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: Madness to Maddening
March 23, 2020
By Karissa Niehoff
NFHS Executive Director
March Madness took on another meaning for everyone in the sports world during the week of March 9 – a week like none other in the history of organized sports with the acceleration of the coronavirus (COVID-19) in the United States.
The Madness was not the bouncing of basketballs in arenas around the country. Instead it was organization after organization trying to determine the viability of continuing to operate – particularly after the suspension of the NBA season and the cancellation of the NCAA Division I Men’s and Women’s Basketball Championships.
And NFHS-member state high school associations were among those organizations faced with making decisions because the heightened state of the coronavirus pandemic occurred in the middle of state high school basketball tournaments across the country. While 13 states had completed their tournaments, the remainder were faced with tough decisions throughout the week.
By the end of that week, another four states were able to complete their girls and boys basketball tournaments – although all of these states had to impose extreme limits on the number of fans in attendance.
About two-thirds of our member state associations had to shut down their tournaments. At this point, 19 state associations have cancelled their state basketball tournaments, while 15 others have postponed or suspended their events, although the hope of completing them seems to fade with each passing day.
In addition to basketball, some states were in the midst of conducting ice hockey, gymnastics and swimming championships. While most of those sports championships, along with wrestling, were completed, some states were forced to suspend or cancel these as well.
Because of varying information from state health leaders, the Centers for Disease Control and Prevention (CDC) and state governors, some states were able to continue playing longer than others. Each state’s high school basketball tournament is one of the anticipated events of the year – particularly for residents in towns with schools playing for a state title.
From start to finish of state basketball tournaments in the 50 states plus the District of Columbia, more than one million fans trek to gymnasiums to watch these events. This year, however, many of these fans, along with about half of the 950,000 boys and girls who play high school basketball, were not able to experience March Madness.
And if this wasn’t enough, spring sports seasons and championships are at risk – mainly because schools are closed in many states, which means the discontinuation of school activity programs. The NCAA has cancelled all spring sports championships; and while state associations haven’t cancelled spring championships yet, athletics and activities programs are on hold for a set period of time – or indefinitely in some states.
While the loss of college and professional sports has an enormous impact on everyday life, considering that events surrounding the coronavirus affect some 19,500 high schools and 12 million participants in high school sports and performing arts activities, the impact on high school sports is perhaps even larger.
We support our 51 member state association leaders as they continue to work through these challenges. The loss of state basketball championships in many states is a sizeable financial challenge ahead as they work to continue to make state-level athletics and activities programs available.
On many occasions, we have written about the value of high school sports and activities. This month, we have witnessed the disappointment of thousands and thousands of players and fans who were not able to experience a state championship – many of whom were “going to state” for the first time.
High school sports is different from every other level of sport as these programs are a vital part of communities across our nation. Two weeks ago, when the doors were closed in many gymnasiums, it was confirmation of the desire and need for education-based high school sports and activities in the United States.
During this time of imposed social distancing, it is a time to step back and be thankful for these programs in our nation’s schools.
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.