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.

The Inside Scoop On Ski Safety: 6 Tips

January 10, 2023

Injuries happen to skiers of all levels, even under pristine conditions and when using the best available equipment. “Beginners are more likely to get injured. But when experienced skiers go down, they tend to have more severe injuries,” says Michelle Gambino-Gorney, a certified athletic trainer at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.

Henry Ford Health logoBut you don’t have to let the risk of injury hold you back from having fun on the slopes. A few basic safety tips? Stay within your ability level and ensure your skis are in good condition. That said, going beyond ski safety basics and learning how to avoid injuries can help you stay safe on the slopes. Here are six expert tips: 

Use caution when getting on and off the ski lift. Ski lifts make a lot of people anxious. Being high off the ground on your journey up the mountain can invoke a fear of falling. “But it’s getting on and off the ski lift where the vast majority of lift-related injuries occur,” Gambino-Gorney says. To lower your risk of injury, remove pole straps and backpacks before loading, look over your shoulder to make sure you sit squarely on the seat at the correct time, and don't try to retrieve items you lose hold of (including poles, gloves and phones). It’s best to let them go and ski back for them.

Keep it simple at terrain parks. Terrain parks include human-made features like ramps and rails that enable skiers to do jumps, flips and other maneuvers. Any time your skis leave the ground, injuries are possible. You can safely enjoy terrain parks by starting with smaller obstacles and maneuvers and mastering them before moving on to other challenges. Do not rely on online tutorials to learn new skills. Ski instructors can help you learn the correct technique and provide personalized tips for achieving your goals.

Beware of trees. Trees present multiple dangers. Colliding with a tree, especially at high speed, leads to some of the most severe ski injuries. A small number of skiers die each year from tree collisions. To avoid collisions, ski with control.  Other concerns include tree wells and snow immersion suffocation. This type of injury occurs when a person falls head first into a pocket of loose snow near a tree trunk and gets trapped. Skiing with a partner on ungroomed paths, which typically run past tree wells, is essential. If you become immersed in a tree well, a partner can step in to help you break free. 

Pay extra attention during your final run of the day. Injuries are more common during skiers’ last runs. “Skiing later in the day can be dangerous because small changes can affect your ability to maneuver and react to conditions,” Gambino-Gorney says. Fresh powder may get matted down. Groomed areas become bumpy. And fatigue can make you less aware of hazards and other skiers. While it may be tempting to give it your all on your last run, it’s better to ease up and take your time.

Follow the Skier Code of Responsibility. People of all ages, abilities and ski levels can safely share the slopes when everyone follows the National Ski Area Association™ Responsibility Code. Key points include: Giving right of way to people ahead of (downhill from) you, staying off closed trails, and looking uphill for other skiers when merging.

Expedite access to help in an emergency. Being prepared can help you quickly reach ski patrol in an emergency. Most ski areas list their ski patrol phone number near the lifts. While you are waiting in the ski lift line, program it into your phone. If you or someone nearby experiences an injury, being able to call for help will save precious time. Instead of waiting for someone to ski down the mountain and ask for help, you can stay with the injured person and call for help. Calling also makes it easier to share important details so that ski patrol arrives with the appropriate people and equipment.

“Skiing is like any sport in that there’s a risk of injury. But many people hit the slopes without incident. Some skiers go decades without a single fall,” Gambino-Gorney says. Follow these insider tips and don't forget to wear a helmet so you can relish your next powder day and get the most out of the season.

To find a sports medicine provider at Henry Ford, visit henryford.com/sports or call 313-651-1969.

Michelle Gambino-Gorney is a certified athletic trainer at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.