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: 'New Normal' Sportsmanship

May 20, 2020

By Karissa Niehoff
NFHS Executive Director

The “new normal” is one of the many terms we hear repeatedly as the country begins its return to normal activities from the COVID-19 pandemic. Keeping six feet apart from other people, wearing a mask and frequent washing of hands are three of those important warnings.

And then there is the new “no-no” that cuts at the heart of high school sports – the handshake. Shaking hands has been a part of our culture for centuries and a mainstream of high school sports forever. It is hard to imagine high school sports without handshakes.

In addition to emotional displays among team members involving handshakes, high-fives and hugs, the handshake has been a way of demonstrating good sportsmanship toward the opponent.

In wrestling, for instance, shaking hands before a match is actually a part of the rules, which, of course, will have to be relaxed for the coming season. There are handshakes at the coin toss in football and before the opening jump ball in basketball.

After a hard-fought, back-and-forth tennis match, players meet at the net to shake hands – congratulating each other for their efforts. The actions are the same after golfers battle each other for 18 holes – removing the cap and shaking hands. 

These age-old practices demonstrate respect for the opponent, and in the case of post-game handshakes, graciousness in victory or defeat. 

The emotions in high school sports are often off the chart, with end-of-game celebrations by players, coaches and fans involving handshakes, high-fives and hugs. So, as the early phases of return to sports occur this fall, how do we meet social distance guidelines and continue to exhibit emotions and emphasize sportsmanship, which typically have involved touching between individuals?

While the social-distancing and no-contact guidelines are necessary – at least for the short term – to diminish the spread of the virus, they should not dampen the enthusiasm and emotion by everyone involved with high school sports. We hope these types of restrictions will be lifted at some point down the road, but for now, this is our “new normal.” 

The absence of these time-honored ways to express respect for the opponent does not diminish the importance of displaying sportsmanship in high school sports. In fact, we believe concern for fairness and displays of kindness, respect and graciousness will be more pronounced once high school sports resume; however, the methods of sharing these feelings will be different. 

Although perhaps not as endearing as a handshake, high-five or hug, there are other ways to express these feelings and emotions – for the opponent as well as teammates.

Some alternatives to consider are a slight bow with the palms pressed together, an air high-five, a smile and quick wave, a double-tap of the right hand across the heart and a wink with the thumbs up. Certainly, there are other possibilities – in fact, teams could develop their own methods for demonstrating sportsmanship to their opponents and celebrating big plays or victories with teammates. Through their resilience and great spirit, we look forward to how the millions of participants in high school sports and activities will accept this challenge.

There will be many concessions necessary to resume athletic competition, and shaking hands is one that must cease – at least for now. However, let’s view this change as an opportunity to find new ways to showcase sportsmanship in high school sports.

Dr. Karissa L. Niehoff is in her second 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.