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: Good Time to Appreciate Officials
April 9, 2020
By Karissa Niehoff
NFHS Executive Director
During this shutdown of normal life in our nation, we are learning to deal with a new challenge – how to handle the unexpected time on our hands at home. Simply keeping up with the days of the week is a major accomplishment!
While we anxiously await the re-opening of schools and a return of high school sports and performing arts, this down time can be used in positive ways to take advantage of educational opportunities. And kudos to some individuals who already are seizing those opportunities – men and women who officiate high school sports.
Two weeks ago, we began to offer the 11 officiating courses on the NFHS Learning Center free of charge, and the response has been nothing short of amazing. By the end of March – merely a week into this new opportunity – more than 5,200 courses had been taken.
In addition to veteran officials fine-tuning techniques in one or more of the seven sports featured in these courses, this has been a great opportunity for individuals interested in officiating to take a free course to determine their interest level.
Those of us in leadership positions are so appreciative of these individuals who give freely of their free time to officiate high school sports or adjudicate music contests. We would suggest that everyone – student-athletes, coaches, parents and other fans – use this down time to do the same.
At various times this year before the shutdown of schools, officials have been the victim of verbal and physical abuse. Inappropriate behavior by parents and other fans was causing officials to quit before they even reached two years on the job.
And yet, in the past three years, more than 35,000 individuals have signed up to become officials through the NFHS’ #BecomeAnOfficial campaign and 5,200 courses that have been taken in the past couple of weeks by men and women who want to give back to high school sports. These are good signs more people will continue to be involved in officiating when the games return.
But what about the parents and other fans in the stands? Will their behavior be changed upon return? The conclusion of the New Mexico Activities Association’s state basketball tournament last month provided an interesting perspective on the impact of fans to the atmosphere at high school sporting events.
After completing the first two days of its state tournament with fans in the stands, the NMAA conducted the final three days without fans because of concerns about the spread of the COVID-19 virus. Dana Pappas, commissioner of officials for the NMAA, noted the following about the final three days of competition:
“Officials would make a call and if coaches had a question about it, they asked – calmly and respectfully. In huddles during time-outs, coaches just talked to their players, without raised voices. The behavior of coaches on the sidelines from Thursday through Saturday was in stark contrast to what we witnessed on Tuesday and Wednesday. Perhaps they did not feel the need to be overly emotional for the benefit of their fans.
“My hope is that the absence of sport throughout the world gives us all a moment to gain perspective and do a ‘gut check’ as to the kind of fans we are at contests. If the quality of the game is unchanged (or even better) without fans there to scream at the coaches, officials and players, then is that behavior really necessary when the games resume?”
The message here is that while the games can continue without fans, the ideal situation is for stands full of fans positively cheering for their teams.
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.