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: March Madness Begins Again

March 4, 2020

By Karissa Niehoff
NFHS Executive Director

The calendar has turned to March, which in the world of high school sports can only mean one thing – Basketball. It is time for state tournaments, March Madness and, yes, the annual rhetoric about the merits of the shot clock.

For the almost one million boys and girls who participate in high school basketball, there is nothing quite like the state tournament. Although there are great memories from the one-class days, led by Carr Creek’s almost upset of powerhouse Ashland in Kentucky in 1928 and Milan’s Cinderella victory in Indiana in 1954, today, basketball provides more opportunities for girls and boys teams to be crowned state champion than any other sport.

This month, about 450 girls and boys teams will earn state basketball titles in championships conducted by NFHS member state associations. Multiple team champions are crowned for both boys and girls in all states but two, with the majority of states sponsoring tournaments in 4-6 classifications for each, and four states conducting state championships in seven classes.

That is truly March Madness, which is appropriate since the term was first used in connection with high school basketball. Although the tag line became familiar to millions on a national scale in relation to the NCAA Division I Men’s Basketball Championship, the NCAA shares a dual-use trademark with the Illinois High School Association (IHSA), thanks to H. V. Porter, the first full-time executive director of the NFHS.

In his final year as IHSA executive director in 1939, Porter published his “March Madness” essay in reference to the mania surrounding the IHSA’s annual state basketball tournament. Eight years later, in a 1947 Associated Press article, Porter said, “Naturally, we think basketball has done a lot for high school kids, but it’s done something for the older people, too. It has made community life in general a lot more fun each winter.”

While many things have changed in the past 73 years, the value of high school sports – and especially state basketball tournaments – remains as strong as ever today. In some states, seemingly the entire community will travel to the site of the state tournament in support of the high school team.

As a footnote to the use of March Madness, Scott Johnson – recently retired assistant executive director of the IHSA in his book Association Work” – discovered through research that the first recorded mention of March Madness in relation to basketball occurred in 1931 by Bob Stranahan, sports editor of the New Castle Courier-Times in Indiana. 

While the sport remains strong and March Madness is set to begin in earnest across the nation, there is a belief by some that the addition of a shot clock would make the game even better.

Although there are some arguments for implementing the shot clock, the 

NFHS Basketball Rules Committee, similar to the other 14 NFHS rules committees, must make decisions based on what is best for the masses – the small schools with less than 100 students as well as large urban schools with 3,000-plus students. Rules changes will always be made with considerations for minimizing risks, containing costs and developing rules that are best for high school athletes. 

Nine of our member state associations have elected to use a shot clock in their states, which certainly adds to the clamor for its implementation nationally. And, we at the NFHS have read the headlines, seen the social media posts and received the phone calls advocating for the shot clock’s adoption. However, the Basketball Rules Committee will continue to assess the shot clock based on the aforementioned considerations, as well its members representing all areas of the country.

We encourage everyone to support their local high school teams by attending this year’s exciting state basketball tournaments.

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.