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.
Involvement vs. Meaningful Involvement
November 27, 2012
By Jed Blanton
MSU Institute for the Study of Youth Sports
As I've worked with the MHSAA in student leadership development and through my role in performance consulting and mental training, a number of coaches and athletes have asked me how to “get kids to buy in” or see the vision of their coach/captain, etc.
Particularly in high school sports, rosters consist of players with reasons for participating in their sport that range from pure enjoyment and social life, all the way to kids with aspirations and ability to play in the highest level of college athletics.
Having a range of talent, and then a range of desire and commitment can be a difficult load to balance as a coach.
Based on the questions I've been posed over the years, it seems that the magic answer lies somewhere in this notion of “buy-in” and if, just if, the coach could trigger that “buy-in” everything would work out. A winning season or at least a more successful season would be a certainty, and all the athletes would be emotionally involved, or more so, emotionally invested, as well as completely and fully physically and mentally committed to THE GAME.
This almost sounds like the ideal ending of a Disney sports movie … but that doesn't mean it isn't a possibility, and we can find some ways to make your reality closer to this vision.
The trick is … there is no trick; there is no magic formula. The ability to create “buy-in” means giving up something that might make a coach shudder and cringe just a bit. My challenge to coaches is this: Give up control. SHARE some of the duties and tasks you feel are your job, with … your players.
DON’T hit the back button or close your browser just yet. Let me explain.
The first thing to understand here is how people learn. If we want our athletes to “buy in,” we may have to teach “buy-in” first, which involves understanding how people learn behaviors and adopt a mentality, as the state of “buy-in” would be considered.
Psychologically, we know that people can learn merely from watching and modeling others. But in the short-term, this tends to include only behaviors, not the more abstract notions of passion or commitment which is seemingly what coaches desire more of in their players when we talk about “buy-in.”
However, it is important. So the first thing a coach needs to do is behave in such ways that indicate they are “bought in,” more so than just telling kids to be more committed. Have you ever stopped to think about what it looks like when someone has “bought in” to an athletic team’s vision? Do you have a team vision statement to guide behaviors and goals?
The next step in how people learn new behaviors upon watching others is having those behaviors they are attempting to mimic reinforced. Encouraging players and showing gratitude to those who demonstrate the desired mentality will help foster the expectations you have for your players. I must point out here that punishing or dismissing players and behaviors that stray from this desired state won’t help the learning process.
Next, and here is where the challenge lies, is sacrificing some control and sharing some responsibilities with your players. This entails involving them in the process of the sport. So often our high school athletes experience sport very passively. They are told what to do, how to do it, and when to do it. Then critiqued, sometimes put down and constantly judged on their abilities to do very little else than act in the ways they are told to act.
There is no option for personal investment here. Trust is the guiding factor. And while trust is extremely important, it’s not what may ultimately create “buy-in.”
Involvement fosters ownership. Meaningful involvement requires an emotional investment because the amount of responsibility increases. So what does being meaningfully involved look like? Being meaningfully involved in the sport as an athlete would mean being able to make decisions that are then actually carried out before they are critiqued. If you ask a player what they think about any given decision, then tell them what you think (which is also what they’ll do), you are merely seeking input rather than allowing them to be involved. What would it look like if the captain or senior players were able to set the starting line-up or batting order? Or what if the athletes were in charge of running a two-hour practice once a week? How about letting one or two of the athletes decide what play is going to be run in the final minutes of a close game? I mentioned the word “trust” earlier, and the key in these examples is coaches are showing athletes “trust.” This just might be what fosters the all important “buy-in.”
The hardest part on the coaches’ end is letting the decision play out, and then talking about why it may have failed. Discussing it rationally, debriefing the decision, and allowing them to process where the mistake was made without placing blame on them is where athletes can really learn about their sport, their role on the team, and how to make tough decisions while sharing in the full experience of the competition and preparation.
There is always a chance they’ll make the same decision you would make as the coach. After all, they have been practicing in your system. This is a great way to assess if you are having an impact and if your athletes are learning rather than just passively participating.
As a former athlete, I can honestly say I never truly understood my sport (distance running) until I was asked to serve as a race director or create training programs for younger athletes and people interested in taking their running to a more competitive level. I’m sure for most first-time coaches, the number of decisions you have to make humbles your former-athlete self rather quickly.
Watching the student leadership program participants I work with struggle with projects and presentations they are asked to design is tough, and I want nothing more than to help them and make sure that it’s “right.” But I can also say that in those times when I've been able to see the end result in those instances when they made the decisions, they created something on their own, they are happier, more knowledgeable, and certainly “bought in,” as they have control for the first time.
Blanton is a doctoral candidate at Michigan State University in the department of Kinesiology, specializing in the PsychoSocial Aspects of Sport and Physical Activity, and a research assistant for MSU's Institute for the Study of Youth Sports. He has served as a facilitator at MHSAA Captains Clinics the last three years and currently is assisting the association with its student leadership programs.