NFHS Voice: Reading the Crystal Ball

May 15, 2020

By Karissa Niehoff
NFHS Executive Director

Re-opening is the key word in sports at all levels right now. Every day, there are new projections for when the National Basketball Association and Major League Baseball will resume – and if the National Football League will start on time this fall.

Along with leaders of youth-level sports and the NCAA, the NFHS and its member state associations are exploring all options for conducting sports this fall. And while we all want answers, the truth is that there are more questions than answers at this point.

Dr. Anthony Fauci, the leading national medical authority throughout the COVID-19 pandemic, told ESPN earlier this week that “the virus will make the decision for us” on whether sports will return this fall. His comments underscore the need for leaders of all levels of sport in the United States to exercise great caution as we re-engage in activities.  

Without a doubt, education will play a larger role in the decision-making process for high school programs than for non-scholastic programs. Despite the significant loss of revenue that could occur at some levels if programs remained closed, health and safety concerns must take priority when it comes to re-opening the sport or activity.

At the high school level, sports and other activity programs will most likely not return until schools re-open. High school sports and performing arts are education-based programs and complete the learning process on a day-to-day basis. As such, academics during the school day and sports and other activities after school are inseparable. 

Could any of those sports and activities return without fans? That option is certainly not one schools favor, but it is a very real possibility. While a few state associations opted for that arrangement to complete state basketball tournaments, that is not a desired ongoing plan for school sports. Besides, this troubling question would have to be addressed: If it is unsafe for fans in the stands, is it safe for the students to be participating?

Students, parents and other fans in the stands cheering for and supporting student-athletes, and applauding from the theatre audience, are among the most wonderful aspects of education-based activities. Before accepting that arrangement, efforts will continue to make attending events a safe experience for everyone.

While we remain uncertain as to the timetable for the return of high school sports and other activities, we believe that when these programs return – and they will return – that everyone will bring renewed zeal to provide the 12 million participants in these programs the best experience possible.

One of the challenges to solving the crystal ball of high school sports and activities this fall is the uncertainty of the spread of the virus as states begin to re-open this month. The NFHS will continue to work with its Sports Medicine Advisory Committee on an ongoing basis to provide the most updated information.

With the non-negotiable tenet of safety for student activity participants, expect every avenue to be pursued so that students can be involved in football, soccer, volleyball, field hockey, speech, debate, music and many other school activities this fall.   

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.

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.