Navigating Twists, Turns Of Ankle Sprains

November 30, 2020

Henry Ford Health System

Oh, how the ankle turns! If you’ve had a misstep or wrong turn result in a sprained ankle, you know how painful this injury can be. Henry Ford podiatric surgeon Paul Di Liddo, DPM, discusses ankle sprains and treatments.

Ankle Injury 101

From risk factors to treatments (and nearly everything in between), here’s what to know — and do — about ankle sprains.

Sprained Ankles Are Painfully Common

In fact, they’re among the most frequent injuries in the United States, with up to 25,000 people per day spraining their ankles. Although often associated with sports, ankle sprains can happen to anyone, anywhere. “I see ankle sprains from tripping over curbs, stepping in holes in a yard or simply walking,” says Dr. Di Liddo. “Ankle sprains — like accidents — happen.”

Ankle Sprains Injure Ligaments

“Ankle sprains occur when the ankle suddenly and forcefully twists or rolls past a point that the ankle ligaments can tolerate,” remarks Dr. Di Liddo. “The ankle ligaments will stretch or tear, either partially or completely.” An ankle can twist, turn or roll during a fall, jump or change of direction, while walking on uneven ground and more.

A Weak Ankle Is A Vulnerable Ankle

Most sprained ankles heal without long-term concern. In some cases, however, ligaments may not fully heal, resulting in a weak or unstable ankle. “A weak or unstable ankle can make an individual more susceptible to repeated ankle sprains,” explains Dr. Di Liddo.

High Arches Can Be Risky Business
People who have high-arched feet are more at risk of rolling — and therefore spraining — their ankles. So are people who have “loose joints,” because the ankle can overstretch with a seemingly minor twist. People who are at-risk for ankle sprains should take extra precautions when playing sports or performing other activities.

Some Sprains Can Be Treated At Home — Emphasis On Some
How you treat a sprained ankle depends on the severity of the injury. Minor sprains can be treated at home with the RICE method. The RICE method include:

 
  • Rest by avoiding use of the injured ankle
  • Ice applied to the ankle (without touching the skin) for no more than 20 minutes every three to four hours
  • Compression with an elastic bandage
  • Elevation above the heart

Ice, compress and elevate your ankle for the first few days. Rest and refrain from sports until ankle pain and swelling have subsided.

At-home treatments aren’t right for everyone — or every ankle injury. “A swollen ankle is typical if you have experienced a sprain,” says Dr. Di Liddo. “However, if you have severe ankle swelling, are in extreme pain or notice an odd ankle appearance, seek medical attention.” This is also true if you can’t walk more than a few steps or have limited ankle mobility. A foot and ankle specialist can diagnose your injury and begin treatment.

Ankle Treatments Abound

Ankle sprain treatments are designed to decrease pain and swelling, while protecting the ligaments from further injury. Treatments include wearing an ankle brace, walking boot or cast. Physical therapy to strengthen the ankle and maintain range of motion may also be incorporated after the ligaments have started to heal.

“Of course, for more severe injuries, a thorough physical exam and X-rays are necessary,” says Dr. Di Liddo. “This helps ensure that there is no other underlying injury, such as a fractured ankle or Achilles tendon rupture.”

Healing Times Vary

The recovery time for a sprained ankle depends on the severity of the injury. Sprains with minimal ligament stretching and no tear require one to three weeks. Partially torn ankle ligaments may take up to six to eight weeks to heal. A fully torn ligament can take several months to fully heal.

What To Do When Ankle Problems Persist

For people who continue to experience ankle instability, there are a host of options. “Physical therapy is the first step — but not the only one,” says Dr. Di Liddo. “If physical therapy has not been beneficial, we can discuss surgical approaches.”

Surgical options include:

  • Ligament repair or reinforcement via an outpatient procedure
  • Osteotomy, which is surgical cutting of bone, to lower arches when ankle instability is caused by high arches

For those with frequent ankle sprains or instability, a medical assessment is necessary and may include:

  • Physical exam
  • X-rays to assess bones and joints
  •  MRI to evaluate ankle ligaments

With this information in mind, you can prevent — or address — the twists and turns of ankle sprains.

Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.

Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.

Hastings' Life-Saving Response Reinforces Vital Importance of Being Prepared

By Geoff Kimmerly
MHSAA.com senior editor

August 23, 2022

HASTINGS – Preseason silence, mixed with anticipation, made Hastings High School’s gym feel especially pristine last week.

Mid-MichiganThe raucousness is returning soon as the school’s volleyball teams are into their first matches of a new season, with winter sports bringing everyone inside in a few months. This is a place where big-game memories are made – but one from a scrimmage June 14 certainly will stick with many who were at Hastings High that day.

That evening, Potterville junior Da’Marion Hicks was playing in a basketball scrimmage when he suffered a heart attack due to a valve that later required open-heart surgery.

During a period of just a few minutes that could have meant his life, Hastings staff, students and a doctor who fortunately happened to be watching his son’s team from the stands, responded to assist Hicks before it was too late. In fact, he’s expected to be cleared to return this upcoming basketball season.

It’s a situation everyone hopes will never happen, but very occasionally it does. And when it did this time, Hastings – with crucial assistance coming out of the bleachers – showed what can be done to assure a best-possible result.

“We debriefed after this whole thing, and we actually had six people from our school (there) trained in CPR and AED use. Enough people felt comfortable enough to take some action to cause it to have a good outcome,” Hastings athletic director Mike Goggins said. “I think more times than not in a situation like this, bad results don’t come from people trying to help. Bad results come from people being afraid to help. What was great about this situation was … lots of people took the initiative to jump in.”

As another school year begins, Hastings’ ready response should continue to reinforce the importance of being prepared for the scariest of situations. (The Grand Rapids Press spoke with Hicks as he was beginning his recovery; click here to read.)

Emergency planning for sports venues has emerged as an important topic especially over the last decade, and the National Federation of State High School Associations (NFHS) and National Athletic Trainers’ Association (NATA) detail how these should work, with the “Anyone Can Save A Life” plan provided to all member schools by the MHSAA at the start of the 2015-16 school year.

Goggins said that while Hastings doesn’t necessarily have a “formal” plan like those linked above, what his department does is “saturate” his teams’ coaches and athletes with knowledge of where to find AEDs – and Hastings also has created a setup whereby a person is never more than one minute from an AED while on school property.

That evening, four boys basketball teams were playing on adjacent courts – including Potterville against Wyoming Tri-unity Christian. Goggins himself wasn’t at the school at the time (although he quickly arrived after being notified of the situation), but the following is the collection of information he has gathered over the last two months.

  • Hicks had felt especially fatigued that evening and actually had mentioned to a few Hastings players during their scrimmage earlier that night that he was having a hard time catching his breath – definitely rare for a three-sport athlete who had run the 400 meters at an MHSAA Track & Field Finals a few weeks earlier.
  • Hicks went to his bench for a break during the Tri-unity scrimmage, and laid down. Goggins said Potterville teammates thought Hicks was just gassed, but then noticed his eyes rolling back into his head. They started yelling for help.
  • Hastings boys basketball coach Rich Long sprang into action, running over to the Potterville bench and then calling into the crowd to see if anyone with medical expertise could help a student in distress. Meanwhile, Long was joined by Hastings’ strength coach (and U.S. Marine) James Avery – who was training athletes in the weight room in the balcony overlooking the gym – and Dr. Luke Van Klompenberg, an emergency medicine physician at Holland Hospital who was there watching his son play for Tri-unity.
  • Long sent an athlete to retrieve the closest AED, located on the wall just outside the gym doors. He also sent a parent to call 9-1-1, and Saxons boys track & field coach Lin Nickels sent multiple athletes to set up a relay near the school’s doors to direct paramedics when they arrived.
  • Van Klompenberg, meanwhile, couldn’t find Hicks’ pulse, and the athlete’s breathing was shallow. Avery had begun chest compressions, the AED was used, and as the ambulance arrived Hicks was beginning to regain some consciousness. He was transported to the local Spectrum Health Pennock hospital, then to Helen DeVos Children's Hospital in Grand Rapids.

“It was one of those things where it just worked,” Goggins said. “My message, if nothing else, is we all practice it for a time that may never come – but the more you can saturate your people with the idea of A, being prepared, and B, don’t be afraid to take action … that’s really I think the key.”

Strength coach James Avery emerged from the balcony weight room to assist in Hicks’ care that evening. Beginning this year, the MHSAA is requiring all head coaches at the varsity, junior varsity and freshman levels to have CPR certification. That training almost always includes direction in the use of an AED.

Hastings has been on this track for a while. The MHSAA’s first CPR requirement for coaches was added for the 2015-16 school year, just for varsity head coaches – but Goggins made it a requirement for all of his coaches at all levels at that time.

Hastings also has taken AED prep to another level. There are 16 throughout the district – one each at the four elementary schools, two at the middle school and 10 at the high school – and they represent an even bigger investment in the life-saving technology as the district’s school board purchased those 16 a year ago to replace 12 that were nearing their expirations.

Goggins said doctors have told him that if Hicks had not received care for even 4-5 more minutes, he would not have survived because of the damage done to his heart and brain. Potterville athletic director and boys basketball coach Jake Briney said surgeons have broken things down to a 45-second window that made the difference between a good result and a sad one.

Coincidentally, Briney had scheduled a game this upcoming season against Wyoming Tri-unity Christian;  Potterville should be tough, and Tri-unity is last season’s Division 4 runner-up. But the events of June 14 will make the events of this upcoming Jan. 14 much more meaningful.

Briney said Potterville also has formed a close relationship with Hastings. Multiple Saxons administrators have checked in, including Goggins almost daily during the first weeks after the incident.

Briney is filled with nothing but praise for Hastings’ preparation. And both athletic directors noted a similar effect at their schools as another school year begins.

“It really, really made the training, made you look at it through a different lens,” Briney said.

“Our fall coaches are now like, ‘You know, if Heather (Coipel, Hastings’ trainer) wanted to stop by and run through the AED procedure again, that would be great,’” Goggins said. “(Or) ‘Where is the AED? We have one at the fieldhouse, right? Where’s the closest one for me again?’ They’re just doublechecking.”

Geoff Kimmerly joined the MHSAA in Sept. 2011 after 12 years as Prep Sports Editor of the Lansing State Journal. He is a senior editor of  MHSAA.com's editorial content and has served as MHSAA Communications Director since January 2021. Contact him at [email protected] with story ideas for the Barry, Eaton, Ingham, Livingston, Ionia, Clinton, Shiawassee, Gratiot, Isabella, Clare and Montcalm counties.

PHOTOS (Top) An AED, located just outside the doors to Hastings’ gymnasium, was used to save Da’Marion Hicks’ life June 14. (Middle) Strength coach James Avery emerged from the balcony weight room to assist in Hicks’ care that evening. (Photos by Geoff Kimmerly.)