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: Nationally, Lost Spring Ends

May 8, 2020

By Karissa Niehoff
NFHS Executive Director

On Monday, the New Jersey State Interscholastic Athletic Association became the 51st and final NFHS member state high school association to cancel its spring sports championships due to the Coronavirus pandemic. 

The cancellation announcements began in late March and stretched to early May as states made every attempt possible to conduct spring sports and other activity programs.

Driven by a desire to offer perhaps a few weeks of competition – particularly for graduating seniors – many states waited as long as possible to move from postponed to cancelled, ultimately forced to make decisions when schools were closed to in-person learning for the remainder of the academic year.

While the leaders of our state associations knew that spring activities could not occur if schools did not re-open, and that the health and safety of the millions of participants ultimately drove these decisions, having to make these announcements was perhaps the most difficult task they had experienced as state leaders.

“We are disappointed for the thousands of New Jersey student-athletes who will be unable to compete this spring,” said Larry White, executive director of the New Jersey State Interscholastic Athletic Association. “While we remained hopeful to the end, and left open every possibility, competition simply is not feasible given the circumstances. It has been a harrowing time for everyone, and we know our student-athletes are extremely disappointed. That said, these unfortunate circumstances may have put an intriguing challenge in the path of our young people. As New Jersey’s own Vince Lombardi once said, ‘It's not whether you get knocked down, it's whether you get up.’ We’re confident all our kids will get back up and stand tall.”

Rhonda Blanford-Green, commissioner of the Colorado High School Activities Association, showed her emotions in making the difficult decision in her state:

“This decision, unlike the many decisions our office makes over the course of a year, has been extremely difficult because we are personally connected as former participants and officials, current parents and grandparents of graduating seniors, as well as educators and members of our high school communities. Our hats are off to the many seniors who have shown maturity and resolve as their culminating year of high school has been impacted beyond activities and athletics due to the worldwide COVID-19 pandemic. The Class of 2020 will not be forgotten.”

Craig Anderson, executive director of the Illinois High School Association, said, “Our thoughts are with all the impacted students, coaches and communities, especially the seniors. It will be difficult for them to find a silver lining in all of this, but we stress that even if they don’t get the chance to compete again at the high school level, they are better for having been a part of their respective high school teams. They were exposed to life lessons in teamwork, leadership and overcoming adversity that are difficult to replicate elsewhere.”

What was at stake and who was affected by these cancellation announcements? More than 500 girls and boys spring sports championships in about 18 sports and involving about three million student-athletes. Along with multiple classes for both boys and girls in track & field, other sports affected this spring were baseball, softball, lacrosse, golf, tennis, soccer, flag football, boys volleyball, water polo, weightlifting, gymnastics, riflery, judo, Unified track & field and ultimate Frisbee. Also grounded were perhaps another million participants in band, choir, orchestra, speech, debate, robotics and other activity programs.

And last, but far from least, we remember the thousands of volunteers who make these events happen every year – ticket-takers, concession stand workers, booster club parents, meet officials and the leaders in communities throughout the country where these events were planned. We thank these individuals for their faithful service year after year, and we look forward to the day we are all back together again.

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.