High ankle sprains, such as this one suffered by Dirk Nowitzki of the Dallas Mavericks, can be treated in a variety of ways, according to the Running Doc, including rest, a cast, surgery or PRP.
Dear Running Doc: Football training camps are rapidly approaching.
Before the last Patriots Super Bowl, my favorite player, Rob Gronkowski, sustained a high ankle sprain. Since then I have heard more and more about this injury. And my boyfriend, who tripped and sprained his ankle, had this diagnosed last week. Please tell me more about this injury so I can better understand it. Bonnie G. Boston, NY.
Thanks for the question Bonnie. This is a painful injury and if severe, can take up to six months to be fully healed.
Sprains, by definition, are tears in ligaments which are soft tissue structure that attach bone to bone. Ankle sprains resulting from a twist are usually just around the anle and respond well to rest, ice, elevation, compression with an ace and early motion. Only complete tears of the ligaments may need surgery but this is relatively rare.
The tibia and fibula (the 2 bones of the lower leg) are also held together by ligaments. Should the twist on the ankle be severe enough, the ligaments between these bones (called the syndesmosis) may tear. This is called a "high ankle sprain."
High ankle sprains are more painful than ankle sprains and usually take longer to heal. There are all different grades of sprain based on how high up the tears go and the completeness of the tear.
Diagnosis is simple. A squeeze test is done: squeezing the lower leg
bones together with a mild twist increases pain. X-rays are done to be
sure there is no break of the bones. An MRI is done to assess the
ligaments.
Treatments range from an ace and rest, immobilization in a walking boot or cast, to surgery to insert screws to hold together the bones while the ligaments heal, to PRP(platelet rich plasma) injections to speed ligament healing.
Decisions on the course of treatment and the rehab schedule necessary to restrengthen the surrounding structures is determined by the extent and position of the tear and speed needed to get back to play. Obviously, professionals demand the most speedy treatment.
A word of caution if you undergo the surgical option and get screws placed.
In my experience, if you leave the screws in after healing and then exercise on a regular basis, the screws can stress the bone and cause a stress or complete fracture.
In order to compete on a regular basis in the future, removing the screws and allowing the holes in the bone a chance to heal provides for a better result.
Regardless of your treatment plan, the end result will be the same: a healthy ankle.
Please wish your boyfriend good luck and I hope I answered your questions.
LEWIS G. MAHARAM, M.D.
***
Lewis G. Maharam is one of the world's most extensively credentialed and well-known sports health experts. Better known as Running Doc™, Maharam is author of Running Doc's Guide to Healthy Running and is past medical director of the NYC Marathon and Rock 'n' Roll Marathon series. He is medical director of the Leukemia & Lymphoma Society's Team in Training program. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.http://www.nydailynews.com/sports/more-sports/high-ankle-sprains-treated-variety-ways-article-1.1406920
Before the last Patriots Super Bowl, my favorite player, Rob Gronkowski, sustained a high ankle sprain. Since then I have heard more and more about this injury. And my boyfriend, who tripped and sprained his ankle, had this diagnosed last week. Please tell me more about this injury so I can better understand it. Bonnie G. Boston, NY.
Thanks for the question Bonnie. This is a painful injury and if severe, can take up to six months to be fully healed.
Sprains, by definition, are tears in ligaments which are soft tissue structure that attach bone to bone. Ankle sprains resulting from a twist are usually just around the anle and respond well to rest, ice, elevation, compression with an ace and early motion. Only complete tears of the ligaments may need surgery but this is relatively rare.
The tibia and fibula (the 2 bones of the lower leg) are also held together by ligaments. Should the twist on the ankle be severe enough, the ligaments between these bones (called the syndesmosis) may tear. This is called a "high ankle sprain."
High ankle sprains are more painful than ankle sprains and usually take longer to heal. There are all different grades of sprain based on how high up the tears go and the completeness of the tear.
Treatments range from an ace and rest, immobilization in a walking boot or cast, to surgery to insert screws to hold together the bones while the ligaments heal, to PRP(platelet rich plasma) injections to speed ligament healing.
Decisions on the course of treatment and the rehab schedule necessary to restrengthen the surrounding structures is determined by the extent and position of the tear and speed needed to get back to play. Obviously, professionals demand the most speedy treatment.
A word of caution if you undergo the surgical option and get screws placed.
In my experience, if you leave the screws in after healing and then exercise on a regular basis, the screws can stress the bone and cause a stress or complete fracture.
In order to compete on a regular basis in the future, removing the screws and allowing the holes in the bone a chance to heal provides for a better result.
Regardless of your treatment plan, the end result will be the same: a healthy ankle.
Please wish your boyfriend good luck and I hope I answered your questions.
LEWIS G. MAHARAM, M.D.
***
Lewis G. Maharam is one of the world's most extensively credentialed and well-known sports health experts. Better known as Running Doc™, Maharam is author of Running Doc's Guide to Healthy Running and is past medical director of the NYC Marathon and Rock 'n' Roll Marathon series. He is medical director of the Leukemia & Lymphoma Society's Team in Training program. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.http://www.nydailynews.com/sports/more-sports/high-ankle-sprains-treated-variety-ways-article-1.1406920
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