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: Find Answers at Youth Level

November 13, 2019

By Karissa Niehoff
NFHS Executive Director

Are there long-term solutions to increasing the number of participants in high school sports and improving parental behavior at high school contests? The answer to both questions might start at the youth sports level.

The NFHS hosted a first-ever meeting of about 25 leaders of National Governing Bodies and the U.S. Olympic & Paralympic Committee last week to discuss common concerns and opportunities to align and work together.

Within the youth areas of these organizations, the issues are familiar ones to high school leaders – decline in participation, parent behavior, coaches education and minimizing the injury risk. Clearly, however, reaching parents with appropriate educational messages on sportsmanship, injury risk and the values of participation is a top priority for leaders at all levels – youth, middle school and high school sports.

Recently, the NFHS formed a Middle School Committee in an effort to build interest in education-based sports at that level and to share the proper messages with parents before their kids reach high school. However, as we learned last week, middle school may even be too late!

Those educational messages will be enhanced if the process starts in out-of-school youth sports. If messages about the values of multi-sport participation, playing for the love of the game, and limiting contact in sports like football are consistently shared and demonstrated at the youth level, the education-based concept should be firmly in place by the time students reach high school. 

Coaches education is another common concern. While the NFHS has created an outstanding online education program for interscholastic coaches through the NFHS Learning Center (www.NFHSLearn.com), there is no standard requirement to coach at the youth level. There should be some type of required certification for anyone to walk onto a field or court to coach. And while knowledge about teaching the proper tackling form in football or the proper defensive positioning in basketball is important, those are not the most important prerequisites for coaching.

Similar to the NFHS’ online Fundamentals of Coaching course, youth coaches should be required to take courses that help them learn how to coach the kids more so than the sport. And since many of the coaches at this level are parents of players on the team, these individuals – and all youth parents – should be presented materials similar to what is presented at preseason meetings at the high school level. This would include, among other things, the non-negotiable requirement to positively support their child while letting the coaches coach, and the officials officiate.

Lofty goals, for sure, without a collective governing organization over youth sports. However, these concepts can be endorsed and promoted within the youth areas of sport-specific NGBs. These fundamentals of education-based athletics are essential for the 2-3 percent who play sports beyond high school as well as the majority who apply the values learned in high school sports in their chosen careers.

The skills will eventually fade – even for those individuals who play sports beyond high school – but the values learned from playing sports, beginning at the youth sports level, will last a lifetime.

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.