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: Give Thanks for Officials

February 19, 2020

By Karissa Niehoff
NFHS Executive Director

While the behavior of parents and other fans at high school games is still a work in progress, there is some good news on the officiating front.

Last fall, we reported on a growing shortage of officials nationwide – even reaching a crisis stage in some areas as games were being cancelled. Through a nationwide recruitment effort, progress is being made in attracting more people to the high school officiating avocation. 

Thanks to the NFHS’ #BecomeAnOfficial campaign that was launched in the spring of 2017, more than 4,000 men and women across the country have registered and become certified officials. Many of these individuals are former high school athletes who want to remain involved in sports, earn some extra income and stay in shape, including first responders such as police officers, firefighters and EMTs. 

On the flip side, however, is the fear that any gains in new officials coming in the front door are being offset by other officials heading out the back door because of the continued boorish behavior on the part of parents and other fans.

Rickey Neaves, associate director of the Mississippi High School Activities Association, is struggling to cover all basketball games in his state in his role as officials’ coordinator.

“Fans and coaches alike feel freer to downgrade officials, and holler and scream at them, as opposed to the way it was 10 years ago,” Neaves said. “You can see where it is getting worse and worse with parents and coaches blaming officials or staying on an official to the point where they’re just not going to take it, so they just get out.”

Unfortunately, we continue to hear reports like this from across the country. A recent survey conducted by Officially Human: Behind the Stripes that was completed by about 19,000 respondents in 14 states indicated that the problem persists, with fans who do not know the rules being the main culprit.

If efforts by the NFHS at the national level – and others at state and local levels – to attract more people to officiating are to be successful, unsportsmanlike behavior on the part of parents and other fans must cease or we will lose some of these new officials within two years.

While we recognize the task of improving the culture at high school events is challenging and is one more item on the busy plates of school administrators, it is essential if we are to retain officials.

Brenda Hilton, founder of Officially Human: Beyond the Stripes, said, “The time is now for all of us to realize that officials are human and their existence and hard work at sporting events allows all of us to enjoy the games that we love. We must start to humanize officials now before the whistles fall silent.” 

Recognition and thanks should also be a part of the game plan. We must regularly share our appreciation for the men and women who officiate high school sports.

Dana Pappas, commissioner of officials for the New Mexico Officials Association, shared the following with officials in her state during a special appreciation week:

“Never think that what you do as an official doesn’t matter because it does. Never let one contest where the fans are exceedingly brutal and the scrutiny is overly intense derail your love for what you do. Never think that you are not making a difference because you most definitely are. You are educators, role models and guardians of the integrity of the sport you officiate. You officiate because you care about kids, you care about your chosen sport and you care about your community.”

Instead of viewing these officiating issues as a crisis, let’s see them as an opportunity to impact lives through education-based athletics.

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.