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: Football's Promising Results

September 9, 2020

By Karissa Niehoff
NFHS Executive Director

Normally at this time of year, the NFHS releases the latest figures from its annual High School Athletics Participation Survey. One of the most important and successful endeavors in the organization’s history, the NFHS has collected participation data through its 51 member state associations annually since 1971.

Before the 2018-19 school year, the number of participants in high school sports had increased for 29 consecutive years. Despite the first decline last year since 1988, we anticipated a quick turnaround in 2019-20 because of the continued strength of education-based high school athletics programs across the country.

There were encouraging reports last fall that football participation numbers were headed in a more positive direction. Interest in other fall sports continued to be at a high level, and winter sports were experiencing tremendous success. Then came the pandemic in mid-March, which shut down all high school sports competition.

Two-thirds of the states were unable to complete state basketball tournaments, and participants in the traditional spring sports of baseball, softball, track and field, and lacrosse – in most cases – were never able to take the field.

With spring sports unable to even get off the ground, state associations could not compile comprehensive surveys of sports participation for the 2019-20 school year. As a result, for the first time in the 50-year history of the survey, the NFHS is unable to release its annual summary of high school sports participation.

However, there is a silver lining to report. Though complete statistics are unavailable, numbers from a couple of sports last fall were obtained; and the optimism surrounding a positive trend in football participation came to fruition. 

After annual declines of 23,311, 20,540 and 30,829 the past three years, participation by boys in high school 11-player football in 2019 dropped by only 2,489 – from 1,006,013 to 1,003,524. These numbers suggest to us that parents are appreciative of the risk minimization efforts that have been put in place. Every state has enacted rules that limit the amount of contact before the season and during practice, and every state has established concussion protocols and laws.

Participation in 11-player football reached an all-time high of 1,112,303 in 2008-09, and except for 2013-14, has declined every year since; however, this year’s decline is the smallest in 10 years.

The continued enthusiasm for football has been evident this fall – even amid the COVID-19 pandemic. State associations have worked with government, education and health leaders to do everything possible to offer the sport at some time during the 2020-21 season.

Some of the 34 states that are conducting football this fall have started play, and there is a special sense of gratitude on the part of students, coaches, officials and fans for the opportunity. While there may be pauses with some players and teams quarantined, and while 17 other states will not play until later in the school year, the excitement and anticipation of Friday Night Lights continues.

In addition to football, girls volleyball continued its tremendous growth last fall, increasing by 9,751 participants for a total of 462,559. In the past 10 years, the sport has added 60,000 participants and has passed basketball as the No. 2 sport for girls behind track and field.

Though a complete participation report for 2019-20 will not be available due to the loss of spring sports, totals on more fall and winter sports from 2019-20 will be formulated in the coming weeks. Judging from the early returns, it appears the past year’s participation numbers would have started the NFHS on a new streak of record participation if spring sports had not been cancelled. 

Most likely, next year’s participation survey will be anything but ordinary as well. Regardless of the challenges in compiling participation statistics in 2020-21, the opportunity and desire to participate in all education-based activities remain.       

Dr. Karissa L. Niehoff is starting 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.