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: Punish Bad Fan Behavior
October 2, 2019
By Karissa Niehoff
NFHS Executive Director
About four weeks ago, we distributed an op-ed suggesting that inappropriate behavior by parents and other adult fans at high school sporting events was causing many officials to quit before they even reached two years on the job.
Although we received mostly positive support from this article, some people thought we went too far in telling parents to “act your age” and “stay in your own lane.” On the contrary, perhaps we should have been more direct.
Last week, one of our member state associations shared a resignation letter it had received from a 20-year veteran soccer official who had taken all the abuse he could handle. A portion of that letter follows:
“Soccer parents: you are absolutely 100% the reason we have a critical refereeing shortage and games are being cancelled left and right. And you are at least a part of the reason I’m done here. The most entitled among you are the ones that scream the loudest. And every time you do this, you tell your son or daughter the following:
‘I do not believe in you, I do not believe in your team, I do not believe in your collective ability to overcome your own adversity and you absolutely will not win and cannot do this without me tilting the table in your favor.’
“On behalf of myself and so many other referees – and I say this with every ounce of my heart and soul – shut up about the referees, and let your kids rise or fall as a team, as a FAMILY. Because the vast majority of you truly have no idea what you’re talking about, and even if you have a legitimate gripe about one play or one decision, you’re not fixing anything.”
And if that wasn’t enough, last week the Eastern Panhandle Youth Football League in West Virginia released the following statement:
“Unfortunately, it has come to the point that because of the abuse, negativity and utter disrespect shown to our officials from parents, coaches and most recently from our players, the Eastern Panhandle Officials Association president stated today that the association will no longer schedule officials for our league games at any field. This means effective immediately all remaining games are cancelled.”
This statement is from a youth league, which means the coaches are likely also parents of players, and the players are sons and daughters who are emulating their parents’ behavior.
So, no, our previous message was not too direct or emphatic. The kind of boorish parental behavior that compels a 20-year soccer official to quit cannot be allowed to continue. While we would hope that parents and other fans would embrace the concepts of education-based athletics by respecting the efforts of those men and women who officiate high school sports, that unfortunately is not occurring in some cases.
As a result, schools must adopt and enforce a strict, fan behavior policy. In soccer, a player receives a “yellow card” as a first warning for unsportsmanlike conduct. If the action occurs again, the player is hit with a “red card” and is ejected from the contest. Some schools have implemented a similar penalty structure for parents and other fans – not just at soccer games but all high school events. If the inappropriate behavior and verbal abuse of officials continues after one warning, the person is removed from the venue. There must be consequences for these offenders before we lose any more officials.
Most of the 7.9 million participants in high school sports are on the fields and courts every day to have fun and compete as a team with their classmates, and the 300,000-plus officials assist in that process. Now, if parents would let the players play and the officials officiate!
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.
