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.
When Can I Walk Off Knee Pain — And When Should I See A Doctor?
June 7, 2022
Whether you wake up with a stiff knee, sustain an injury, or start feeling knee pain for seemingly no good reason, you might wonder what to do. Should you immediately rush off to the doctor? Can you just ignore it and hope it will get better? Can you treat it yourself? Knowing when you need a doctor’s intervention can be a tricky decision to make.
We see people at the start of injuries and after they’ve been ongoing,” says Nancy White, M.D., a sports medicine physician at Henry Ford Health. “While the sooner you see an expert, the better, there’s really no right or wrong to it. However, there are a few key signs that it’s a good idea to get it checked out.”
Dr. White recommends seeing a doctor if:
► You are waking up with consistent knee stiffness. If there’s no history of an injury involved, it could be due to osteoarthritis or rheumatoid arthritis.
► If your knee pain isn’t going away.
► Your knee is swollen and you can’t bear weight on it.
► You can’t fully flex or extend your knee.
► Your knee is warm to the touch. This could signal inflammation.
If your pain is mild — or you’re trying to decide whether to see someone — Dr. White recommends icing it on a scheduled basis. “That means two to three times a day,” she says. “Apply the ice to your knee. It will get cold. It will burn, then it will get numb. Remove the ice when it gets to the numb stage.”
She also recommends elevating your leg and putting a compression wrap or sleeve on your knee. If the pain is bad, you can try taking ibuprofen or naproxen for a few days.
Common Causes of Knee Pain
But if your knee is not getting better, it’s a good idea to see a doctor, as common causes of knee pain include:
► ACL sprains and tears. Short for anterior cruciate ligament, the ACL is one of four ligaments in the knee that allows it to flex and extend. The ACL can tear when your foot is firmly planted in place, and the knee locks and twists or pivots at the same time.
► MCL sprains and tears. Short for medial collateral ligament, the MCL connects your shinbone to your thighbone. It can tear when landing after a jump, or after an exterior blow to the knee (usually during contact sports). Luckily, most MCL injuries heal on their own.
► Meniscal tears. The menisci are your knee’s shock absorbers; they're two discs made of soft cartilage. Abrupt movements (like pivots, stops, turns, squats or lifts) can cause them to tear.
► Kneecap dislocation. A direct hit to the knee — or a sudden twist or pivoting of the leg — can make the kneecap can shift out of place.
► Patellar tendonitis. This is also known as Jumper’s Knee, as it’s a common injury in basketball and volleyball players. The patellar tendon connects the bottom of the kneecap to the top of the shinbone, and can become inflamed from overuse, excessive force or repetitive stress.
Knee bursitis. The bursa is a small, fluid-filled sac located near the knee joint. Knee bursitis occurs when the bursa becomes inflamed, often because of a knee injury or overuse from frequent kneeling.
How to Help Prevent Knee Pain
And if you want to help prevent knee pain in the future? “Exercise regularly so that you’re strengthening your quadriceps, hamstrings and gluteal muscles,” says Dr. White. “It’s also important to stretch to increase quadricep and hamstring flexibility.”
Wearing shoes with sturdy soles and proper arch support can also help ease pain and issues you may already have, says Dr. White. “I would say the top reasons people get into trouble with their knees are things they could prevent by changing lifestyle habits. This includes maintaining a healthy weight, as being overweight can also lead to increased wear and tear on the joints.
To learn more about your orthopedic condition or to find a provider, visit henryford.com/ortho.
Dr. Nancy White is a sports medicine physician at Henry Ford Health. She sees patients at Henry Ford Medical Center – Novi, and Henry Ford Medical Center — Bloomfield Township.