Keep Your Feet Feeling Young

Tomorrow is one of my favorite days…Super Bowl Sunday! Always bittersweet since, as a big football fan, it also indicates the end of another football season. I’m hoping it’s a good game between the Indianapolis Colts and the New Orleans Saints. Not a fan of either team and I don’t have a particular aversion either….so I’m hoping I get to see a good game here in Houston.

One thing that I’m following is the Indianapolis Colts’ defensive end Dwight Freeney’s severe right ankle injury. Now, I wouldn’t play on it and wouldn’t advise my patients to do so either, but professional sports is a different story. They professionally beat their bodies up and push them to the limits for our entertainment and get paid royally to do so. So it certainly is possible, even though he hasn’t participated in any recent workouts, that he probably will play in tomorrow’s game.
From what I read, he sustained a grade 2-3 ankle sprain, which is a complete tear of some of the ligaments that support the ankle. This leads to severe pain and swelling and a very significant instability in his ankle.  Of course, with anti-inflammatory medication, possibly a cortisone injection, taping, and bracing, he can be pieced together to play.

Of course, there is some very real risk to him playing as well.  Without good sensation in his ankle, he will not be very sure-footed and his speed and reaction time will be affected.  Also, there is the good possibility of worsening his injury, rupturing the remaining ligaments that are supporting his ankle.  In fact, he is putting his career at risk, but so is every football player when they walk on the field.  Best case scenario, after the game, he will be immobilized followed by physical therapy to restore strength and balance. Worst case would be surgery to stabilize his ankle, again followed by physical therapy

If you twist or sprain your ankle, get it examined immediately.  Ligaments do heal, but are quick to heal in a stretched position that will provide less stability in the long run.  Even for moderate sprains, studies have shown that a period of immobilization is best to ensure more complete healing of the injury.

I like to see heart…I really do. But, when your job is not on the line, and you have a history of injury…is a risky scramble the right thing to do in a PRESEASON game?

Well, that’s exactly what happened last night in Reliant Stadium when the Texans played Brett Favre and the Minnesota Vikings.  I’ll admit, I don’t usually go to preseason games, but since both starting teams and quarterbacks were going to play at least the first half, the fact that it was Monday Night Football, and I’ve been pretty starved for football, I’d give it a chance.

Fortunately, it seems that Schaub’s ankle sprain is not serious.  After scrambling to the sideline (nice play, although I don’t agree with it) he limped slightly going back to the huddle.  After throwing a touchdown pass later in the drive, he really was limping as he was leaving the field.  Halftime came and went and Schaub did not return to the game.

Any twisted ankle can damage the three ligaments on the outside.  They are there to support the ankle.  The ligaments can either be stretched or torn when this happens.  Studies have shown that immobilization provides the best environment for the ankle sprain to heal.  For mild sprains, however, good quality elastic ankle support usually suffices.

As with any acute injury, a great way to manage the swelling and pain is through the RICE principle:  Rest, Ice, Compression, and Elevation.  This especially holds true for ankle sprains, since they can swell pretty quickly.  Don’t write off a sprained ankle as something that is minor…it is usually the annoying “minor” issues that linger.

I hope Schaub shows the same heart when he plays in the regular season…but he better stay healthy!!

A sprained ankle is one of the most common injuries of the lower extremity, with approximately 8 million people spraining an ankle each year. Also known as twisting or turning the ankle, it can happen as a result of playing sports, running on uneven surfaces, or just walking along. The foot turns in on the leg, which can lead to a stumble, trip, or fall.

There are some interesting statistics that show that people who sprain their ankles will injure them again in the same way up to 80% of the time. Why does one injury put someone at such major risk of repeating the injury?

Studies have shown that many people who have a tendency of spraining their ankle have poor balance. This can be demonstrated by standing upright (have something close to hold on to) and standing on one foot. The more wobbly you feel, the better the chances are that you will sprain an ankle, often repeatedly. This can be remedied by some simple exercises to increase the strength of the muscles. Again, stand on one leg and try not to wobble. Hold that position for one minute and repeat on the other leg.

Why does balance training help someone from repeatedly turning their ankle? As an ankle is sprained, the supporting ligaments are injured. They do heal, but in a stretched position. There are receptors in the ligament that are damaged also, which provides feedback to the brain about the position of the joint. This feedback becomes faulty with persistent injury and the balance suffers as a result.

While ankle supports and braces are helpful to provide stability to the weakened joint, pursuing a regimen of exercise to increase the balance is particularly helpful. This can be as simple as standing on one foot and balancing when you are brushing your teeth every day. If you want a greater challenge and result, there are a number of balance boards and mats available.

Judge Sonia Sotomayor, who was recently nominated by President Obama to be an associate justice on the Supreme Court, tripped at Laguardia Airport while trying to catch a flight back to Washington today. Once on the plane, she realized that she needed treatment and was taken to an ambulatory hospital in Washington for treatment. She is now using crutches as she continues her meetings with senators on the path towards her confirmation.

This is another example of an everyday activity gone bad. Last week, actress Jennie Garth stumbled in her home and broke her foot. Now we see how something simple as walking through the airport can have significant consequences. No, I’m not going to comment that she should have gotten to the airport earlier so she didn’t have to rush (trust me, I’m not one to criticize that!). I do commend Judge Sotomayor for seeking care quickly…most do not.

The ankle has several ligaments on both sides to stabilize the joint. There are also several tendons traveling down all sides of the ankle. When an ankle is twisted, most commonly the supporting ligaments are damaged. This is known as an ankle sprain. Occasionally, however, the ligaments or tendons can pull off a piece of bone, which is an ankle fracture. The ankle bones may also fracture without a direct pull of the soft tissue.

Both fractures and sprains will be painful, with swelling and bruising noticeable. The idea that if it is broken or fractured you won’t be able to walk on it is not true. The only way to tell is to get an x-ray, available quickly and painlessly in all podiatrists’ offices. No need to go to the hospital for this, unless, of course, you’re in the running for the Supreme Court.

Beverly Hills 90210′s Jennie Garth is recovering from a broken foot. She’s the next in high profile celebrity injuries. What is particularly interesting about her story, however, is how uneventful it really was. Reports are that she was home and carrying her baby. She went to answer the door, stumbled, and twisted her foot which led to the break. Is there anyone reading this who honestly can saw they’ve never done something similar?

It doesn’t take much to break a bone. Sometimes a quick twist of the ankle is enough to cause a major fracture in the foot. Walking to the bathroom in the dark and tripping over the kids’ toys. Knocking the toe on the furniture. It has happened to us all. Because of that, it’s very easy to dismiss it as something that will go away quickly.

But what if it doesn’t. Some of these injuries can become quite serious. A twisted ankle, for instance, can lead to a fracture of the base of the fifth metatarsal bone. If this fracture is not immobilized quickly, it can displace and require surgery to get it healed. Even a broken toe should be examined with an x-ray to make sure it is not displaced. If it is, it is important to address it before it starts to heal on its own or the treatment later on will become more complicated.

It sounds like Jennie is getting the treatment she needs. Let’s learn from her good example and take care of our minor injuries…before they become major ones.

Another foot injury plagues the Houston Rockets. In Friday night’s playoff game against the Lakers, center Yao Ming suffered what was believed to be an ankle sprain. The next day, it was announced that the injury was, in fact, a hairline fracture. Although not displaced and requiring no surgery, the injury will require a full 8 to 12 weeks of rehabilitation before Yao can play on the foot again. This is the end of Yao’s season. Hopefully the Rockets can continue to move forward with their playoff ambitions.

Yao’s left foot has been plagued with various injuries. A stress fracture in his foot almost forced him to miss the Beijing Olympics. When repeated fractures such as this occur in the foot, often a custom orthotic is necessary. An orthotic will stabilize the mechanics and redistribute the pressures so no one specific area has an undue load on it. This most commonly will stop future fractures from occurring.

For basketball players, an additional level of support is sometimes needed. An ankle-foot orthotic not only redistributes pressures in the foot, but also helps to provide support to the ankle. I hope that during Yao’s downtime, his trainers and physicians will reassess his biomechanical control so he can stop having these injury-plagued seasons.

Ask the casual reality show observer which show would end up with more foot and ankle injuries. I’m sure many would think Survivor, right? After all…malnourished on a remote area. Physical challenges abound. Catch your own food…sounds logical, right?

Turns out Dancing with the Stars has them beat by a landslide. Over the several seasons, Dancing with the Stars boasts the following:

• Misty May-Treanor: ruptured Achilles Tendon (after successfully winning an Olympic Gold unscathed)
• Susan Lucci: Sprained Ankle/Stress Fracture
• Lance Bass: Broken toe
• Jewel: Fractured tibia
• Kristi Yamaguchi: Ankle injury
• Brooke Burke: Injured foot
• Karina Smirnoff: Ankle sprain

Now compared to foot and ankle injuries from Survivor:

• (staring up and whistling)

So how can we explain this. Quite simply, actually. Dancing is a sport. It requires discipline, practice, and a high level of fitness. So like any sport, it’s going to carry with it a wide variety of injuries. Couple that with taking celebrities who are not professional dancers and putting them through the rigor of training for the dance routines with their professional partners that they are not prepared for.

Look who are the most successful to date: Sports stars…Kristi Yamaguchi, Emmitt Smith, Apolo Anton Ono. And the favorites this year? Shawn Johnson (Olympic Gold Medal Gymnast) and Lawrence Taylor (Super Bowl Winner). As in all sports, conditioning and training still are the key to excellence.

When it comes to basketball, the risk of spraining an ankle is constant. Quick breaks, starts, stops, pivots, and, of course, jumps. Whenever an ankle is sprained, there is always ligament damage. The time out of the game will depend on the extent of the damage. You’d expect that a sprain resulting from a jump would result in more damage from simply rolling the ankle. All we know is that McGrady’s ankle was sprained in practice.

The Rockets announced that McGrady was a game-day decision to play tonight’s game, which leads me to believe it’s not so severe. Hopefully T-Mac will be back soon and stay healthy along with Yao and Artest to make this a great season.