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: Lights Signal Thanks, Hope

April 24, 2020

By Karissa Niehoff
NFHS Executive Director

The closing of schools and the cancelling of spring activities is a disappointing end to high school for this year’s senior class. However, there is still reason for optimism.

We anticipate that senior athletes and activity participants in the class of 2020 will move on to the highest of leadership roles in their chosen professions in the years to come.

Prior to this year, these seniors have accrued the general benefits of high school sports and other activity programs in which students learn self-discipline, build self-confidence and develop skills for practical situations – teamwork, fair play and hard work. Not to mention that many have higher grade-point averages, better attendance records and are set for a higher success rate in their chosen careers.

Seniors in this year’s class, however, will be among the toughest graduates ever as their lives have been the bookends to two of the worst tragedies in our nation’s history. Born sometime during the 2001-02 school year, which began with the horrific events of September 11, 2001, these resilient 2020 graduates had an abrupt ending to their high school days with the ongoing national health crisis.

Understanding their disappointment of not getting to compete this spring, people from coast to coast are expressing their support for these high school students.

With an idea apparently born in Texas, further developed in Colorado and supported by many others during the past several weeks, lights at high school stadiums throughout the country have been brightening the night-time skies. The #BeALight hashtag accompanies post after post of schools participating in this recognition of seniors who are missing their final season of high school sports or performing arts.

In some cases, the lights come on at 8:20 (20:20 in military time) and glow for 20 minutes, 20 seconds – a connection to the 2020 spring season at hand. Currently, 38 states have officially cancelled spring sports and activities due to the COVID-19 pandemic, and it is likely more will follow.

Among the traditional spring sports of track & field, baseball, softball, lacrosse, tennis and golf, almost three million girls and boys will be affected by this shutdown, including upward of one million seniors.

These lights have been turned on to say thanks to those seniors and to let them know they will be missed. Their contributions to high school activity programs will be remembered forever, and the benefits they received will guide them throughout their chosen careers.

Electric bills notwithstanding, perhaps these lights can burn for 20 minutes every night until the games return later this year. The lights signify hope – a hope that these lights will burn again this fall to showcase high school sports and performing arts. 

While the timing of the return of high school sports and activities will rest with each state high school association in consultation with local governments and state health officials, the positive impact on communities nationwide will be tremendous. Once all the critical medical precautions have been addressed, high school sports and performing arts could take center stage once again. Although it is still too early to forecast the return of high school sports, its impact could be extraordinary.    

With the loss of many non-school and club sport opportunities due to financial issues, high school sports and performing arts could fill an even larger void in the lives of our nation’s youth. And we look forward to that time ahead when student-athletes are on the field and fans are in the stands. Be safe. Stay healthy.

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.