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: Amateurism Benefits
October 9, 2019
By Karissa Niehoff
NFHS Executive Director
While we addressed a number of important issues with our member state associations at section meetings the past month, perhaps none of the topics are as significant as the tremor that occurred in California on September 30 – the signing of the “Fair Pay to Play Act” by California Governor Gavin Newsom.
Although there are more questions than answers at this point, this ruling would allow college athletes in the state of California to make money from their name, image and likeness through endorsement deals, sponsorships, autograph signings and other opportunities. The legislation is due to take effect in 2023.
Obviously, the NCAA opposes this legislation and is working through its governance structure to address the issue. As Mark Emmert, NCAA president, told the Indianapolis Star, “for all intents and purposes, athletes become employees of the schools. This is just a new form of professionalism and a different way of converting students into employees.”
And since it would not work for athletes in one state to be receiving money legally while athletes in the other 49 could not, a national bill similar to California’s is already being considered by U. S. Representative Anthony Gonzalez of Ohio.
Needless to say, the NFHS and its member state associations oppose the California ruling as it could further erode the concept of amateurism in the United States. At the high school level, current issues with parents pushing their kids into specialization in the fight for scholarships would only be exacerbated as they considered the “best offer” from colleges.
In the aforementioned Indianapolis Star article, Emmert noted the following: “Under the California law, there would be complete elimination of all of those rules (regulations related to shoe companies). It would also include the use of agents in that process and the agent could represent high school students.”
There is nothing more sacred and fundamental to the past – and future – history of high school sports in the United States than the concept of amateurism. While this California ruling addresses college sports directly, it undoubtedly would have an impact on sports at the high school level as well.
The signing of the “Fair Pay to Play Act” comes on the heels of the Alston v. NCAA case earlier this year in which a federal judge in California found the NCAA’s scholarship rules to be illegal – to a point. The NFHS filed an amicus curiae brief in support of the NCAA noting the following:
“Amateurism in athletics is not only valuable for its own sake, but also is a key aspect of a well-rounded education. The NFHS is concerned that the district court’s opinion does not fully appreciate either the concept of amateurism or the many benefits it brings to college and high school sports – and to American sports in general.
“... If amateurism were to give way to professionalism at the collegiate level ... high schools would struggle to fulfill their ultimate goal of preparing large numbers of well-rounded individuals for futures beyond athletics. … The NCAA should be afforded the freedom to define amateurism in a way that preserves the ideal of the student-athlete in higher education which would protect important values of education-based sports at all levels.”
The NFHS will continue to support the NCAA in its efforts to preserve amateurism as it is our belief that paying student-athletes – whether it is in the form of selling one’s name, image or likeness, or whether it eventually becomes a paycheck – will erode the spirit of sport at all levels in this country.
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.