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.

NFHS Voice: Campaign Touts Benefits of High School Football

By Karissa Niehoff
NFHS Executive Director

May 21, 2021

A full return to high school sports and performing arts programs – that’s the hope for this fall in schools across the country.

After a year of unprecedented challenges in keeping these programs going due to the pandemic, which included 11 states that conducted their primary football season this spring, there is great optimism as we look to a new school year.

Even in those states that were able to conduct activities last fall, attendance restrictions kept many fans out of stadiums and watching games online. However, with vaccine eligibility now at 12 years of age and older and with vaccinations continuing during the next three months, the likelihood of routines and traditions returning this fall grows stronger each day.

And there is no tradition more anticipated than the full-scale return of high school football. While there were 34 states there were fortunate enough to conduct football at some level last fall, the routines were anything but normal.

This fall, however, we anticipate a return to the energy and excitement of the 2019 season when 1,003,524 boys participated in 11-player football. That total marked a decline of only 2,489 from the previous year and was a good sign of a renewed confidence on the part of parents and student-athletes that concerns about the risk of injury were being addressed.

While boys participation in 11-player football has exceeded one million participants every year since 1999 and is overwhelmingly the most popular boys sport, there have been concerns about declines in past years.

Last fall, the NFHS and the National Football League announced a partnership to promote the growth, understanding and support for football at the high school level. The NFHS and NFL have been studying participation trends, developing educational tools and striving to restore confidence in students and parents that the sport is, in fact, more focused on risk minimization than ever before.  

As a result, the springboard to the return of high school football next fall begins this week with the launch of the #ThisIsHSFootball campaign. Through this effort over the next few months, the NFHS will be reaching out to coaches, students, parents, officials, athletic directors and others with research information, participation trends and data on various risk mitigation efforts that, we believe, continues to make high school football safer than it has ever been.

As a part of this effort, the NFHS produced a video entitled “This is High School Football” designed to detail the benefits of participation in high school football.

As the video states, more so than at any other level of play, parents should feel good about their kids playing high school football.

>Here are some of the many educational and medical safeguards put in place the past 12 years to offer parents a comfort level about the safety standards that are a part of high school football.

► Concussion research and education. All NFHS high school playing rules require a student who is exhibiting signs of a concussion to be removed from the game and not allowed to return until the student has been cleared by a medical professional. Thanks to education and training on the part of students, coaches, trainers, parents and others, research data has shown positive trends in concussion rates. In a recent five-year period, concussion rates during practices dropped from 5.47 to 4.44 concussions per 10,000 athletic exposures.  

► Concussion in Sport Course. This free online education course has been available through the NFHS Learning Center since 2010, and millions of individuals have taken the course for a deeper understanding about concussions.  

► Concussion Laws. By 2014, every state had adopted state concussion laws that established mandatory protocols, and every state high school association has adopted policies that limit contact during preseason drills and in practices during the season.  

► Football equipment. Manufacturers continue to produce higher quality equipment every year, and high school coaches are doing a much better job at teaching and coaching the rules of the game and making attempts to minimize risk of injury for players.

► Emergency Action Plans. Thanks to the NFHS Foundation, a copy of the “Anyone Can Save a Life” emergency action plan originally developed by the Minnesota State High School League was sent to all state high school associations and their high schools, and all schools have access to an AED to help save lives.

► Playing Rules. Risk minimization is a major focus of every NFHS sports rules committee. In football, helmet-to-helmet hits are not allowed.

High school football has been a significant part of schools, towns and communities across America for almost 100 years. The NFHS is committed to making the sport as safe as possible for the millions of kids who will play the sport in the years to come.

Dr. Karissa L. Niehoff is in her third year as executive director of the National Federation of State High School Associations (NFHS) in Indianapolis, Indiana. She is the first female to head the national leadership organization for high school athletics and performing arts activities and the sixth full-time executive director of the NFHS, which celebrated its 100th year of service during the 2018-19 school year. She previously was executive director of the Connecticut Association of Schools-Connecticut Interscholastic Athletic Conference for seven years.