Ankle Sprain
Ankle sprains are one of the most common injuries for athletes. Anyone who has played a sport is likely to have
experienced this type of injury. Also known as ankle instability, or a lateral ankle ligament tear,
it occurs when someone awkwardly plants the foot. When this happens, the foot is turned inward and is occasionally
followed by a "popping" sound. Walking is difficult and the foot shows immediate swelling. During this time, there
is extreme pain.
Typically, patients with such injuries are prescribed an MRI. While this does aid in the diagnosis of a torn ligament, it is expensive, sometimes unclear, and at Dr. Sanders’ clinic, unnecessary. Instead, Dr. Sanders prefers to perform a physical exam on the ankle by palpating and stressing the ligaments, along with the Achilles tendon. After that, he will decide whether or not further testing is necessary. If so, the patient will receive a Telos Stress X-ray. This low-cost exam uses the Telos Stress Device to apply stress to the ligaments of both ankles under X-ray. A comparison between the normal and abnormal ankle X-rays using digital technology will then allow Dr. Sanders to determine if there is a significant difference between the two ankles.
In treating this injury, a system referred to as "RICE" is used and includes Rest, Ice, Compression, and Elevation.
The best instrument for achieving both ice and compression is the Cryo/Cuff®. Therefore, patients are encouraged
to immediately begin using a Cryo/Cuff®, while keeping the ankle elevated. Following several days of elevation,
patients are told to begin walking, with or without crutches - though crutches are discouraged. Patients are then
put in a special brace called an Air-Stirrup Ankle Brace, which can be placed over
a sock and worn with a high top tennis shoe. This brace provides support and compression for the injured ankle
within the shoe, allowing athletes to begin exercising, and regaining strength more quickly.
Working out the ankle and stretching the heel cord are very important for the rapid recovery of an ankle sprain.
By working the ankle in dorsi and plantar flexion, an athlete can begin practicing his sport once again. If the
Air-Stirrup Ankle Brace is worn for the full four weeks, rarely is additional treatment required for a sprain.
An ordinary ankle sprain does not require an urgent MRI. Nor does it require a cast, crutches, or regular
treatments by a doctor. It does not require immediate surgery. Ninety five percent of acute ankle sprains are
successfully treated with conservative rehabilitation and proper care.
Surgical Treatment
There is, though, a small, repeat small, group of people with sprained ankles, which have recovered with
"residual laxity." This occurs when the sprain is not properly treated. These patients are always subject to
re-spraining the ankle with even the most minimal trauma. Patients, who were not properly treated for the first
sprain and continue to experience ongoing problems with the ankle, may need to consider other surgical treatments.
While this condition is uncommon, the surgical treatment Dr. Sanders uses for recurring sprains or instability
is called Ankle Ligament Reconstruction.
It is performed in the Day Surgery section of a hospital. In this procedure, Dr. Sanders, first regularly performs an arthroscopy of the ankle. Approximately 40% of patients have an associated injury to the articular cartilage. The repair is typically quite simple. The residual stretched out ankle ligaments are incised and over sewn, just like the seat of a pair of pants being taken in. In less than 50% of patients the heel bone is crooked or turned inward, not because of the previous ankle trauma, but on the congenital or developmental basis. When this occurs, this bony problem must be addressed by repositioning the heel so it is straight.
Post surgical treatment for patients includes a Cryo/Cuff® and crutches until the wounds heel - both of which
are sent home with the patient. This treatment continues for approximately two weeks. They are then put in a Moon boot or Post Op Walker. After a six-week period, the brace is removed and an Air Stirrup brace is used for a period of time, and when engaging in sports during the first year.
Staying Strong
A sound nutritional program and Reconditioning exercise plan are encouraged for all patients at the Sanders Clinic.
Lateral collateral ankle ligaments are similar to tendons and work optimally with regular training and proper nutrition.
Dr. Sanders recommends a course of nutritional supplements containing Glycosaminoglycans, and Chondroitin sulfate.
These, as well as other vitamins, are found in Nutriex Sport.
