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