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.
Concussion Care: Signs & Symptoms to Watch
October 27, 2020
Henry Ford Health System
When you experience a blow to the head, knowing whether you've suffered a concussion isn't always clear cut.
Head injuries have a range of physical, psychological and intellectual effects — and only a small number of people lose consciousness.
"It's critical for parents, coaches, players and trainers to recognize the potential signs and symptoms of a concussion," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology. "The basic rule is that a concussion can affect any aspect of brain function."
Signs of Concussion
The Latin root of the word "concussion" means "to shake violently" — which makes sense. Concussions happen when there's a combination of movement and impact. So, any injury that involves a hit to the head — a fall, collision or hard hit by a heavy object — could cause one. So could a hit to the body that causes the head to move quickly.
"But every brain injury is different," Dr. Kutcher says. "Some symptoms show up right away while others develop gradually over days."
Here are common concussion symptoms to watch for — both immediately following a head injury and in the hours and days after:
Physical Concussion Symptoms
- Changes in sleep patterns
- Difficulty with balance
- Dizziness or lightheadedness
- Fatigue
- Headache
- Light sensitivity
- Nausea
- Numbness or tingling
- Sensitivity to sound
- Visual problems
- Vomiting
Emotional Concussion Symptoms
- Anxiety
- Depression
- Irritability
- Mood swings
Cognitive Concussion Symptoms
- Confusion
- Difficulty concentrating
- Feeling "slow" or "foggy"
- Memory problems
Diagnosing Concussion: Getting It Right
One reason concussions are frequently misdiagnosed is because they're assessed on the field or courtside during game play or practice. Coaches, trainers and parents often make lightning fast decisions about whether symptoms, such as headache, nausea and light sensitivity, are signs of concussion.
"Unfortunately, it’s more complicated than completing a concussion checklist. Everyone — and every concussion — is different. So, observers shouldn’t be diagnosing a head injury on the spot, but rather making a triage decision for safety. They should leave the diagnosis to the medical professionals," Dr. Kutcher says. In fact, those in-the-moment assessments are wrong about half of the time.
People should focus instead on getting immediate, emergency care for anyone who displays the following signs and symptoms right after a hit:
- Difficulty walking
- Weakness on one or both sides
- Not waking up
- Repeated vomiting
- Persistent confusion
- Seizures
- Unconsciousness
No matter how hard (or lightly) you think you've been hit, it's important to take head injury symptoms seriously. Even a seemingly minor blow could have a major impact. A complete evaluation by a medical professional will not only determine whether you have a concussion, it can also identify more serious, or even life-threatening, concerns.
"In every case, medical professionals are better equipped to assess the extent of the damage if you have a comprehensive baseline evaluation on file," Dr. Kutcher says. This thorough evaluation with a sports neurologist, including a complete family and neurological history, can act as a critical point of reference when trainers and medical professionals are trying to diagnose or manage a concussion.
Dr. Jeffrey Kutcher is a sports neurologist and the medical director of the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.
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.