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.

5 Concussion Myths Debunked

November 8, 2022

Awareness about the dangers of concussions is at an all-time high. In response, athletic organizations — from Pop Warner football (a nonprofit program for kids 5 to 16) to USA Hockey — have safe-play protocols in place. But misconceptions about injury — prevention, management and return to play — are still all too common.

Henry Ford Health System"It's great that parents, coaches and athletes are focused on the potential for concussions, but they also need to be aware of the complexities involved in evaluating, diagnosing and managing concussion," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.

The best way to get the knowledge you need? Learn how to separate fact from fiction.

Separating Concussion Fact From Fiction

Here’s the truth behind five common concussion myths:

Myth #1: Concussions are only caused by blows to the head.

Concussions happen in response to force. While they often result from a blow to the head, they can also occur after a hit to the neck, shoulders or anywhere else on the body. To cause brain injury, the force of the impact only needs to cause the head to move rapidly back and forth (think whiplash from a car crash or a spill down the stairs).

Myth #2: Concussions always involve a loss of consciousness.

A very small percentage of all concussions, 10 percent or less, result in a loss of consciousness. For the remaining injuries, parents, coaches and medical providers should watch for additional symptoms such as:

· Confusion
· Balance problems
· Slurred speech
· Physical complaints including headache, nausea and vomiting.

Myth #3: You should keep a person awake overnight after a concussion has occurred.

It's important to observe and interact with a recently concussed person for the first few hours to recognize the potential signs of a more serious injury. However, if they are interacting normally after four hours, it’s okay to let them sleep. If you have any doubts or questions, always err on the side of caution and seek medical attention.

Myth #4: After a concussion, kids should avoid digital media until they feel better.

Unless digital activities or screen time significantly worsen symptoms, there's no reason to avoid them. "You shouldn't force people who have suffered a concussion to rest too much — or deprive them of sensory input — if they are comfortable engaging in activity," Dr. Kutcher says. What’s more, taking away activities that bring a person joy or keep them socially connected could end up prolonging their recovery by creating additional symptoms.

Myth #5: All physical activity should be avoided after a concussion.

It’s important to rest for the first two to three days after a concussion. However, you need to be careful not to rest too much or avoid all activity for too long.

Engaging in physical, mental and social activities can be beneficial. But knowing how much to do and when to take it easy can be difficult. If you have any questions, consult a sports neurologist for specific recommendations.

Ground Rules for Concussion Prevention and Management

When it comes to preventing concussion, common sense offers the greatest impact, Dr. Kutcher notes. He recommends starting with these four tenets:

  • Whenever possible, limit the amount of contact in practices and games.
  • Wear proper fitting and certified helmets or other head protection whenever appropriate.
  • Spread contact drills out over time as much as possible.
  • Practice good technique and play by the rules.

Athletes — especially those who play contact sports — should undergo an annual neurological evaluation that includes a comprehensive, focused neurological history and examination. This information provides a critical point of reference for medical professionals.

Knowing the truth about concussions — including what to watch for and what to do if one occurs — is really the best game plan.

Dr. Jeffrey Kutcher is a sports neurologist at the Henry Ford Concussion and Sports Neurology Clinic and the global director of the Kutcher Clinic.

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.