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.

MHSAA Provides Heat Management Reminders in Advance of 2022 Fall Practices

By Geoff Kimmerly
MHSAA.com senior editor

August 3, 2022

With communities across Michigan preparing for forecasts this week including temperatures in the 80s and in some places low 90s, this is an opportune time for the Michigan High School Athletic Association to provide its annual reminders on training in hot weather as fall sports teams are set to begin practices next week and competition later this month.

Each year, the MHSAA provides information to its member schools to help them prepare for hot weather practice and game conditions during the late summer and early fall. Practices for all Fall 2022 sports – cross country, football, Lower Peninsula girls golf, boys soccer, Lower Peninsula girls swimming & diving, Lower Peninsula boys and Upper Peninsula girls tennis, and volleyball – may begin Monday, Aug. 8.

The “Health & Safety” page of the MHSAA Website has links to several information sources, including the MHSAA preseason publication Heat Ways, which is available for download and includes valuable information on heat management in addition to requirements and resources regarding head injuries and sudden cardiac arrest.

The first days of formal practices in hot weather should be more for heat acclimatization than the conditioning of athletes, and practices in such conditions need planning to become longer and more strenuous over a gradual progression of time. Schools also must consider moving practices to different locations or different times of day, or change practice plans to include different activities depending on the conditions. Furthermore, football practice rules allow for only helmets to be worn during the first two days, only shoulder pads to be added on the third and fourth days, and full pads to not be worn until the fifth day of team practice.

The MHSAA advises student-athletes to make sure to hydrate all day long – beginning before practice, continuing during and also after practice is done. Water and properly-formulated sports drinks are the best choices for hydration.

A number of member schools follow the MHSAA’s Model Policy for Managing Heat & Humidity, which while not mandated for member schools was adopted as a rule for MHSAA postseason competition in 2013. The plan directs schools to begin monitoring the heat index at the activity site once the air temperature reaches 80 degrees, and provides recommendations when the heat index reaches certain points, including ceasing activities when it rises above 104 degrees. (When the temperature is below 80 degrees, there is no combination of heat and humidity that will result in a need to curtail activity.) The model heat & humidity policy is outlined in a number of places on the MHSAA Website, including as part of Heat Ways.