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.

Commentary: Flag Football First

October 29, 2014

By Chris Ervin
St. Johns Athletic Director

Throughout my career I have always argued that most schools/youth programs start tackle football too early. Most are putting young children in full pads and letting them have full contact as early as third or fourth grade. At this stage in life I don’t believe that children are physically prepared for that type of contact. At this age many of these kids are too big to touch the ball on offense. What fun is that?

But I understand why it is, what it is. Every football program feels the need to do the same, if not more, than our competition. Every program feels it must do what our neighbors are doing to remain competitive. In today’s society everyone believes that our programs must start early, practice often and hit hard, to win championships.

In today’s society we have more science than ever before. We know more about concussions, knee injuries, heat stress, etc. If the NFL, college football, and high school football are making changes as a result of these concerns, why should we not look at current practices of youth football?

I believe that if there was a study conducted with high school football coaches, most would prefer more flag than tackle football for younger children. I believe that most coaches would buy into starting tackle football later in life. But I also believe that coaches will not change unless change occurs across the board, in every community, in every program, to ensure an equal playing field.

Legendary Fowler Football Coach Steve Spicer won championships. He experienced great success even though Fowler started tackle football in the ninth grade for many years. Coach Spicer was able to coach athletes his way. He taught them proper tackling techniques and all of the necessary football skills in merely four years. And for that his teams won championships and were feared as one of the greatest small school football programs in Michigan.

So why flag football instead of tackle football? My take on this is that we start tackle football too early in life. Kids figure out quickly that hitting or getting hit hurts. They do this for six or seven years and then arrive in our high schools.  Many of these kids have had enough of getting hit at this point and then hang up their cleats for another activity, work, girlfriend, etc. Some stay with football and enjoy the next four years, but too many go in a different direction due to burn out.

I keep hearing a common theme in Michigan and I suspect this is the case throughout the entire country. Football participation numbers are plummeting!  Is this a result of kids having so many opportunities these days, starting school after Labor Day (football practice takes away their August vacation time), or the almost daily coverage by the media about the impact of concussions? All of these are factors.

So what is the solution to saving tackle football? I view this as an easy answer; Flag Football!  We need to rally the troops (ADs, Football Coaches Associations, youth football programs, legislatures, parents, children) to take a philosophical stance that supports flag football across the board until at least middle school, and then transition into tackle football for the following years. We all talk about this, but we need action!  Maybe a social media campaign is how we get the ball rolling. 

Flag football is fun for kids! Flag football provides an opportunity for kids to learn the necessary skills so that later in life they are physically able to handle tackle football. And maybe they will enjoy the football experience so much that they will stick around and be part of our high school program!

Ervin is in his 21st school year as an athletic director, with nine at St. Johns, eight at Carson City-Crystal and four at Webberville. He also coached boys basketball at Webberville for six seasons.