| Spring is in the air in most of the country. The brief | | | | Many a foot fracture has been missed in the |
| snows are gone and recreational sports are starting | | | | emergency room when x-rays were taken only of |
| their schedules. The soccer, baseball and lacrosse | | | | the ankle and not the foot. The fifth metatarsal is |
| leagues are having their first games; the high-school | | | | often broken with the same mechanism of injury of |
| track team is gearing up for competition, and The | | | | an ankle sprain, so the foot should be evaluated as |
| Leukemia Society's Team-in-Training groups are just | | | | well. If severe ligament injury is suspected, an MRI |
| starting to increase their mileage aiming for an early | | | | can evaluate the grade of injury. This is really what |
| summer marathon finish. Spring is in the air, and our | | | | decides whether surgery is needed for full recovery. |
| old friend the ankle sprain is starting to show up | | | | Treatment for ankle sprains really depends on the |
| more frequently in the office. Basketball and volleyball | | | | degree of severity, which can only be determined by |
| seasons always the main producer of this injury; but | | | | your doctor. Initial treatment always includes "R-I-C-E" |
| you would probably be surprised how many ankle | | | | therapy - Rest, Ice, Compression, and Elevation. Pain |
| sprains occur in outdoor sports like soccer, baseball, | | | | and edema is usually controlled with NSAID's |
| lacrosse and of course track and field. Ankle sprains | | | | (non-steroidal anti-inflammatories) like ibuprofen. |
| have been reported to be approximately 20% of all | | | | Bracing or casting coupled with non-weightbearing on |
| sports injuries with more than 25,000 occurring every | | | | crutches may be needed in more severe injuries to |
| day in the United States. | | | | rest and stabilize the ankle while it heals. Return to |
| Uneven, wet fields coupled with early season fatigue | | | | pain-free ROM and stability is the goal. Surgery is only |
| and competitive full-contact intensity equal injuries. | | | | recommended in Grade 3 severe injuries in athlete's |
| The ankle is the joint that compensates for uneven | | | | or in those patient's who have had multiple ankle |
| surfaces. 85% of ankle injuries are sprains, which are | | | | sprains and suffer from chronic ankle instability. |
| caused by a failure to compensate for this uneven | | | | Long-term ankle instability can often be avoided with |
| footing. Jumping, cutting and pivoting puts the ankle | | | | an aggressive physical therapy program. Bracing |
| at risk. Many athletes put themselves at further risk | | | | should only be used in the short-term during |
| by not rehabilitating these injuries properly, returning | | | | rehabilitation because long-term bracing actually |
| to sport too early, and giving themselves an | | | | causes atrophy and decreased ROM. |
| inadequate adaptive ability. The use of narrow cleats | | | | Physical therapy is needed for all ankle sprains. The |
| with minimal arch support or the use of running shoes | | | | goals of physical therapy should be to regain full |
| for a court sport can also place an athlete at risk for | | | | ROM, strength and proprioception (where your brain |
| ankle sprains. | | | | thinks your ankle is in space). Regaining strength in |
| Ankle sprains occur in runners mainly because they | | | | the peroneal tendons as well as overall balance |
| are chatting away as they are on a long run and are | | | | training are the keys to successful rehabilitation of an |
| simply not paying attention. How many runners have | | | | ankle sprain. A maintenance program of ankle |
| you seen fall off the curb or in a pothole while | | | | strengthening, stretching, and proprioception |
| running? Lots…Pay attention to where you | | | | exercises helps to decrease the risk of future ankle |
| are going and you can prevent this type of injury. If | | | | sprains, particularly in individuals with a history of |
| you know you are a klutz, run on an even surface, | | | | multiple ankle sprains or of chronic instability. |
| like a track, when you are tired or distracted. | | | | Bottom line: if you happen to fall down and go |
| If you have an ankle sprain, you should be evaluated | | | | "Boom", have your ankle sprain evaluated by a |
| by a sports medicine podiatric foot and ankle surgeon | | | | podiatric foot and ankle surgeon. Delaying treatment |
| if you have localized pain, swelling and bruising, as well | | | | and rehabilitation can lead to life-long instability. |
| as inability to walk more than 5-7 steps comfortably. | | | | |