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.

Workout Basics: Warm-Ups & Cool-Downs

February 3, 2021

By Nick Parkinson, M.Ed., AT, ATC, TSAC-F
Henry Ford Health Systems

You may know a good warm-up — and cool-down — are essential to getting a good workout. You may also know that warming up your muscles and stretching them out after exercise can help prevent injury and keep you at the top of your game.

They’re the two bookends that help maximize a workout. Unfortunately, a lot of exercise enthusiasts don’t know how to warm up and cool down correctly.

Warm-Up Basics

A warm-up is exactly what it sounds like: The goal is to warm up your muscles and prepare your body for whatever you’re asking it to do. Warming up increases your body temperature and helps blood flow to the muscles that you’re using.

So if you’re going to play soccer, your warm-up should touch all of the muscles in your legs and core. Shooting hoops? You’ll need to add shoulders and arms to your routine. Circuit training at the gym? Choose a warm-up that flexes all of the muscles you’re about to use.

The thing that all warm-ups have in common is that they require dynamic (or constantly moving) motion, not static stretching (holding poses for a certain amount of time). In fact, static stretching prior to a workout can inhibit power and strength, especially if you’re doing something like weightlifting.

The anatomy of a solid warm-up:

• Before any activity, do about 10 minutes of light cardiovascular activity, whether walking, biking or jogging.

• Dynamic stretches. After you get your muscles moving, do a series of lunges, jumping jacks or toe touches to stretch a bit.

• Dive in. When you start your workout, begin slowly and gradually increase power and speed.

Cool-Down Basics

After you’ve put your body through a challenge, a good cool-down is essential. It helps slow down your heart rate gradually, relax your muscles and stretch them out.

Cool-down routines should always include some type of motion before you get to static stretching, especially if you’ve just finished a high-intensity workout. Static stretching improves flexibility and performance and it can also help stave off future injury.

As with warm-ups, the right cool-down exercises depend on the activity you engaged in. If you biked for 20 miles, you might coast on your cycle for a while before coming to a stop. If you ran, you might jog or walk before you begin stretching. As with your warm-up, the key is addressing every muscle group you worked during your workout.

The anatomy of a solid cool-down:

• At the end of your workout, slow the pace and intensity of whatever activity you’re doing. So, if you’re running, slow to a jog and then a walk for 5 to 10 minutes before stopping.

Stretch out the muscles you work, but don’t push past the point where you feel tight. Then, hold the position for at least 30 seconds. That’s how long it takes for the body to overcome its stretch reflex.

• Breathe through your stretches and make sure to finish your cool-down with deep, belly breaths.

Running short on time? Target muscle groups you may have injured in the past or that tend to get sore after activity. Cooling down will preserve your athleticism — and your ability to participate in daily activities — over the long term.

Be Good to Your Body

While there’s some controversy about whether warming up and cooling down can help prevent injury, there’s little dispute that they can help you ease in and out of activity.

The key is to find something that works for you. Your warm-up could be as simple as walking to the gym and doing a set of jumping jacks when you arrive. Your cool-down might just involve ending your workout 10 minutes early so you can slow down.

It doesn’t have to be complicated. It just has to give your heart and blood vessels a chance to breathe before and after activity.

Nick Parkinson, M.Ed., AT, ATC, TSAC-F, is the Supervisor of Athletic Training with Henry Ford Sports Medicine and also leads Sports Performance training at the William Clay Ford Center for Athletic Medicine. Learn more about Nick.

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.