grade I Ankle Sprain
A Grade I ankle sprain, also referred to as a first-degree sprain, involves stretching of the ankle ligament. This type of sprain is characterized by:
- Mild pain
- Normal range of movement
- Minimal swelling
While Grade I sprains are the least severe, they still require proper care and attention to prevent further complications.
Grade II Ankle Sprain
A Grade II ankle sprain, or second-degree sprain, is more severe than a Grade I sprain. In this case, the ligament is partially torn. Symptoms of a Grade II ankle sprain include:
- Significant pain
- Noticeable swelling
- Restricted movement
- Mild to moderate joint instability
Grade II sprains often require more extensive treatment and a longer recovery period compared to Grade I sprains.
Grade III Ankle Sprain
A Grade III ankle sprain, also known as a third-degree sprain, is the most severe type of ankle sprain. This injury involves a complete tear of the ligament. Symptoms of a Grade III ankle sprain include:
- Moderate to severe pain
- Significant swelling
- Substantial joint instability
- Difficulty bearing weight on the affected ankle
Grade III sprains often require more intensive treatment and may sometimes necessitate surgical intervention.
Diagnosing a Third-Degree Ankle Sprain
Proper diagnosis of a third-degree ankle sprain is crucial for effective treatment and recovery. Orthopedic specialists employ various methods to accurately assess the severity of an ankle sprain.
Physical Examination
The initial step in diagnosing a third-degree ankle sprain involves a thorough physical examination. During this process, the orthopedic physician will:
- Inspect the ankle for visible signs of injury, such as swelling and bruising
- Gently palpate the affected area to assess tenderness and pain levels
- Evaluate the range of motion and stability of the ankle joint
- Compare the injured ankle to the unaffected ankle
Imaging Tests
To confirm the diagnosis and rule out other potential injuries, the physician may order imaging tests such as:
- X-rays: To check for any associated bone fractures
- MRI (Magnetic Resonance Imaging): To visualize soft tissue damage and assess the extent of ligament tears
- Ultrasound: To evaluate ligament integrity and identify any fluid accumulation
These diagnostic tools help the orthopedic specialist determine the most appropriate treatment plan for the patient’s specific injury.
Conservative Treatment Options for Ankle Sprains
In most cases, ankle sprains, including third-degree sprains, can be effectively treated using conservative methods. These non-surgical approaches aim to reduce pain, promote healing, and restore function to the injured ankle.
The RICE Method
The RICE method is a widely recognized approach for managing acute ankle sprains. It stands for:
- Rest: Avoid putting weight on the injured ankle
- Ice: Apply cold packs to reduce swelling and pain
- Compression: Use an elastic bandage to minimize swelling
- Elevation: Keep the ankle raised above heart level to reduce fluid accumulation
Implementing the RICE method immediately after injury can significantly improve outcomes and speed up the healing process.
Medications for Pain and Inflammation
Orthopedic physicians often recommend over-the-counter medications to manage pain and reduce inflammation associated with ankle sprains. Common options include:
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
- Acetaminophen (Tylenol)
It’s essential to follow the recommended dosage and consult with a healthcare professional before taking any medication.
Immobilization Techniques
Protecting the injured ankle during the healing process is crucial for optimal recovery. Immobilization methods may include:
- Ankle braces
- Splints
- Walking boots
- Crutches or canes for support
The specific immobilization technique will depend on the severity of the sprain and the individual patient’s needs.
Rehabilitation and Physical Therapy for Ankle Sprains
Rehabilitation plays a crucial role in the recovery process for ankle sprains, especially for more severe cases like third-degree sprains. A well-designed rehabilitation program aims to restore strength, flexibility, and stability to the injured ankle.
Progressive Exercise Programs
Physical therapists and orthopedic specialists develop tailored exercise programs that progress through various stages of recovery. These programs typically include:
- Range of motion exercises
- Strengthening exercises for the ankle and surrounding muscles
- Proprioception and balance training
- Functional exercises that mimic daily activities and sports-specific movements
The progression of exercises is carefully monitored to ensure optimal healing and prevent re-injury.
Manual Therapy Techniques
In addition to exercise-based rehabilitation, manual therapy techniques can be beneficial for ankle sprain recovery. These may include:
- Joint mobilization
- Soft tissue massage
- Taping or bracing techniques
Manual therapy can help improve joint mobility, reduce pain, and promote proper movement patterns during the healing process.
Surgical Interventions for Severe Ankle Sprains
While conservative treatment is often sufficient for most ankle sprains, some severe cases, particularly third-degree sprains, may require surgical intervention. Surgery becomes a consideration when non-surgical methods fail to provide adequate healing or when there is significant ligament damage.
Ligament Reconstruction
Ligament reconstruction surgery is a common approach for severe ankle sprains. This procedure involves:
- Repairing the torn ligament using sutures
- Reinforcing the ligament with a graft if necessary
- Addressing any associated injuries, such as cartilage damage
The goal of ligament reconstruction is to restore stability and function to the ankle joint.
Arthroscopic Procedures
Arthroscopy is a minimally invasive surgical technique that can be used to address ankle sprains and associated injuries. During an arthroscopic procedure, the surgeon:
- Makes small incisions around the ankle
- Inserts a tiny camera (arthroscope) to visualize the joint
- Uses specialized instruments to repair damaged tissues
- Removes any loose fragments of bone or cartilage
Arthroscopic surgery often results in shorter recovery times and less postoperative pain compared to traditional open surgery.
Preventing Chronic Ankle Instability After a Sprain
Chronic ankle instability is a common complication following severe ankle sprains, particularly third-degree sprains. Taking proactive measures during and after the recovery process can significantly reduce the risk of developing this condition.
Adherence to Rehabilitation Programs
Consistently following the prescribed rehabilitation program is crucial for preventing chronic ankle instability. This involves:
- Completing all recommended exercises and stretches
- Gradually increasing activity levels as directed by healthcare professionals
- Continuing with maintenance exercises even after the initial recovery period
Patients who diligently adhere to their rehabilitation programs often experience better long-term outcomes and reduced risk of re-injury.
Proprioception Training
Proprioception, or the body’s ability to sense joint position and movement, is often impaired following an ankle sprain. Incorporating proprioception training into the recovery process can help:
- Improve balance and coordination
- Enhance ankle stability during dynamic movements
- Reduce the risk of future ankle sprains
Examples of proprioception exercises include single-leg balance activities, wobble board training, and sport-specific drills.
Long-Term Management and Prevention of Ankle Sprains
After recovering from a severe ankle sprain, implementing strategies for long-term management and prevention is essential to maintain ankle health and reduce the risk of future injuries.
Proper Footwear and Support
Choosing appropriate footwear and using supportive devices can significantly contribute to ankle sprain prevention. Consider the following recommendations:
- Wear shoes that provide adequate ankle support and fit properly
- Use sport-specific shoes for athletic activities
- Consider custom orthotics or over-the-counter inserts for additional support
- Utilize ankle braces or taping techniques during high-risk activities
Maintaining Overall Fitness and Flexibility
A well-rounded fitness routine can help prevent ankle sprains and other lower extremity injuries. Focus on:
- Strengthening exercises for the legs, ankles, and feet
- Regular stretching to maintain flexibility
- Core stability exercises to improve overall balance
- Cardiovascular fitness to reduce fatigue-related injuries
By incorporating these elements into your lifestyle, you can significantly reduce the risk of future ankle sprains and maintain optimal ankle health.
Understanding the severity of ankle sprains, particularly third-degree sprains, is crucial for proper diagnosis and treatment. While conservative methods are often effective, severe cases may require surgical intervention. By following rehabilitation guidelines, implementing preventive strategies, and maintaining overall fitness, individuals can minimize the risk of chronic ankle instability and future sprains. If you experience persistent ankle pain or instability, consult with an orthopedic specialist to develop a personalized treatment plan and ensure optimal recovery.
Third Degree Ankle Sprain | EmergeOrtho
A sprained ankle can be caused by any number of things ranging from a simple slip on ice to a fall while playing basketball. Quickly addressing an ankle sprain with your orthopedic doctor is crucial. This is especially true in the case of a more severe third-degree ankle sprain. Immediate and proper treatment reduces the likelihood of repeated sprains and long-term ankle problems.
At EmergeOrtho our elite-grade physicians have extensive experience treating a wide variety of injuries, including ankle sprains. Our compassionate, comprehensive orthopedic care enables us to help area residents get back on their feet and Emerge Stronger. Healthier. Better.
Sprained Ankle Symptoms and Diagnosis
The goal of the EmergeOrtho Foot and Ankle Team is to effectively treat ankle sprains to return patients to their regular activities as soon as possible. The first step to diagnosing your ankle sprain includes an evaluation and examination of your ankle.
Orthopedic physicians apply “grades,” to ankle sprains based on the severity of injury:
- Grade I Ankle Sprain
Also referred to as a first-degree sprain, a grade I diagnosis refers to a stretched ankle ligament. Symptoms include mild pain with normal movement.
- Grade II Ankle Sprain
A second-degree ankle sprain is characterized by a partially torn ligament. Symptoms include significant pain and swelling, restricted movement, and mild-to-moderate joint instability.
- Grade III Ankle Sprain
A third-degree ankle sprain refers to a ligament that has been completely torn. Symptoms include mild to severe pain, swelling, and significant joint instability.
It is important to understand that once you have sprained your ankle, you increase the chance of spraining it again—especially over the next couple of years. This risk increases with athletes and active people who place more strain on the joints.
Research demonstrates that one to two out of 10 people who have had a third-degree ankle sprain experience chronic ankle instability. Ankle instability leaves the ankle at a much higher risk for unexpected ankle twists and increased sprains.
How to Treat a Sprained Ankle
Conservative treatment is the first recommendation because with time, sprains generally heal on their own.
Non-surgical treatment methods include:
- RICE Method
Rest, ice, compression, and elevation is a common conservative treatment for ankle sprains.
- Medications
Often, your EmergeOrtho doctor will suggest taking a non-steroidal anti-inflammatory medication such as ibuprofen or naproxen to ease pain and inflammation.
- Immobilization
It is particularly important during initial ankle sprain recovery to keep the ankle protected. A boot, brace, splint, or other immobilization device keeps the ankle secure and supported while it heals.
- Therapeutic Exercises
When considered healed enough, special exercises and stretches are implemented to improve strength, flexibility, and range of motion of your ankle. Your doctor may have you perform these exercises independently, with the aid of a physical therapist, or both.
Patients who follow the rehabilitation guidelines of their doctor often fully recover from an ankle sprain. One of the most common problems for those who stop practicing recommended exercises and stretches too soon is developing chronic ankle instability.
If pain persists beyond four to six weeks, you likely have a chronic ankle sprain. In the event you are still experiencing pain and discomfort after the six-week mark, it is important to consult with your orthopedic doctor.
When You Need More Than Conservative Treatment
Although many ankle sprains heal from the use of non-surgical treatment methods, certain severe cases may require surgical intervention. Third-degree ankle sprains with serious damage often need surgery for optimum outcomes. Pieces of torn ligament must be removed and the ligament reconstructed.
Our EmergeOrtho foot and ankle surgeons may use one of the following surgical techniques:
- Reconstruction Surgery
The torn ligament is repaired with stitches or sutures. Or, the damaged ligament is replaced with a soft tissue graft or other ligaments and tendons in the foot.
- Arthroscopy
By making a small incision, your doctor will insert a tiny “arthroscope” camera to look inside your damaged ankle joint. Equally miniature surgical instruments are then used to remove any loose fragments of cartilage or bone.
If you have an ankle sprain, our specialists can instruct you on how to best care for the sprain for it to heal safely. Our orthopedic experts are also happy to share preventative strategies and ways to keep your ankles safe and protected from injury.
Simple tips such as wearing the right kind of shoes, avoiding uneven pavement and road surfaces can go a long way in preventing an ankle sprain.
EmergeOrtho’s nationally recognized physicians have remained at the forefront of the latest medical advances. Their skills, knowledge, and advanced capabilities have created one of the best practices in the Southeast.
To learn more about ankle sprains and the services we provide for patients throughout the Carolinas, request an appointment with one of our EmergeOrtho doctors now.
Arlington/Mansfield Foot & Ankle Centers: Podiatrists
Did you know ankle injuries are one of the most common bone and joint injuries for athletes, weekend warriors, and those of us just walking through different daily activities? Many people assume it’s easy to tell the difference between a fractured bone and a joint sprain, but sprains and fractures share many symptoms making it hard to know what’s causing your pain.
At Arlington/Mansfield Foot & Ankle Centers, our experienced team of providers help patients in Arlington and Mansfield, Texas, with effective diagnoses and care for ankle sprains and ankle fractures. Read on to learn how to tell the difference between ankle sprains and fractures and what you can do about both!
What’s the difference between an ankle sprain and ankle fracture?
Your ankle is a complex joint comprised of ligaments, tendons, and three main bones: your talus, your fibula, and your tibia. These elements work together to help you move, and even a slight displacement in the joint can result in pressure or pain.
Both ankle sprains and fractures result from similar activities, such as tripping, falling, or twisting, and occur when the ankle is stressed at an angle. The difference is that sprains result when there is damage to the ligament, whereas ankle fractures require a break in the bone.
How can I tell if it’s a sprain or fracture?
Both sprains and fractures can cause pain, swelling, and bruising. In addition, it may be difficult to put weight on your injured foot with both ankle sprains and ankle fractures.
The best way to determine if your ankle is sprained or fractured is to have it evaluated by an ankle expert at Arlington/Mansfield Foot & Ankle Centers. Your provider identifies the nature of the injury using physical evaluation and digital X-ray and/or CT scan if required.
Here are some symptoms to consider when trying to figure out if your ankle injury is a sprain or fracture:
Signs of an ankle sprain
- Ability to bear weight on your ankle (either immediately or after several hours)
- Mild-to-moderate pain
- Ankle instability
- Some swelling and bruising
Signs of an ankle fracture
- Inability to bear weight on your ankle (both immediately and after several hours/days)
- Moderate-to-severe pain upon injury, sometimes with numbness
- Swelling and bruising are typically immediate and obvious
- Deformity of the ankle
When should I seek medical attention for my ankle?
If your ankle is deformed, you’re experiencing extreme pain, or if you’re unable to walk at all, you shouldn’t wait to seek medical care. If you believe you have an ankle sprain but your injury isn’t improving after a few days of rest and ice, it’s important to schedule an appointment with your provider at Arlington/Mansfield Foot & Ankle Center.
Ankle fractures that aren’t treated correctly can cause serious and debilitating complications. And ankle sprains that don’t heal properly can lead to recurrent ankle sprains and instability. It’s important to have your ankle evaluated by trained ankle specialists to ensure you get back on your feet and back to your daily routine as quickly as possible!
Ready to learn more about treatment options for ankle sprains and fractures? Contact the Arlington/Mansfield Foot & Ankle Center office most convenient to you or request an appointment online now!
Ankle Injuries: Sprains and Fractures
What is an ankle sprain or fracture?
Sprains and fractures are two of the most common ankle injuries.
Ankle sprains stretch and tear the ligaments that support your ankle. The injury ranges from many microscopic tears in the ligament fibers to a complete tear or rupture. Ankle sprains are often mistreated or not treated at all, which can lead to prolonged discomfort, re-injury, chronic disability and early arthritis.
An ankle fracture is a break in one or more of the bones that make up the ankle joint. Broken ankles vary from a simple break in one bone to multiple fractures that prevent you from walking.
How does an ankle injury occur?
Ankle injuries occur when the ankle joint is twisted too far out of its normal position. Some common causes include:
- Rotating or rolling the ankle
- Tripping or falling
- Landing awkwardly after a jump
- Walking or running on an uneven surface
- Trauma from a fall, car accident or sports injury
- Faulty footwear, such as very high-heeled shoes or loose-fitting sandals
What are the symptoms of an ankle injury?
Symptoms vary depending on the severity of the injury. Mild ankle sprains cause tenderness, swelling and stiffness. If the sprain is more acute, or the ankle is broken, symptoms typically include extreme pain, instability, limited range of motion and the inability to bear weight. In some cases, you’ll hear a crack or snap as the injury occurs. If the break is bad enough, the bone will protrude from the skin. This is known as a compound, or open, fracture.
How is an ankle injury diagnosed?
If you have an ankle injury, your doctor will check for swelling, point tenderness, discoloration, deformity and range of motion – the foot’s ability to move in all its normal positions. In addition to a physical exam, your doctor can use specific tests, including X-rays, MRIs and CT scans to diagnose the severity and exact location of a broken ankle.
What is the treatment?
It is important to have an ankle injury evaluated by a qualified surgeon for proper diagnosis and treatment.
If you think you have sprained your ankle, the recommended first aid is RICE (rest, ice, compression and elevation), which should begin as soon as possible after the injury occurs. Additional treatment could include an ankle brace or air cast, non-steroidal anti-inflammatory medications and, for more severe sprains, physical therapy.
There are many types of ankle fractures, and treatments vary significantly depending on the location and severity of the injury. If your ankle is badly broken or unstable, surgery may be necessary. In this procedure, the bone fragments are first repositioned into their normal alignment. This is called a reduction. The surgeon then inserts special screws and metal plates to hold the bones together as they heal. Healing usually takes about six weeks. Rehabilitation is necessary to restore strength, flexibility and range of motion.
Broken ankle – NHS
Get medical advice as soon as possible if you think you have broken your ankle. It may need treatment to heal properly.
Do not worry if you do not know if your ankle is broken, dislocated or sprained. Get it checked by a doctor.
Urgent advice: Call 111 or go to an urgent treatment centre if:
You have had an injury and your ankle:
- is painful, bruised or swollen
- hurts when you put weight on it
- feels stiff and is difficult to move
Find an urgent treatment centre
Immediate action required: Call 999 or go to A&E if:
- your ankle is at an odd angle
- a bone is sticking out of your ankle
- you have a bad cut or wound on your ankle
- you’re in severe pain
- your toes look blue or white, or feel numb
What we mean by severe pain
- Severe pain:
- always there and so bad it’s hard to think or talk
- you cannot sleep
- it’s very hard to move, get out of bed, go to the bathroom, wash or dress
- Moderate pain:
- always there
- makes it hard to concentrate or sleep
- you can manage to get up, wash or dress
- Mild pain:
- comes and goes
- is annoying but does not stop you doing daily activities
Things to do while you’re waiting to see a doctor
Do
raise your ankle if possible
gently hold an ice pack (or a bag of frozen peas) wrapped in a towel on your ankle for 15 to 20 minutes every 2 to 3 hours
stop any bleeding – put pressure on the wound using a clean cloth or dressing
if your ankle is not at an odd angle, wrap it loosely in a bandage to help support it
remove any jewellery on your ankle or toes
take paracetamol
Don’t
do not take ibuprofen until you have seen a doctor
do not eat or drink anything in case you need surgery
do not move or put weight on your ankle if possible
Treatments for a broken ankle
You’ll usually have an X-ray to check if your ankle is broken and see how bad the break is.
If you have a very minor break, you may not need any treatment.
For a more serious break, you may need:
- a special boot to help support your ankle
- a plaster cast to hold your ankle in place while it heals
- the bones to be moved back into place by a doctor (they’ll give you an injection to numb your ankle)
- surgery to fix the broken bones
You’ll usually have follow-up appointments to check your ankle is healing properly.
How long it takes to recover from a broken ankle
A broken ankle usually takes 6 to 8 weeks to heal, but it can take longer.
The doctor will tell you:
- how long you’ll have to wear the boot or have the plaster cast on
- how much weight to put on your ankle – you may be given crutches or a walking frame to help keep weight off it
Once it’s healed, use your ankle as normal. Moving it will stop it getting stiff.
You may need to see a physiotherapist. They can help you with exercises to get your foot and ankle gently moving again.
Ask your doctor when you can return to contact sports or other activities that put a lot of strain on your ankle.
Things you can do to help during recovery
It’s important to follow any advice you’re given by the hospital or fracture clinic.
There are some things you can do to ease pain and help your broken ankle recover.
Do
rest and raise your ankle whenever possible
take paracetamol or the painkiller your doctor has given you to ease pain
gently move your toes and bend your knee while wearing the boot or cast to ease stiff muscles
Don’t
do not get your plaster cast wet
do not carry heavy things
do not move your ankle too much
do not use anything to scratch under your cast
Find out how to take care of your plaster cast
Urgent advice: Call 111 or go to an urgent treatment centre if:
- the pain in your ankle gets worse
- your temperature is very high or you feel hot and shivery
- your leg, foot or toes start to feel numb or like they’re burning
- your leg, foot or toes look swollen, or turn blue or white
- the plaster cast or boot is rubbing, or feels too tight or too loose
- there’s a bad smell or discharge from under your cast
Page last reviewed: 18 April 2019
Next review due: 18 April 2022
Guide | Physical Therapy Guide to Ankle Sprain
Physical therapists help people with ankle sprains recover more quickly than they would without treatment. The time it takes to heal an ankle sprain varies, but results can often be achieved in 2 to 8 weeks. Your physical therapist will work with you to design a specific treatment program that meets your needs and goals.
During the first 24 to 48 hours following your diagnosis, your physical therapist may advise you to:
- Rest the area by avoiding any activity that causes pain.
- Apply ice packs to the area for 15 to 20 minutes every 2 hours.
- Consult with a physician for further services, such as medication or diagnostic tests.
- Walk on the affected foot as soon, and as much as you are able, without making the pain or swelling worse.
- Use crutches or other walking aids to help alleviate pain and support balance.
- Wrap your ankle or use an ankle brace for support and to prevent swelling.
These self-treatments will allow you to be as active as possible with the least amount of pain, and will help speed healing.
Your physical therapist will work with you to:
Reduce Pain and Swelling. You will learn how to avoid or modify your daily and sports activities to allow healing to begin. Your physical therapist may use different types of treatments and technologies to control and reduce your pain and swelling, including ice, heat, ultrasound, electrical stimulation, taping, specific exercises, and hands-on therapy, such as specialized massage.
Improve Motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in the ankle. These might begin with “passive” motions that the physical therapist performs for you to gently move your ankle and foot, and progress to “active” exercises and stretches that you do yourself.
Improve Flexibility. Your physical therapist will determine if any foot, ankle, or lower leg muscles are tight, begin to stretch them, and teach you how to stretch them.
Improve Strength. Ankle sprains may be related to weak, injured, or uncoordinated leg muscles. Certain exercises will aid healing at each stage of recovery; your physical therapist will choose and teach you the correct exercises and equipment to use, to steadily and safely restore your strength. These may include using cuff weights, stretch bands, and weight-lifting equipment.
Improve Endurance. Regaining your muscular endurance in the ankle and leg is important after an injury. Your physical therapist will teach you exercises to improve endurance, so you can return to your normal activities. Cardio-exercise equipment may be used, such as treadmills or stationary bicycles.
Improve Balance. Regaining your sense of balance is important after an injury. Your physical therapist will teach you exercises to improve your balance ability.
Restore Agility. Speed and accuracy of leg movement is important in athletics and in many daily activities. Your physical therapist will help you regain these skills in preparation for a return to sports and to your daily routine.
Learn a Home Program. Your physical therapist will teach you strengthening and stretching exercises to perform at home. These exercises will be specific for your needs; if you do them as prescribed by your physical therapist, you can speed your recovery.
Return to Activities. Your physical therapist will discuss activity goals with you and use them to set your work, sport, and home-life recovery goals. Your treatment program will help you reach your goals in the safest, fastest, and most effective way possible. Your physical therapist will teach you exercises, work retraining activities, and sport-specific techniques and drills to help you achieve your goals.
Speed Recovery Time. Your physical therapist is trained and experienced in choosing the best treatments and exercises to help you safely heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.
If Surgery Is Necessary
Surgery is not commonly required for ankle sprains. But if surgery is needed, you will follow a recovery program over several weeks, guided by your physical therapist. Your physical therapist will help you minimize pain, regain motion and strength, and return to normal activities in the safest and speediest manner possible.
Sprained Ankle: Diagnosis, Treatment, & Recovery
RICE
The acronym, RICE, stands for Rest, Ice, Compression and Elevation. RICE is a time-honored way of healing a number of lower leg and foot injuries, including a sprained ankle [6].
Rest
Sometimes the best way to rest your leg is to stop standing and walking on it. Your doctor will tell you how long you need to stay off your ankle, and it will depend on the type and severity of your sprained ankle. The time can range, however, from several weeks to several months. Sometimes even just a few days of keeping weight off your ankle are all that’s needed to start feeling better, and there are several mobility devices to choose from to help you stay off your injured foot while allowing it to heal.
Ice
Placing ice on the most painful area of the ankle while you rest will also be helpful. It can be done throughout the day to help with swelling and pain relief. You can ice for up to 20 minutes, up to four times a day, but do not place the ice directly on your skin. Use a thin cloth between the ice and your skin to protect from ice burn. If your skin becomes red or numb, remove the ice pack, and ice for shorter periods of time.
Compression
A compression wrap can help control swelling while immobilizing and supporting your injured ankle. Applying a compression wrap, elastic bandage or Ace bandage is fairly easy and can be done at home. For a quick reference on the correct method, here’s a video: “How to Wrap an Ankle With an Ace Bandage.” For additional support you can wear a protective brace or splint. Both are relatively inexpensive and can be found at most drugstores.
Elevation
Whenever possible, elevate your sprained ankle to help prevent or limit swelling. Elevating the injured ankle above your heart keeps fluid and blood from pooling in the ankle due to gravity. The best way to elevate your sprained ankle in bed is to place several pillows under your leg, one under your knee and one under the ankle. You can also elevate your ankle in a recliner, but place several pillows under it so it’s higher than your heart. Keep your ankle elevated for 48 hours and don’t walk on it.
If your sprain improves with the RICE treatment, seeing a doctor may not be necessary. However, if you experience any of the following symptoms you should see a doctor:
- The pain is difficult to bear,
- The swelling doesn’t go down with the RICE treatment,
- You experience significant instability in the joint.
Be cautious, because self-diagnosed ankle sprains can often hide a broken bone. If your ankle isn’t improving, see a doctor who may order X-rays to check for broken bones in the foot or ankle. The injured ligament may feel tender, and the doctor may need to move your ankle into a variety of positions to determine which ligament has been hurt or torn. .
PRICE Treatment for Ankle Sprains and Pains
Choose an AuthorAaron Barber, AT, ATC, PESAbbie Roth, MWCAdam Ostendorf, MDAdriane Baylis, PhD, CCC-SLPAdrienne M. Flood, CPNP-ACAdvanced Healthcare Provider CouncilAila Co, MDAlaina White, AT, ATCAlana Milton, MDAlana Milton, MDAlecia Jayne, AuDAlessandra Gasior, DOAlex Kemper, MDAlexandra Funk, PharmD, DABATAlexandra Sankovic, MDAlexis Klenke, RD, LDAlice Bass, CPNP-PCAlison PeggAllie DePoyAllison Rowland, AT, ATCAllison Strouse, MS, AT, ATCAmanda E. Graf, MDAmanda GoetzAmanda Smith, RN, BSN, CPNAmanda Sonk, LMTAmanda Whitaker, MDAmber Patterson, MDAmberle Prater, PhD, LPCCAmy Coleman, LISWAmy Dunn, MDAmy E. Valasek, MD, MScAmy Fanning, PT, DPTAmy Garee, CPNP-PCAmy Hahn, PhDAmy HessAmy Leber, PhDAmy LeRoy, CCLSAmy Moffett, CPNP-PCAmy Randall-McSorley, MMC, EdD CandidateAnastasia Fischer, MD, FACSMAndala HardyAndrea Brun, CPNP-PCAndrea M. Boerger, MEd, CCC-SLPAndrea Sattler, MDAndrew AxelsonAndrew Kroger, MD, MPHAndrew SchwadererAngela AbenaimAngela Billingslea, LISW-SAnn Pakalnis, MDAnna Lillis, MD, PhDAnnette Haban-BartzAnnie Drapeau, MDAnnie Temple, MS, CCC-SLP, CLCAnthony Audino, MDAnup D. Patel, MDAri Rabkin, PhDAriana Hoet, PhDArielle Sheftall, PhDArleen KarczewskiAshlee HallAshleigh Kussman, MDAshley Ebersole, MDAshley EcksteinAshley Kroon Van DiestAshley M. Davidson, AT, ATC, MSAshley Minnick, MSAH, AT, ATCAshley Overall, FNPAshley Parikh, CPNP-PCAshley Parker MSW, LISW-SAshley Parker, LISW-SAshley Tuisku, CTRSAsuncion Mejias, MD, PhDAurelia Wood, MDBailey Young, DOBecky Corbitt, RNBelinda Mills, MDBenjamin Fields, PhD, MEdBenjamin Kopp, MDBernadette Burke, AT, ATC, MSBeth Martin, RNBeth Villanueva, OTD, OTR/LBethany Uhl, MDBethany Walker, PhDBhuvana Setty, MDBill Kulju, MS, ATBlake SkinnerBonnie Gourley, MSW, LSWBrad Childers, RRT, BSBrandi Cogdill, RN, BSN, CFRN, EMT-PBrandon MorganBreanne L. 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90,000 Ankle pain – causes, diagnosis, treatment.
Ankle pain can often be associated with direct injury or miscarriage over an extended period of time. Ankle pain is a nuisance that affects both casual and athletic people. It is important to distinguish between acute ankle pain and chronic ankle pain.
Scroll down to to watch two great training videos with exercises that can help you improve ankle stability.
VIDEO: 6 exercises against plantar fascitis and ankle pain
This exercise program may be for people with plantar fascitis – but in fact they are ideal for those with ankle pain. The plantar fascia is the tendon plate under the foot. If it is stronger and can handle more, then it can directly weaken the tendons and ligaments in your ankles. Exercise strengthens both feet and ankles.
Join our family and subscribe to our YouTube channel for free exercise tips, exercise programs and health knowledge. Welcome!
VIDEO: 10 strength exercises for the hips (and ankles!)
Stronger hips mean less congestion in the legs and ankles. This is because your hips are extremely important when it comes to cushioning impact while walking, running or running.
These ten strength exercises strengthen your thighs and visibly improve ankle function. Click below.
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Common causes of ankle pain
Some of the most common causes of ankle pain are overcoat, tendon injuries, myalgia, but this can also be related to the mentioned pain in the leg or leg, and lack of movement of the ankle. – especially the ankle, which is the joint that allows you to bend up and down the foot (dorsal and plantar flexion).
The foot and ankle are made up of many small legs and joints. To have optimal function, the movement of the joints must also be good. The blockage between these small legs can in some cases cause stressful loads that can cause problems such as the knee, hip, or lower back. Treatment often consists of restoring good joint movement and relieving muscle tension.
RELATED PRODUCT / SELF-RULES: – compression sock
Compression socks can help improve blood circulation in those who have suffered from ankle injuries and problems.It can promote faster healing and can also work prophylactically.
Click on the image to read more about it if you like.
In acute ankle injuries, it is important to rule out more serious differential diagnoses such as fibula fracture, metatarsal fracture, sinus rupture and fibular dislocation. The reason it is important to rule them out is because these diagnoses require early immobilization and, in some cases, surgery.
A chiropractor has a referral right and may request diagnostic imaging if needed. In the case of X-ray examinations, the patient is usually given one o’clock in the afternoon. It is recommended that such injuries be promptly investigated.
Acute ankle injuries – you do it yourself:
- Free your ankle.
- Put it high.
- Cool it down. (Also read: How often and for how long should I freeze a sprained ankle?)
- Have a problem investigated by qualified professionals.
When you freeze / chill your ankle, you use 15 minutes, then 45 minutes before you cool down again. It’s important to avoid frostbite, so place a towel or similar object around the item you are using to cool the affected area.
definitions
Ankle: Synovial joint formed by the joint between the tibia and fibula of the talus. The main movements of the joint are dorsal flexion and plantar flexion.
Some common causes and diagnoses of ankle pain
Here is a list of various causes and diagnoses that can cause ankle pain.
Achilles Bursitis (Achilles tendon mucosa)
Achilles tendinopathy
ankle injury
Arthritis (Arthritis)
osteoarthritis (pain depends on which joints are affected)
fragments of bones
Inflammation of the ankle (may cause local edema, skin redness, loss of heat and pressure)
Bursitis / inflammation of the mucous membrane
Broken ankle
Diabetic neuropathy
Poor circulation
Bad shoes / shoes
Sprained ankle
arthritis
Haglund deformity (may cause pain in the lower part of the foot blade, in the very back of the heel and in the back of the heel)
heel spurs (causes pain in the lower part of the scapula, usually just in front of the heel)
Ankle infection
Sciatica / sciatica
Ligament injury
Lumbar prolapse (lumbar disc disease)
nervous disorders
dislocations
overweight
Peripheral neuropathy
Plantar fascitis (causes pain in the leaf of the foot, along the plantar fascia from the protrusion of the heel)
Flat feet / pes planus (not synonymous with pain, but can be the cause)
Psoriatic arthritis
tendon rupture
Tendon injury
Serious illness
Sinus paw syndrome (causes characteristic pain on the outside of the foot between the heel and talus)
Stenosis of the spinal canal
Spondylisthesis
Tarsal canal syndrome also known as tarsal canal syndrome (usually causes quite severe pain inside the foot, heel)
tendonitis
tendinosis
rheumatism (pain depends on which joints are affected)
Less common causes and less common diagnoses of ankle pain
Serious infection
cancer
MR image of ankle
Normal MRI of the ankle – Photo Wikimedia
MR image description: Here we see an MRI image of the ankle. In the picture: the extensor of the big toe, ankle concave joint, the extensor of the big toe, tibia, fibula, long flexor of the big toe, anterior tibia, long flexor of the big toe, ankle, calcaneus, transverse tarsus and plantar-calcaneal-articular ligaments.
Ankle X-ray
Normal X-ray of the ankle joint – lateral angle – Photo IMAI
X-ray description
Here we see an X-ray of the ankle from a lateral angle (side view).The picture shows the external tibia (fibula), subtalar joint, ankle joint, calcaneus, calcaneus, cuboid, calcaneo-cuboid joint, medial cuneiform, sphenoid-venous joint, navicular bone, ankle, calcaneus creeping sinus, neck of the talus, lateral malleolus, medial malleolus, ankle and lower leg (inner lower leg).
Explanation of CT scan: This is a CT scan taken after a snowboarder injured his ankle after a fall.In the picture, we see obvious damage.
Injuries are of such a nature that they will most likely have to be operated on immediately to avoid long-term injury.
Diagnostic ultrasound examination of the ankle
Diagnostic ultrasound image of the ankle joint after inversion coating.
Image shows Posteriomedial Impact (POMI), which often occurs secondary to overlapping inversion.This damage occurs because the deep posterior fibers of the deltoid ligament are strongly compressed between the medial wall of the talus and the medial malleolus (an osteoblast within the ankle).
Ankle pain treatment
Here is a list of the most common treatments for ankle pain.
physiotherapy
Laser treatment (performed by a licensed physician)
Modern Chiropractic
Rehabilitation Training
Tendon Tissue Tool (IASTM)
Shockwave (performed by a publicly licensed physician)
Chiropractic care: research and research
RCTs (López-Rodríguez et al 2007), also known as a randomized controlled trial, examined the effect of ankle manipulation in 52 ice hockey players diagnosed with a grade II ankle sprain.
The conclusion was positive and showed that the manipulation led to a more correct distribution of biomechanical forces through the foot and ankle – which, in turn, leads to improved function and shortened healing time.
Another study (Pellow et al 2001) also showed a statistically significant improvement in pain and decreased limb function during ankle manipulation in grade I and II ankle dislocations.
Exercise, training and ergonomics for ankle pain
A specialist in muscular and skeletal disorders can, based on your diagnosis, advise you on ergonomic considerations that must be taken to prevent further damage, thereby ensuring the fastest healing time possible.
After the severe pain has gone away, in most cases you will also be given home exercises to help reduce the likelihood of a relapse.With chronic diseases, you need to go through the motor movements that you do in everyday life in order to weed out the cause of the pain over and over again.
Also read: – 5 exercises against the heel spur
Self-medication: What can I do even for ankle pain?
1. General exercise, special exercises, stretching and activity are recommended, but stay within the pain. Two walks a day for 20-40 minutes are good for the body and aching muscles.
2. Trigger point / massage balls we highly recommend – they come in different sizes, so you can hit even all parts of the body. There is no better self-help than this! We recommend the following (click the image below) – this is a complete set of 5 trigger points / massage balls in different sizes:
3. Training: Special training with training techniques of different opponents (for example, this set of 6 matings of different resistances) can help you train strength and function.Knitting training often involves more specific training, which in turn can lead to more effective injury prevention and pain relief.
4. Pain relief – cooling: Biofreeze is a natural product that can relieve pain by gently cooling the area. Cooling is especially recommended when the pain is severe. When they have calmed down, heat treatment is recommended – so it is advisable to have both cooling and heating.
5. Pain relief – Heating: Warming up muscles can improve circulation and reduce pain. We recommend the following reusable hot / cold pad (click here to learn more about this) – which can be used for both cooling (freezing) and heating (microwaveable).
Recommended Pain Relief Products for Ankle Pain
Biofreeze (Cold / Cryotherapy)
References:
- NHI – Norwegian Health Informatics.
- NAMF – Norwegian Professional Medical Association
- Lopez-Rodriguez S, Fernandez de Las-Peñas S, Alburquerque-Sendin F, Rodriguez-Blanco S, Palomec del Cerro L. The direct effect of manipulation of the ankle joint on stabilometry and baropodometry in patients with ankle sprain. J Manipulative Physiol Ther. 2007 March-April; 30 (3): 186-92.
- Pellow JE, Brantingham JW Efficacy of ankle joint correction in the treatment of grade I and II subacute and chronic ankle dislocations. J Manipulative Physiol Ther. Jan 2001; 24 (1): 17-24.
- Punnett, L. et al. Conceptual Framework for the Integration of Workplace Health Promotion and Work Ergonomics Programs , Public Health, 2009; 124 (Appendix 1): 16-25.
Ankle Pain Frequently Asked Questions
What are the common causes of ankle pain?
Some of the most common causes of ankle pain are top coverings, tendon injuries, but this can also be related to the mentioned pain in the leg or leg, as well as a lack of movement of the ankle – especially the ankle, which is the joint that allows you to tilt up and down on the foot (dorsal and plantar flexion).
Related questions with the same answer: Why do you have pain in your ankles? Why do you have pain in your ankle? Why does it hurt when I move my ankle? Why can you get? ankle discomfort? “
Pain in the ankle from the outside after improper loading. What could it be?
You seem to be describing a sheath, or rather an inverted sheath – this can stretch the ligaments or tendons on the outside of the ankle, which can cause irritation or injury.It can also lead to partial or complete rupture / rupture.
Why did I injure my ankle and leg?
Several muscles in the leg attach naturally to the foot and ankle. Depending on where you injured your leg, there may also be pain due to muscle, tendon, or joint malfunction. A called ankle and leg pain can also come from the back when sciatica is caused.
What should be done for acute ankle pain?
If you are referring to a sports injury such as overload or the like, then you should first follow the RICE protocol (rest, ice, compress, lift) and then assess the injury. You can read it about how long and how often you should ice over a sprained ankle.
For many years there was a blow to the back of the ankle. What needs to be done?
If you have had a problem for several years, it has become chronic and therefore often difficult to treat. A burning sensation in the back of the ankle, such as the Achilles tendon, may be due to Achilles tendinopathy, a condition in which gradual misuse over several years has resulted in thickening of the Achilles tendon.
This Achilles tendinopathy can be treated with instrumental soft tissue therapy (IABVB – graston), laser, pressure wave or muscle treatment such as massage. Adjusting the sole can also be an option in the treatment of long-term pain / ailments in the ankles / feet.
What can you do with a sore ankle and tight Achilles? What types of treatments should I use?
If you have ankle pain and tighten your Achilles tendon, you are almost guaranteed for tense leg muscles too. Ankle pain and pain are usually caused by an overload in relation to what the associated muscles and tendons are capable of.Maybe you increased your exercise volume too quickly or started running more?
There are several treatments for this problem, including massage / work against leg muscles, foot care, soft tissue instrumentation (Graston instrument), ankle mobilization and / or pressure wave treatment if indicated.
Treatment depends on what you learn at the time of the actual diagnosis of the injury.
How is ankle tendon injury treated?
Treatment will depend on the tendon injury. In the case of the coat, lengthening, partial rupture (rupture) or complete rupture of the tendons that support the ankle may occur.
Where the injury has occurred, so-called scar tissue, also known as scar tissue, will be closed, this tissue will not be as strong as the original tissue (usually), and recurring problems with accompanying pain may occur if you do not understand it correctly treatment.
Some therapies used for ankle tendon injuries include instrumental soft tissue therapy (IABVB – graston), laser, pressure wave, massage and sole fitting.
Of course, if there is excessive inflammation in the area, it is important to calm it down first, this can be done with an icing protocol, adequate rest and, in some cases, anti-inflammatory laser treatment.
– Related questions with the same answer as above: “You have tendonitis of the ankle and foot.What kind of treatment should be given? “
Why can you injure your ankle after walking?
There can be several reasons for injury while walking or other physical stress, among other reasons, due to poor shoes, underlying dysfunction of the foot or ankle, or previous injuries.
Pain is the body’s way of speaking, its only way of communicating, so when it speaks you should listen.
It is true that overcoming this pain can later lead to severe discomfort and possible damage to ligaments, tendons, or other structures. Pain usually indicates poor exercise (bad shoes?) Or overload (have you gone a little far? Have you increased your activity level a bit?).
If you have had previous coatings this may also be a factor as the ligaments and ligaments may just be a little loose. It is then important to have proper training to take the strain off the ligaments and not in the direction of the functional musculature.
– Related questions with the same answers as above: My ankle hurts after hiking.Why does it hurt me? – Why do my ankles hurt after walking?
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the ankle – Translation into Russian – examples English
These examples may contain rude words based on your search.
These examples may contain colloquial words based on your search.
I saw a woman pick up her daughter by the ankle and swing her into some old guy’s head.
I saw a woman lift her daughter by the ankle and throw it in the head of some old man.
This little devil bit him right on the ankle .
So this imp bit him right on the ankle .
All right, I got to reset the ankle , get the blood flow back into the foot.
So. You need to adjust ankle to restore blood flow in the leg.
Below the ankle was a greenish-blue bruise.
Under the malleolus , a yellow-green hematoma was noted.
His wife, Geraldine Finucane, was also injured when a bullet probably ricocheted and hit her in the ankle .
His wife, Geraldine Finucane, was also wounded in in her ankle , most likely a ricocheted bullet.
Just stabilize the ankle and then he can pull it out.
Hold firmly on the ankle of and have him pull his leg off the branch.
Is when I put my trousers on and sometimes it captures the long sock and takes it down to the ankle .
When I pull my pants down and sit down, sometimes it snaps into my long socks and pulls them down to ankles .
So, you deliberately shot him in the ankle ?
So, you KNOWINGLY shot him in the ankle of ?
Ben Spies had a big fall with bruising to his foot and dislocation of the ankle .
Ben Spies fell and hurt himself badly, scratching his leg and dislocating ankle .
If you would tie her wrists, bind her feet around the ankle .
You can tie her wrists, tie her legs around ankles .
If it gets too bad, I’ll just gnaw it off at the ankle .
If you get really sick, then I’ll bite off my leg at ankle .
You know, always switching from the hip holster to the shoulder to the ankle .
You know, changing the holster from the hip to the shoulder holster, then to the ankle .
Since your bones have splintered, Dr. Torres will place metal plates and screws to hold the ankle together.
Since your bones have splintered, Dr. Torres will place metal plates and bolts to hold ankle
Dad, you want I should plug him in the ankle ?
I stupidly sprained my ankle … not the ankle … the wrist!
Yesterday I stupidly sprained my ankle… not ankle … wrist!
That’ll be $ 20 for the ankle and $ 20 for the abortion.
All in all, $ 20 for ankle and $ 20 for an abortion.
In Sonya’s ending, Jarek’s death is legitimate, while in Jarek’s own ending, his hand reaches up over the edge to grab Sonya by the ankle and pull her off.
In the ending of Sonya, Jarek’s death is justified, while in the ending of Jarek himself, his hand reaches the edge to grab Sonya by ‘s ankle and pull her off.
Ballard got hit in the ankle .
Well, that explains the ankle .
I faked the ankle because I couldn’t watch you self-destruct.
I lied about ankle because I couldn’t watch you destroy yourself.
Oh, this foreign thirst! How to deal with it? How do you want the series not to end, like the books)).How much time still. In anticipation of the next season, let’s figure it out together, why did the 4th cause a whole range of all kinds of diametrically dissimilar emotions? What did the writers think so and is the adaptation so good compared to what we read and what we wanted to see? Well, let’s continue … In the series, Bree leaves a letter to Roger and leaves in search of his parents, without saying anything to Roger about his decision, which could lead to a point of no return. In the book, Briand also did not say anything, and instead of a letter with explanations, she sent Roger five huge boxes and a note: “You once told me that your father claimed: everyone needs at least some story – he read. – This is my version. Does it match yours? ” There were no greetings or goodbyes in the note; just a single letter “B” instead of a signature, drawn in a bold, bold manner … The boxes contained everything that Brianna held dear: photographs, dolls, dresses, everyday things, a silver dinner service, art treasures, several rings, brooches and earrings, and etc. “History. Holy Jesus, why does she call it history? Suddenly, through surprise and bewilderment, a disturbing thought burst through, stabbing him right in the heart. Roger called Dr. Abernathy. The doctor said that Bree flew from Boston to Edinburgh and then planned to take the train to Inverness. After a short conversation, they both figured out where to find Bree. “Oh my God, damn it,” said Dr. Abernathy. “She did it.” In the series, Roger called the apartment where Brianna lived, her friend answered the phone. Arriving in Lallibroch There is no walking path, sprained ankles and no accommodation in the book of Learry. ( unfortunately, the real life of the actors, makes its own adjustments to the script, so we have what we have ) Bree rode a horse. A large white house is visible on the horizon. On the road she met a horseman. It turned out to be Jamie Fraser Murray, Jamie Jr. “When Brianna decided to go in search of her father, she did not think at all that at the same time he will find a whole new family for himself. Big family. When Brianna entered the hallway with shabby wooden walls, the inner door swung open and ran out to meet her … …. ” weeks.Since Bree was tall, red-haired and very similar to her grandmother Helen, it was simply impossible not to recognize her daughter Jamie. “As she climbed the steps behind Jenny, the light from the window in front of the portrait revealed more and more an amazing canvas in front of her. And now Helen Mackenzie looked at her the same way as then … majestic, with a long neck and slanting eyes, in which lurked amusement … but the laughter hidden in her eyes did not touch the woman’s lips. But nevertheless, the similarity was obvious, and so strong that it was simply amazing, and wide cheekbones and thick eyelashes and red hair were exactly the same on both.And there was also a pearl necklace hanging around Helen’s neck, and its gold frame glowed softly … … “ It was her grandmother who gave her the gift of drawing. Brianna experienced a whole range of feelings from what she saw and heard: she saw the living Lallibroch blooming, her father’s big family welcomed her; felt a Scottish Highlander unfamiliar to her – he became alive to her when she read his letters.Then, standing on the dock: “Brianna never thought of herself as a Scotswoman — and she didn’t know until recently that she was of Scottish blood; and she did not yearn so much, even after the departure of her mother or after the death of her father, as she does now, parting with the people and places with whom she had met only recently. ” Judge for yourself how much Bree needed to get to know the entire Fraser-Murray family, and especially her aunt Jenny (we hope you read our reference ).But the fact that Brianna “saw” Frank on the pier was ingeniously invented and filmed. Who else could see off to a life unknown to her, if not the person whom she considered her own father. As you already understood, in the book Bree did not visit Learry’s house, but they met anyway. “Brianna abruptly, loudly slapped her hand on the table, making everyone present shudder. Later, Ian said that it was Jenny who came up with the idea to marry Jamie to Leary in order to somehow alleviate the suffering of her brother – looking at the lonely and wild Jamie was unbearable. And for a moment it worked About what Jenny saw Claire between them during their wedding, Bree also learned from Ian. Frank and Bree. In the book, Brianna herself, while looking for parents in the archives, finds an article about the fire in Fraser Ridge. Roger didn’t know that Bree had found the same article he had found. In the series, Bree reads this note in the office of Frank’s dad, who is also secretly trying to figure out what happened to Claire. Only then did Bree not understand what kind of people the article was talking about. And Frank decided not to let his daughter into family secrets. If you liked it, and you are interested in the details of the last season, we kindly ask HERE |
Unexplained minimum – Spark No. 41 (5537) dated 29.10.2018
While in Russia they are trying to restrict or even ban homeopathic medicines, in France they are used by about half of the population. The Ogonyok correspondent visited the homeland of homeopathy, where he held in his hands the holy grail of homeopaths – treatise Materia Medica
Here is a scene worthy of Dan Brown’s pen: we are in a state-of-the-art homeopathic medicine factory in the suburbs of Lyon, France. There is everything that can be imagined in a pharmaceutical production: from turbines where granules and balls are grown (the same ones that are then swallowed by patients), to a workshop for packaging ready-made preparations. All this is controlled by computers, and you can get into the workshop only by putting on a sterile suit … It would seem that this is the future of medicine! But at the same time, an old tome, dated 1884, which one of the company’s employees brings for Russian journalists, arouses no less interest than technological innovations.Before us is the so-called Materia Medica, a kind of “database” of all homeopathic substances known to man … This combination of old and new, ancient treatises and advanced technologies is the essence of modern homeopathy … How does one compare with the other? Let’s figure it out.
Alternative Factor
First, some numbers: the world market for homeopathic medicines is booming. According to the forecast of the research company Fact. MR, in the foreseeable future, that is, by the end of 2026, more than 1 billion homeopathic products will be sold on the planet! Do not think that homeopathy is the destiny of any particular country.It is widespread in Europe – in Germany, Spain, Great Britain (where Prince Charles is a fan of it) or, for example, in France. France is generally a country at the forefront of the homeopathic front. Just think: 30 million French people (or about half of the population) have used homeopathic remedies at least once, 25 percent of French physicians prescribe them in their daily practice, and you can find these remedies in 23 thousand French pharmacies. It is easy to be convinced of this: just go to any Lyon pharmacy – homeopathic remedies are immediately striking.
Why is homeopathy so popular in Europe? One explanation: modern medicine has reached the limit in the consumption of drugs.
Scientists scare: antibiotic-resistant bacteria will kill more people by mid-century than cancer and diabetes combined! But even without them, any person knows: the constant use of anti-inflammatory drugs or, for example, benzodiazepines (strong sedatives) can cause side effects and, in fact, cripple our health. This is where homeopathy comes in handy.This is how the French doctors, with whom the Ogonyok correspondent met, explain it.
– When I first started medical practice, I replaced other doctors in private medical offices, – says general practitioner Martin Tasson. – Once I was called to his patient: he was suffering from vomiting, he had a bad stomach ache. I sent him to the hospital, and the patient was operated on – he developed intestinal perforation. At the same time, the patient was only 40 years old, he was in excellent physical shape, and I thought: why did the disease arise in such an acute form? It turned out that he recently sprained his ankle, and the doctor I was replacing prescribed anti-inflammatory drugs for him! Upon learning of this, I told myself that I could not endanger the lives of patients because of a sprained ankle, and began to look for another solution …
This is how Martin Tasson found herself among homeopathic doctors: she received special training, received a diploma and is now practicing.But Martin is by no means an isolated example: in France, on average, 1,000 medical specialists a year receive additional education in the field of homeopathy. Homeopaths are trained in other countries as well. Of course, it is also not without controversy (recently, the teaching of homeopathy was suspended by the Faculty of Medicine at the University of Lille), but the trend is evident. Moreover, in France, homeopathic treatment … is covered by health insurance! 30 percent – under the state policy (which is about 1200 items), the rest – under the policy of voluntary medical insurance.So homeopathy in this country is recognized at the state level.
At the same time, French doctors emphasize: they do not treat oncology or, say, heart attacks with the help of homeopathy. But what can really help with is with the side effects of the main treatment – for example, with burns after radiation therapy. It turns out that homeopathy has an important aspect: it can easily complement other treatments and not conflict with them. However, the most surprising thing is another thing: starting treatment with homeopathic medicines for one disease, doctors and patients often record improvement along the entire “front”! For example, colleague Martin Tasson, obstetrician-gynecologist and surgeon Christelle Sharve, recalls a patient who came to her with a complaint of hot flashes (sudden wave-like attacks of fever).Christelle prescribed a homeopathic treatment for the patient, and it was unexpectedly found that this treatment also helped her … for headaches. As they say, a trifle, but nice.
Still: How Does Homeopathy Work?
Similar Similar
The homeopathic medicine is based on three types of base substances. These can be plants, for example, the perennial herb Arnica montana (or mountain arnica, a preparation based on it helps against bruises and various injuries), or there can be sources of animal origin.For example, for one of the drugs pharmacists … soak the bees! And the famous “Oscillococcinum” is actually the liver of a muscovy duck. And, finally, there are preparations based on substances of mineral and chemical origin. For example, one large manufacturer of homeopathic medicines produced a medicine … from a mineral – the mineral itself was mined in the bed of a water source. When this channel dried up, the release of the drug had to be stopped. In general, homeopaths are armed with many of the most amazing substances: for example, a copper-based drug helps with spasms, and the drug for the production of which … ants were used – for cystitis and inflammation of the genitourinary system.
The principle of action of these drugs was formulated back in the 18th century by the founder of homeopathy, physician Samuel Hahnemann. It’s funny that Hahnemann was born in Germany, but in France, where he lived later, they consider him their own, French, doctor. So today two countries can claim the title of “homeopathy homeland”.
But back to the principles formulated by Hahnemann, pharmacist Benedict Sunimort, director of professional community relations of one of the most famous manufacturers of homeopathy, the Boiron company, told the Fire about them.
– In addition to medical practice, Samuel Hahnemann was engaged in the translation of medical treatises, – says Benedict. – So in one of them he read that the bark of the cinchona tree causes fever symptoms in a healthy person, but if you take it in small quantities, then, on the contrary, reduces these symptoms. Hahnemann decided to experiment on himself, he took the bark of the cinchona tree and wrote down the sensations that arose …
Actually, it was as a result of these experiments that the scientist formulated the basic law of homeopathy: “Like is treated by like.”And he also clarified: the treatment itself should take place in very small doses!
He also stood at the origins of that very Materia Medica – an impressive work describing various substances and their effects on the human body. They say that in the world there are about 30 variations of this book, while it itself contains hundreds of names of all kinds of drugs. For example, the same “Boiron” manufactures its preparations from 2500 sources of raw materials. And periodically (albeit infrequently) this list expands.
“There is an interesting example,” says Benedict Sunimort.- In 1980, South America noticed that rams grazing in the mountains developed joint calcification over time. This was connected with the fact that the rams eat a certain grass that grows in these places; no such changes were observed in animals that grazed elsewhere. As a result, the idea arose to create a homeopathic medicine based on this herb to treat patients with calcification. So from time to time, new drugs with new substances appear on the market.
At the same time, experts emphasize: the same drug can be used for different pathologies, and practitioners constantly update the hierarchy of symptoms. For example, the Nux vomica remedy, made on the basis of the seeds of the so-called vomit, is used for sleep disorders, but in addition, it can be used for digestive disorders, migraines, anxiety, and excitability. And if you think about it, this is understandable: anxious, easily excitable people are often diagnosed with indigestion – these are elements of the same system.
Super High Dilutions
The most colorful stage in the production of homeopathic medicines is at the same time the very first: it is, in fact, the collection and sorting of sources of raw materials. For example, the same Arnica montana is harvested in the mountains, most often by hand. Then the plant is fresh (that is, within 48 hours after harvest) goes to the plant, which is why the hot season for homeopaths is from April to October. Moreover, it is important that these are just wild plants, otherwise the therapeutic effect will not be the same.
After receiving the lots, samples are taken for botanical control. The main thing here is not to be mistaken, because the same plant can be of different types – and some may turn out to be poisonous. No less important is the check for contamination: it is because of them that problems have recently arisen with the popular homeopathic preparation Croton tiglium (aka Croton laxative) – its batches coming from Asia do not always meet the requirements and are “wrapped up”.
And yet, in most cases, the control is passed, after which the so-called matrix tinctures are made from the selected plants (or, for example, insects) – water or alcohol extracts.The concentration of the matrix tincture is reduced by several times (this is called “dilution”), after which it is “shaken” – due to this, in theory, the effect of the active substance is enhanced. And only after that, it is finally applied to a neutral base, that is, to those very granules, balls or tablets … So the main challenge for homeopathy is that it uses ultra-small doses of a substance: if in the most common dilutions (5CH, 9CH or 15CH) it is still possible to establish the remains of the substance, then in the rarer ones (18CH, 24CH, 30CH) it is impossible to identify them with modern technical means!
How to understand that these are not just sweet balls and that the substance is still there? The producers explain that the solution lies in tracking all stages of production and the ability to prove that this particular plant was taken as a basis at the initial stage.However, the very fact that it is often impossible to “see” the remains of the substance gives all the critics every reason to assert: we are facing the placebo effect. And homeopaths, following the skeptics, have to admit: in fact, the mechanism of action of homeopathic medicines is still a mystery …
They, however, are not discouraged and are counting on the development of nanotechnology. They also remind about the studies already carried out, which seem to confirm the basic homeopathic principles: for example, within the framework of these studies, histamine in homeopathic dilutions affected the degranulation of basophils, and aspirin showed the properties of an antiplatelet … The disputes continue.
How the controversy and over the evidence base for homeopathic medicines continues. And here France is again at the forefront – recently completed one of the largest studies in the history of homeopathy, known as Epi3. The experts compared several groups of patients (treated by homeopathic and general practitioners) and came to unexpected conclusions. For example, 80 percent of patients with musculoskeletal problems in one or the other group had comparable pain relief.On the other hand, patients of homeopathic doctors took half as many non-steroidal anti-inflammatory and analgesic drugs as patients of general practitioners.
Similar data were found in a group of patients suffering from upper respiratory tract diseases. In 80 percent of patients, symptoms improved within one month, and the results were comparable in both groups. However, patients who were treated by homeopaths took half as many antibiotics and antipyretics as those who went to regular doctors … Feel the difference.
Will this study convince skeptics? The question is open. And how can we not recall the German doctor Konstantin Goering, who studied the work of Hahnemann in the 1820s and intended to expose them. One case changed everything. According to legend, while opening the corpse, Goering cut his finger, after which gangrene began. In despair, he took a homeopathic remedy based on white arsenic, and the wound healed, and Goering became one of the most faithful adherents of homeopathy … As the homeopathic doctors with whom Ogonyok spoke, nothing can convince the patient better than the fact that homeopathy helped some of his loved ones, and even better – himself.
– Do you know why homeopathy is effective? – doctor Martin Tasson throws up his hands. – My patients come again.
Kirill Zhurenkov, Lyon – Moscow
Ogonyok remembered medical discoveries for which scientists were ready to risk their own lives
Read more
90,000 Facebook
Michelle was involved in an accident on 6-28-19.They hit her head.
Let’s all show Michelle love and friendship and help her until she gets back on her feet.
June 29, 2019
This is the first of several operations. The left ankle is broken and the dislocation is broken and dislocated in the ankle, the patella is broken, the femur is broken and dislocated. I have a wound on my right leg right down to the bone. I am preparing for the second operation to insert the nail into the femur. I am in so much pain. Please pray for me to go through all the surgeries, okay. I have 3 broken ribs and a bruised lung.I was very lucky. The gentleman who hit me, provided emergency medical care, ran into my lane and hit my head. I was trapped in the car for 30 minutes, they had to use the Jaws of Life to get me out, the device went to my feet. I’ll keep you posted as I know more. Please pray for me. Thank you all
UPDATE June 29: done 2 operations so far. I have pins in my ankle, it is completely dislocated from my leg. The second surgery was on the femur, they put a steel rod all the way through the knee.My knee is broken and dislocated. They will be doing another operation on my ankle to finish repairing it. All this is my left leg. My right foot, the brake pedal cut, and I got a cut to the bone. The doctor said that it would be at least 12 weeks before I could walk again and that I, too, would have to undergo rehabilitation. I want to thank each of you for all the prayers and support, please continue. Just for your information, I’m at Moses Cone Hospital in case anyone wants to know.
July 2, 2019
Current situation.Surgery number 3 was done yesterday to put more pins and screws in the leg and ankle. My kneecap is broken, my hip is broken and dislocated. A steel rod was placed in my thighbone, which will remain there for the rest of my life. All this is an injury to the left leg. The right foot, the brake pedal, was embedded in my leg and lay right down to the bone. Bruises on the chin and arm from the airbag. I have another operation to repair my ankle, the doctor says that if the swelling has subsided, he will do the operation tomorrow afternoon.Please continue to pray for me. You can’t even imagine how much I appreciate all the kind words and prayers. It means so much to know that I have so many people who care about me. I am without any measure lucky to have each of you in my life
July 3, 2019
Please, please continue to pray. Today they are performing another operation to repair the ankle. This is the most excruciating pain I have ever experienced. I just want this to end. I hurt you all so much.Please, please keep praying for me. I really need all the prayers I can receive. Thanks again for all the prayers, you all … Sorry, I’m such a kid, but this is not a joke. We pray for relief from all this pain. I love you all, bunches, thank you for being here with me.
4 July 2019
So, last night they did major surgery on my ankle put pins & screws in, needless to say I have been out of it most of the day. Apparently my ankle was crushed & dislocated & had to be put back together.Today is not a good day for me at all. While I’m glad the surgery went well, I am still in so much pain. Y’all please continue to pray for me that I will get some relief from all this pain. I love y’all so much & I appreciate all the prayers & positive affirmations. I am blessed beyond all measure thave such good friends & family
5 July 2019
Most recent picture of left side & back & legs. I edited it so I could post on here. I was also told today that my heel on my right foot is crushed & dislocated so back to the OR Monday to repair that.Y’all please continue to pray for me. I know I have a tough road ahead but I am strong & I will get through this. With God & through God all things are possible. Thank you all again so very much for all your prayers & support I am so blessed to have such wonderful friends & family. I love y’all so much !!!
July 8, 2019
I have surgery # 5 at 11:50 AM, so if you want, keep praying for me. I love you all so much, I am grateful that I have such a wonderful family and friends who will help me through this
I completed the operation, it was the most intense pain I have experienced so far.Everything went well and I am resting in my room again. They’re trying to make me comfortable right now, but it’s excruciating. Please keep on praying. Hopefully there won’t be any more surgeries, just a lot of hard work and recuperation. I have a very long road ahead of me, but I know that God can handle this, and I am a strong woman, and I will get through it. Many thanks to all my family and friends. I need you, so please keep praying, I have to go through today and tomorrow before I can think of the visitors.But I promise, as soon as I’m ready, I’ll be glad to see you all. All of you are my best recovery. Thank you again and I love you all very much !!
July 11th 2019
I thought it was time for a new update. I was transferred from intensive care and rehabilitation. I will not be able to stand for even 12 weeks. I have a long recovery ahead of me. I was informed that I would be here for a little over a week. 7-10 days to teach me how to get around and take care of myself while I’m in a wheelchair. So far, I am very impressed with the program and have heard a lot of good things about it.I’m going to work my ass to heal and get home. I know I have a long road ahead of me, but I am ready to do it and do my best recovery. Please continue to pray for me. This is a very painful process, I just pray that God will give me the strength and courage I need to get through this. Thank you all very much for all the prayers and support and support. If anyone wants to visit I am on Moses Kon. You can write to me in a personal, and I can inform you if and when I will have visitors.Hopefully I’ll be home in a week. Thank you all once again very much !!! I am really lucky to have so much support. I will continue to update as I know more. There are no words to express how much it means to me to know that you are all praying and I support you. I am blessed without measure
12 July 2019
As I stated yesterday they have moved me to physical therapy. They have said I will be here a week to 10 days. During this time I am asking that y’all continue to pray for me.I am in a lot of pain & working very hard to learn to take care of myself when I get home. My mother & Uncle & my sister are the only visitors I want right now besides my son & daughter. This is hard & painful but it has to be done & I need to be able to focus on my recovery. My mom & Uncle Rick &
Sister will be helping take care of me so that’s why they need to be here & I need my son & daughter they are an important part of my recovery. I promise as soon as I am up for visitors I will let y’all know.Please understand that it’s not personal i just need to focus on my recovery so I can get home. I hope everyone understands. Please continue to pray for me. This is hard y’all, the hardest thing I have ever done. Please know that this is not personal other than to myself. I have to get through this & I know with God giving me the strength & the will to do this that I will be able too. Thank y’all so much for all the prayers & please keep them coming. Again I hope y’all understand.
July16th 2019
So friends and family on FB, some of you have asked to let you know if I need anything.Before I can go home I need a wheelchair ramp. I live in an apartment where there are steps to get to my building and to the landing where my apartment is located. Does anyone know someone who could build me a ramp? The other wise will have to rent one, which is expensive. I know that when I solve my case, I will be reimbursed for everything, but this does not help me now. My friend Audra Rook Coleman opens a GoFundMe account for me. I’m a waiter, so I don’t have $$$ right now. If any of you know someone, please let me know.Renting a ramp is very expensive, so if I could build one that would help me a lot. Thanks again to everyone for the kind words and prayers. Please let me know if anyone can help with this. I would be very grateful.
Tourist review of the hotel Crystal Waterworld Resort & Spa 5 *. Rating of hotels in the world
We were vacationing with our family in June 2015, we were in the hotel for 10 days, and a page to describe the shortcomings of the hotel and the surrounding area would not have been enough, let’s start:
1.For 10 days of stay, sheets and duvet covers were changed 1 time, although there were children and I think it is clear that the linen needs to be changed more often;
2. The hotel does not pull five stars, although they explained to us that in Turkey 5 * hotels are divided into economy, standard and premium class, it would be better if this hotel immediately set itself a 3 *, I explain, for example, in the bathroom, where of course there is no bathroom, I note, a bathroom and distinguishes 5 * from 3 *, which should go in addition to the shower. The shower doors did not close tightly and the water penetrated to the floor, which we warned about at the Reception, but the doors were so cheap, like the entire finish of the shower room, that apparently no longer amenable to “treatment”… Plumbing was also the cheapest, which of course was not pleasing to the eye, the toilet seat had two lower convex steps on one side that balanced the toilet seat, as a result of which, one side always sagged and it was, sorry, it was not comfortable to sit, the hair dryer worked in two modes either cold or too hot and almost did not blow, there was no normal ventilation, after the shower everything was fogged up and it was damp and the smells of damp did not go away for almost all 10 days of staying in the room.
3.Throughout the hotel, all toilets smelled unpleasant, and near the pools, and even more so, especially near the drain holes, the water in the pools was terrible and its smell caused vomiting.
4. Shopkeepers who were located on the way to the main restaurant obsessively offered their goods, which had to be answered with a tough refusal.
5. There are a lot of mosquitoes in the hotel, as a result of which the baby was bitten badly, and the next day his whole body in the area of the bites was covered with blisters, apparently due to an infection that got into the children’s pool.If the hotel is aware that there are mosquitoes, install the tablets in the mosquito sockets in the rooms, in real 5 * hotels they are always available.
6. There were not enough sun beds, in the morning everyone was busy putting a towel or small personal item, although this is prohibited by the hotel rules. According to the hotel rules, it was impossible to jump into the pool from the edge, but all children and even adults dived into it with a “bomb”, which caused splashes and waves that interfered with other vacationers on the water.
7. The food in the restaurant is all fried, fatty, sour and unripe fruits, except for oranges and bananas, it was felt that some food was served and the next day, slightly seasoning and frying, the remaining vegetables were then mixed with all sorts of salad leaves and herbs and served along with onions, such is boron cheese… our traditional salads did not look like they were in any way but there was a continuous “soup set”, although of course for someone it was food …
8. TV alone in the room did not work, then the TV was changed, the door to the balcony did not close at all, the hook was torn off, after our call to the reception, everything was fixed after 3 hours, the refrigerators buzzed and did not let me sleep, I had to turn it off, the isolation of the rooms is very bad. could be heard crying children at night and drunken neighbors returning from the Disco bar.
nine.Upon arrival, we wanted to stay closer to the sea, although we were told that those rooms in buildings closer to the sea are occupied by “Germans”! that there is some kind of agreement with travel agencies in Germany. Why are we worse ????
10. I saw 6-9 year old children on a cobra and in general on adult slides, although the restriction is from 10 years old, and I saw a lot of broken noses and broken and dislocated ankles, apparently the employees of the water park do not work well and will not explain basic safety rules.
11. Tore off for looking after a 1.6 year old child in Chrisby for 2 hours 30 minutes 45 dollars, it’s very expensive……… Considering that my wife and I left the child to visit a water parachute, for which we paid $ 100 in 10 minutes, which, in principle, also brought income to the hotel …. Crisby’s employees tried to sell us some kind of disc with cartoons for $ 15, which did not cost even $ 5, because there was Internet, although wait, the Internet was not everywhere, for example, it was not near the pools at all …
12. Children’s animation every day reminded “Groundhog Day”, as if the program could not be made for a week more varied, and then repeat again, the same songs and dances after 8 pm, everyone gets drunk and sleeps….
In general, there are a lot of comments about the hotels, but we ended up having a rest in our own way and we can definitely say that this hotel is never to be found.
Yes, moderator, do not delete this comment, I voiced all this at the hotel reception and they willingly wrote it down, and if you want me to personally repeat my words, please, my number was 1144, I will easily answer your questions …
A worthy rest for everyone !!!
We were vacationing with our family in June 2015, we were in the hotel for 10 days, and a page to describe the shortcomings of the hotel and the surrounding area would not have been enough, let’s start:
1.For 10 days of stay, sheets and duvet covers were changed 1 time, although there were children and I think it is clear that the linen needs to be changed more often;
2. The hotel does not pull five stars, although they explained to us that in Turkey 5 * hotels are divided into economy, standard and premium class, it would be better if this hotel immediately set itself a 3 *, I explain, for example, in the bathroom, where of course there is no bathroom, I note, a bathroom and distinguishes 5 * from 3 *, which should go in addition to the shower. The shower doors did not close tightly and the water penetrated to the floor, which we warned about at the Reception, but the doors were so cheap, like the entire finish of the shower room, that apparently no longer amenable to “treatment”… Plumbing was also the cheapest, which of course was not pleasing to the eye, the toilet seat had two lower convex steps on one side that balanced the toilet seat, as a result of which, one side always sagged and it was, sorry, it was not comfortable to sit, the hair dryer worked in two modes either cold or too hot and almost did not blow, there was no normal ventilation, after the shower everything was fogged up and it was damp and the smells of damp did not go away for almost all 10 days of staying in the room.
3.Throughout the hotel, all toilets smelled unpleasant, and near the pools, and even more so, especially near the drain holes, the water in the pools was terrible and its smell caused vomiting.
4. Shopkeepers who were located on the way to the main restaurant obsessively offered their goods, which had to be answered with a tough refusal.
5. There are a lot of mosquitoes in the hotel, as a result of which the baby was bitten badly, and the next day his whole body in the area of the bites was covered with blisters, apparently due to an infection that got into the children’s pool.If the hotel is aware that there are mosquitoes, install the tablets in the mosquito sockets in the rooms, in real 5 * hotels they are always available.
6. There were not enough sun beds, in the morning everyone was busy putting a towel or small personal item, although this is prohibited by the hotel rules. According to the hotel rules, it was impossible to jump into the pool from the edge, but all children and even adults dived into it with a “bomb”, which caused splashes and waves that interfered with other vacationers on the water.
7. The food in the restaurant is all fried, fatty, sour and unripe fruits, except for oranges and bananas, it was felt that some food was served and the next day, slightly seasoning and frying, the remaining vegetables were then mixed with all sorts of salad leaves and herbs and served along with onions, such is boron cheese… our traditional salads did not look like they were in any way but there was a continuous “soup set”, although of course for someone it was food …
8. TV alone in the room did not work, then the TV was changed, the door to the balcony did not close at all, the hook was torn off, after our call to the reception, everything was fixed after 3 hours, the refrigerators buzzed and did not let me sleep, I had to turn it off, the isolation of the rooms is very bad. could be heard crying children at night and drunken neighbors returning from the Disco bar.
nine.Upon arrival, we wanted to stay closer to the sea, although we were told that those rooms in buildings closer to the sea are occupied by “Germans”! that there is some kind of agreement with travel agencies in Germany. Why are we worse ????
10. I saw 6-9 year old children on a cobra and in general on adult slides, although the restriction is from 10 years old, and I saw a lot of broken noses and broken and dislocated ankles, apparently the employees of the water park do not work well and will not explain basic safety rules.
11. Tore off for looking after a 1.6 year old child in Chrisby for 2 hours 30 minutes 45 dollars, it’s very expensive……… Considering that my wife and I left the child to visit a water parachute, for which we paid $ 100 in 10 minutes, which, in principle, also brought income to the hotel …. Crisby’s employees tried to sell us some kind of disc with cartoons for $ 15, which did not cost even $ 5, because there was Internet, although wait, the Internet was not everywhere, for example, it was not near the pools at all …
12. Children’s animation every day reminded “Groundhog Day”, as if the program could not be made for a week more varied, and then repeat again, the same songs and dances after 8 pm, everyone gets drunk and sleeps….
In general, there are a lot of comments about the hotels, but we ended up having a rest in our own way and we can definitely say that this hotel is never to be found.
Yes, moderator, do not delete this comment, I voiced all this at the hotel reception and they willingly wrote it down, and if you want me to personally repeat my words, please, my number was 1144, I will easily answer your questions …
A worthy rest for everyone !!!
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