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.

Symptoms of a Meniscus Tear — and When to Seek Treatment

April 2, 2024

Meniscus tears are not one size fits all: Sometimes they cause no pain, other times they’re excruciating.

Henry Ford HealthOnce in a while they heal or adapt on their own, but more often than not they require physical therapy or surgery.    

“Your meniscus is a fiber elastic cartilage that acts as a shock absorber for the knee,” says Ahmad Bazzi, M.D., a sports medicine physician at Henry Ford Health. “It also helps stabilize the knee joint. But when it tears — which can occur in young athletes after a pivot injury or in older people who have arthritis — it can be painful.”

Here, Dr. Bazzi shares symptoms of a meniscus tear and when to see a doctor. 

What Does A Meniscus Tear Feel Like?

Depending upon the level of injury and type of tear, meniscus tears can either be asymptomatic or cause symptoms like:

  • Locking. When the meniscus tears, a piece of it might move into the knee joint, causing mechanical issues like stiffness and locking of the knee joint.
  • Catching or clicking. This often feels like a sudden ‘click’ in the knee joint, where it suddenly gives out while you’re walking or doing certain movements. 
  • Localized pain on the inner or outer part of the knee. In young athletes, a meniscus tear often causes an impaired range of motion and localized pain on the inner or outer part of the knee. 
  • Pain and swelling. In older people, a meniscus tear often causes swelling and an overall aching pain in the knee.  

Treatment Options For Meniscus Tears

A meniscus tear can only heal on its own if the tear is on the outer part of the knee where it has better access to blood supply. If you’re experiencing pain a few days after injury and you have limited range of motion, instability and/or swelling in the knee, Dr. Bazzi recommends seeing a doctor to get an examination and, if needed, an MRI for diagnosis. 

“It’s hard to tell what type of meniscus tear you have if you haven’t seen a doctor,” says Dr. Bazzi. “If you have a mechanically unstable tear and it goes untreated, it could lead to worsening range of motion and stiffness, or worsening arthritis. It’s important to get seen by a doctor to get an accurate diagnosis and the proper treatment. It may take one to three months for a full recovery.”     

Here, Dr. Bazzi shares treatment options:

Surgery

If someone is having mechanical symptoms like locking or catching, surgery may be considered right away, especially if it’s an athlete younger than 40 years old. “Meniscus tear surgery has a shorter recovery compared to other knee surgeries,” says Dr. Bazzi. “Surgery could either consist of a meniscectomy, which is partial or complete removal of the meniscus, or sometimes just a meniscus repair.”  

Hyaluronic acid or cortisone injections

Non-operative treatments are often recommended for older people who have degenerative tears due to arthritis. “This is because meniscus surgery doesn’t often relieve their pain since they have underlying arthritis, meaning they have cartilage loss in the meniscus,” says Dr. Bazzi. 

Instead, a cortisone injection, which is an anti-inflammatory medication that can be injected into the knee, can reduce inflammation, swelling and pain caused by arthritis.

A hyaluronic acid injection may also be considered, which adds cushioning in the knee. “Hyaluronic acid is one of the substances that make up our cartilage, so this injection helps us mimic the lost cartilage,” says Dr. Bazzi. “It also has anti-inflammatory properties.” 

Physical therapy

Physical therapy is another great option, especially for older people who need non-operative treatment options. It can help the knee adapt to the tear, reduce pain and encourage full range of motion. “Physical therapy for meniscus tears focuses on balance exercises and exercises to strengthen the muscles around the knee,” says Dr. Bazzi. “This helps to uphold the knee joint to achieve full range of motion and strength while being pain-free.” 

To find a sports medicine provider at Henry Ford Health, visit henryford.com/athletes or call 313-651-1969.

Reviewed by Ahmad Bazzi, M.D., a sports medicine physician who sees patients at Henry Ford Medical Center – Fairlane.