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.

Coaches Must Set the Example

October 15, 2012

By Scott Westfall
MSU Institute for the Study of Youth Sports
 

NOTE: This is part one of a two-part viewpoint explaining the importance of coaches and parents setting proper examples for young athletes in their treatment of game officials.

In light of the recent uproar over NFL replacement officials, it seems that never before has it been so common and socially accepted to yell disgust at referees.

While this trend is prevalent in both professional and college football, it has unfortunately trickled down into the high school ranks. What is actually accomplished when a coach or fan yells at an official? Do people really believe that if they become irate, a ‘bad call’ will be erased? In all of my years watching, playing, and coaching athletics, not once have I seen a referee change his or her ruling because a coach or a fan yelled at him or her.

When adults lose control and scream at referees, who does this bad behavior really affect? Since youth learn their emotional control from adult leaders, I believe the true damage is done to the young minds that are witnessing their mentors lose their cool. After their display of anger, how can these same adults hope for kids to stay calm when things do not go their way in life? It is pure hypocrisy to expect otherwise.

Whether we like it or not, referees are the absolute authority in athletic contests; they control the game from start to finish, make the tough calls on the playing surface, and even decide who gets to stay and who is sent to the locker room. Yet, it is baffling how often their authority is disrespected.

It is the coach’s responsibility to establish his or her program as one that respects authority. Since players watch all of the moves their coaches make, it is imperative that coaches respect the officials – especially when the calls do not go their way. If a player sees his or her coach going berserk due to a ‘bad call,’ the same player will think it is OK to act like this down the road when upset or faced with adversity. Even more detrimental to these kids is hearing their coach preach a message but contradict it by not backing it up with actions.

Great high school coaches will use the playing surface as an extension of their classroom. In my years as a head coach, I tried my hardest to set a good example for my players and told them to never question, back-talk, or disrespect an official. However, I made the mistake of breaking my own rule on one occasion by questioning the referee’s judgment.

When I was a younger coach, I may have attributed my actions to the heat of the moment, or defended myself on the criteria that I was trying to stick up for my team. However, being a veteran leader who wanted to practice what I preached, I saw my mistake as a teaching moment.

The next practice, when we conducted team discipline conditioning, “Reminders” (usually reserved for players with unacceptable school behavior or poor grades), I asked my players what I had taught them about respecting authority and if I had broken my own rule. The players agreed that I had broken my rule and had not respected the referee.

I let them know that this rule applied to me as much as them. I then lined-up on the goal line and ran my own set of wind sprints as the players, assistant coaches, and managers watched in disbelief. Afterward, to even my surprise, several players thanked me for holding myself accountable.

One kid even had tears in his eyes, and said that after watching my self-imposed discipline, he wanted more than ever to be a man of his word and do the right thing.

Scott Westfall has spent the last 10 years as a teacher, coach, and athletic director in Fort Collins, Colo. He currently is working on his Doctorate at Michigan State University, with an emphasis in Sport Psychology and Athletic Administration, and assisting the MHSAA with its student leadership programs. Westfall is a former athlete who participated in football, wrestling, tennis and cross country at the high school level, and rugby at the collegiate level. He can be reached at [email protected].


PHOTO: Scott Westfall celebrates with his football team while serving as a coach at Boltz Middle School in Fort Collins, Colo.