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.

Timeout to Appreciate Officials

September 23, 2013

By Kevin Wolma
Hudsonville athletic director

Wolma is in his third school year as athletic director at Hudsonville and previously coached basketball and golf. Below is a recent “30-second timeout” he wrote for the Hudsonville district newsletter.

We were five seconds away from one of the greatest upsets in the history of Caledonia basketball.

During the regular season, South Christian had beaten us by more than 30 points on two different occasions. The District Finals became the site for the third contest between the two schools on a warm March day.

We were able to slow them down just enough to stay within striking distance until late in the fourth quarter, when we finally took the lead for the first time. South Christian had one last chance with seven seconds left on the clock. After a timeout, they in-bounded the ball from the sideline and their player forced up a shot. I could see it was going to be short from my viewpoint, and my heart began to race with adrenaline as I could sense the impossible was going to become possible.

What happened next has stuck with me for the rest of my life, as one of the South Christian players pushed one of our players in the back, grabbed the rebound, and put the ball in the basket with one second left.

Game over. South Christian wins the District championship.

For the next eight years as a varsity basketball coach, I held a grudge against officials for that one call. Twelve years later, after I was done coaching, I went back and watched the game over again for the first time. I almost turned the video off when they in-bounded the ball in those last seven seconds because I did not want to relive that moment and the ensuing emotions that took place.

While watching I discovered something.

The South Christian player did not shove my player as much as I thought, and our players did not box out like I had thought, which made it easier for them to get the rebound and score. Looking back, did I even tell my players to box out during that last timeout before the ball was in-bounded?

At that moment it became very clear to me that what we see during a game may be clouded because we want our team to gain every advantage and every call in order for them to be successful. Perception is not reality. Officials are human. They will make mistakes just like the coaches and players do during a game.

There still has never been a game that has been decided by an official. Some people will say that the Class B Semifinal boys basketball game (in 2010) was decided on an official’s call when they ruled one of Forest Hills Northern’s player's foot was on the line on his last-second shot when in reality his foot clearly was behind the line. That call cost them a chance to play in the (MHSAA) Finals.

Coach Steve Harvey was quoted in the paper as saying, "We had opportunities to take care of the game before it even came down to that shot.” In the moment it seemed like that one play cost Forest Hills Northern the game, but there were over 50 possessions on offense and defense that preceded the play and potential outcome.

Having the opportunity to spend time with officials inside the locker room has made it very evident they are serious about their jobs and calling the best game they can. I have had requests from officials to have a monitor available to break down film an hour and a half before their contest begins to see strengths and weaknesses in their placement and mechanics from prior contests. I have had officials upset at halftime or after a game because they realized they made a mistake. I have had officials contact me personally after a game to apologize for a call made during the contest.

In the business world and also in education we use the word collaboration a lot. Officials collaborate before, during, and after every contest to garner more knowledge so they can continue to improve.

This is not even their full time job. Officials do what they do because they love the game and want to give back to the sport that made an impact on them.

The next time we are at a game and we think the officials missed a call, let’s take a 30-second timeout to gather our emotions so we do not say anything we will regret later. Instead let’s spend our energy cheering on our teams to be the best they can be.