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: Security Wake-Up Call

December 4, 2019

By Karissa Niehoff
NFHS Executive Director

Given the increase in school-related shootings since the Columbine massacre 20 years ago, perhaps it is not surprising that these acts of violence are no longer confined to regular school hours. 

The tragic shooting – and eventual death of an innocent 10-year-old – at a New Jersey high school football game last month made headlines across the country and was a somber reminder that events occurring after school hours are subject to the same type of senseless violence.   

This was not the first shooting at a high school sporting event this year – actually it was the 23rd according to the National Center for Spectator Sport Safety and Security (NCS4) – but the death of Micah Tennant and the eventual conclusion of the game five days later at the Philadelphia Eagles’ stadium drew nationwide coverage.

Camden High School and Pleasantville High School finished the playoff game at a nearly empty Lincoln Financial Field before a few hundred family members and friends as the stadium was closed to the public. Larry White, New Jersey State Interscholastic Athletic Association executive director, said the decision to finish the game was made by both schools “to provide closure and send a powerful message that acts of violence and those who perpetrate them will not win.”

High school sporting events traditionally have been safe gathering places for fans to attend and celebrate the accomplishments of high school student-athletes – particularly the sport of football. And we must do whatever is necessary to make sure these venues remain safe and secure.

Reports have been encouraging about attendance as state football playoffs have concluded in many states. In Indiana, about 20,000 people attended the Class 5A championship at Lucas Oil Stadium in Indianapolis on the day after Thanksgiving.  

We want to ensure that our stadiums remain open for everyone to attend. The fans – students, parents, other family members, friends, community residents – are what make education-based athletics different from non-school sports.  

More intense security plans have been in existence at college and professional sports venues for many years; it is essential that leaders in high school sports move after-school safety and security to the top of their priority lists.

In addition to school athletic events that typically start in early evening hours, security plans also should be in place for practices inside and outside the school building. 

Many resources are available for high school athletic administrators to implement an after-school safety and security program, including the free online education course on the NFHS Learning Center at www.NFHSLearn.com. “Afterschool Security” provides practical strategies for developing and implementing a school safety team and an after-school activities supervision plan.

As was the case with increased security at airports after September 11, 2001, the results of heightened safety plans for after-school activities may be an inconvenience for some individuals. However, plans must be in place to ensure that high school stadiums and arenas remain open for the almost eight million participants in high school sports, as well as the estimated 350 million fans annually.

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.