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Tobias Harris Severe Ankle Sprain and Road to Recovery

Posted on November 14, 2013

A severe ankle sprain makes ankles feel unstable and often force the injured individual to limit activity. Depending on how severe the sprain, the ankle can give out and cause pain. Ligaments in the ankle are comprised of strong and flexible tissues that attach the ankle joints together. When the ligaments are stretched beyond its limits they can suffer tears and rupture small blood vessels. Often times...

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Ankle Injury Keeps Nash on Bench

Steve Nash Ankle Injury

Photo Credit: Bleacher Report

Lakers point guard Steve Nash will not suit up for tonight’s game against the Dallas Mavericks, thanks to an ankle injury he sustained during this past Tuesday’s game against the Portland Trailblazers. As a result, he was also absent from Tuesday’s game against the Sacramento Kings. This latest lower leg injury has compounded Nash’s problems this season, in which he has only played 11 games so far.

Nash has been suffering from nerve issues since fracturing his lower leg last season. According to media reports, his latest injury is an ankle sprain. He returned in the second half against the Trailblazers after sustaining his ankle injury in the first, but ended up leaving the game again. As Lakers reporter Mike Trudell put it, “Nash has not been, and won’t be, at 100% this season. He’s battling through pain, as he did again tonight.”

Unfortunately, Nash broke one of the cardinal rules when it comes to ankle sprains: keeping weight off the injured ankle. Ankle sprains are generally treated with rest, ice, and anti-inflammatory medications. Continuing to walk on a sprained ankle can prolong the recovery process. Nash took it even further by playing basketball on the sprain. The movements require by someone in his position are likely to put an even greater strain on the joint, making his timetable for recovery that much longer.

Ankle sprains occur when the ligaments that stabilize the joint are stretched beyond their normal range of motion. Chronic injuries of this nature can lead to more serious conditions down the road, including ankle arthritis. This is because the injured ligament may cause abnormal motion in the joint, which creates pressure that eventually wears down the joint. While professional athletes like Nash may be inclined to risk future arthritis for the opportunity to play now, the rest of us should nurse a sprained ankle properly to minimize the risk of developing more serious conditions down the road.

Ankle Arthritis Relief Through Exercise

In a recent report out of Harvard Health, surveys found that the majority of Americans who suffer from ankle arthritis get far less exercise than is recommended on a weekly basis. This is disappointing, though not surprising, news. It’s disappointing because of the wide range of health benefits that even the minimum recommended amount of exercise can confer. But it’s not surprising, given the pain caused by arthritis, especially those that affect the lower body (like ankle arthritis).

Percentage of adults who walked less than 90 minutes per week. [Courtesy Harvard Health]

When you feel the pain of ankle arthritis, the last thing you want to do is go for a walk. But that is exactly what you should do. Walking for 30 minutes a day, 5 days a week can help ease the pain of your ankle arthritis and improve related symptoms. In addition, this modest amount of exercise is also great for your heart, can improve your mood, and promotes your overall health. If you are currently walking for less than the recommended 150 minutes per week, now is the best time to start incorporating regular walks into your schedule. As with most exercise schedules, it’s important to make the change gradually, and to not do too much too soon.

Of course, walking isn’t the only exercise that can help relieve your ankle arthritis symptoms and improve your total health. Resistance training, swimming, bicycling, and water aerobics can all be a great source of pain relief as well. As long as the exercises are low impact, they should not negatively affect your ankle arthritis. However, it is important to check with a doctor before beginning any new exercise routine. Exercises like those mentioned here can:

  • Increase Your Range of Motion in the Joint
  • Build Muscle
  • Improve Balance

In most cases, these improvements in physical fitness can help you lead a more active, less painful lifestyle.

Matt Kemp’s Ankle Injury Recovery: “Rushing Back Hasn’t Helped”

Dodgers outfielder Matt Kemp, potentially one of the team’s best hitters, is getting ready to return for the 2014 season. Unlike in years past, however, the star player has decided to take it slow and not play until his recovery is complete. As he told Bill Plunkett at the OC Register, “Me rushing back hasn’t helped me any the last two years. I need to take another approach.”

Kemp Ankle Injury Recovery

Courtesy of Wikimedia Commons

Although Kemp’s recovery from his ankle injury has been slow – especially when compared to his recovery after shoulder surgery in the offseason – it should benefit him in the long run. With any injury of this nature, doing too much too soon can completely derail the recovery process. Our own Dr. Bob Baravarian, one of the top podiatrists in Los Angeles, weighed in on the matter.

“When it comes to recovery from an ankle injury, the key is slow and steady working up after an injury to full strength,” he says. “Returning too fast can result in re-injury and return to stage zero.”

For Dodger fans, it seems like a good thing that Kemp is sitting out from outfielder drills for the time being. Although he is likely to miss the team’s opener in Australia, his complete recovery is likely to be better for the team in the long run. As the Dodgers go deeper into the season, they should be happy to have a healthy Kemp on the field, rather than someone playing on a bad ankle.

When Kemp does return after his recovery, the Dodgers will have a new problem: deciding which three outfielders to play out of their four man rotation. But with a healthy Kemp, Carl Crawford, Yasiel Puig, and Andre Ethier to choose from, it sounds like a good problem to have.

Jimmy Butler’s Ankle Rolls but Bulls Still Optimistic

Fortunately, the Chicago Bulls can’t get any worse. With Derrick Rose out for the season with a torn meniscus and Luol Deng also dealing with a knee injury they are still within reach of climbing up the Eastern Conference standings. But now they add on to the list of injuries with shooting guard Jimmy Butler, who went down in Thursday night’s game against the Oklahoma City Thunder when he rolled his right ankle in the first half.

Butler left the game with a reported ankle sprain and avoided reporters as he left the arena on crutches. Currently the guard is averaging 11 points and about 4 rebounds in 14 games. The 24-year-old guard was battling back from turf toe which sidelined him for nearly a month, but he has shown much promise in his last six games until Thursday night.

How Severe Are Ankle Sprains?

Ankle sprains are very common in the NBA. Depending on severity, the amount of time off varies from a week to a month, but fortunately Butler’s case does not sound like a severe issue in recent reports. The team announced that he left on crutches but that is standard to avoid aggravation following a rolled ankle. Since NBA athletes have the best doctors on standby his condition will be determined soon along with an estimated return.

Ankle sprains are graded in three categories depending on the significance of injury. All sprained ankles need appropriate time and treatment for correction without future recurrence, but most NBA players bounce back fairly quickly from low level sprains. The amount of force on the injured area determines the grade of the sprain, such sprains are categorized as the following:

  • Grade 1 sprain – Slight stretching, light damage to ligament fibers

  • Grade 2 sprain – Partial torn ligament, looseness in ankle joint

  • Grade 3 sprain – Complete tear or rupture of ligament

Treating Ankle Sprains

So far ESPN and Rotowire rules Butler as day-to-day, which means he could be back on the court as early as Saturday if X-rays are negative and swelling does not hinder mobility. Since he left the game immediately after being injured, Butler did not cause any further damage or strain on ligament joints which is likely to occur if a player continues to aggravate the injury.

Runners and athletes often take every precaution imaginable when treating ankle sprains, but some forget the steps needed to recover. Ankle sprains can be treated with special attention in recovery phases such as:

  • Rest and protection to reduce swelling

  • Restore range of motion, increase strength and flexibility

  • Gradual return to activities with limited turning and twisting

Butler is not completely ruled out as a key component in Chicago’s lineup just yet, his ankle sprain may hinder his progress over the next week. The Bulls can count on him to return to the court without missing a beat in production.

For more information about ankle sprains and treatment, visit the Ankle Pain Institute in Los Angeles. Depending on severity, the injury may limit physical activity for a few weeks. The ankle specialists will determine treatment to rightfully treat your condition for every grade of ankle sprains.

Tobias Harris Severe Ankle Sprain and Road to Recovery

A severe ankle sprain makes ankles feel unstable and often force the injured individual to limit activity. Depending on how severe the sprain, the ankle can give out and cause pain. Ligaments in the ankle are comprised of strong and flexible tissues that attach the ankle joints together. When the ligaments are stretched beyond its limits they can suffer tears and rupture small blood vessels. Often times, ankle sprains are long-lasting to individuals who do not refrain from strenuous activity and continue to be painful, swollen and weak.

The NBA is in full swing and Orlando Magic’s third-year player, forward Tobias Harris can only watch from the sidelines as he is rehabilitating a severe ankle sprain. Suffered at the end of October, Harris is still weeks away from playing his first game of the 2013-14 season.

Harris was looked at by his coaching staff to be one of the leading role players on the perimeter this season, as he continues to take things slow in his daily workouts. Harris joined the team late last season, playing in 27 games but averaged a dominant 17 points and 8 rebounds per game. He was restricted to walking in a boot following the injury, but now trainers have him doing elliptical training and spot jump shots until his ankle makes a full recovery in the next few weeks.

At most, Harris suffered a grade-three sprain, but even grade-two injuries require multiple weeks of rest, therapy and rehab before making a full return. Fortunately Harris has the best team of podiatrists in his corner. All athletes, amateur or professional should visit their podiatrist after suffering an ankle sprain to determine the severity and induce required treatment for recovery. At the Ankle Pain Institute, their ankle sprain specialists provide medical services and support for anyone suffering ankle sprains and injuries.

Mild Sprains vs Severe Sprains

Mild sprains, grade-one injury, are very light in pain intensity which results in soreness without instability and minimal swelling. Moderate sprains, grade-two injury, includes moderate pain, light joint instability and swelling with bruising in the injured area. Severe sprains, grade-three injury, is a possible ligament rupture which results in severe pain, swelling and bruising.

What Causes Severe Sprains?

Generally, a sprain can result from falls, sudden twists, or strikes to the ankle that forces the joint out of normal position. The ligament stretches or tears from the joint as it gets pushed out of position. Most ankle injuries in basketball occur when the player lands awkwardly on the side of their feet, twisting of the knee from a planted foot on the court or running off balanced and placing a foot in irregular positions causing the ligament to stretch out of normal range to regain balance.

Ankle Sprain Treatments for Full Recovery

No matter what severity of ankle sprain encountered, the individual should visit a specialist to evaluate the injury before engaging in the recovery process. Harris was required to wear a walking boot following his injury to reduce swelling and now he is limited to stationary training. The University of Foot and Ankle Institute recommend the following for severe ankle sprains:

  • Immobilization, reduce stress, swelling and further damage to injury
  • Braces, walking boots and splints following immobilization period
  • Physical therapy to regain strength
  • Pain medication after 24 hours from injury
  • Possible surgical reconstruction for complete tears and ruptures

Professional athletes are exposed to some of the highest levels of treatment and rehab programs, which in this case allow Harris to make a return to his position in the weeks to come.

For more information about treating ankle sprains, visit the Ankle Pain Institute in Los Angeles. Refrain from physical activity for a few weeks if you believe you suffered a severe ankle sprain. Have the ankle specialists determine treatment suitable for your condition and get back on the court before chronic pain induces.

The Ankle Experts Weigh in on Choosing the Proper Running Shoe

The most common type of ankle injury is the sprain. Every day thousands of runners experience this injury and can only rest, ice, compress and elevate it so much that they start searching for other methods of prevention. They turn to stretching, alternating their foot strike (distance between each foot strike), reduced exercise and even quitting running altogether. The culprit of their ankle injuries may be the cause of ill-fitting running shoes. A runner’s shoes should provide more cushioning impact than anything. Running shoes are designed to perform shock absorption for both feet. Though they are not guaranteed to fight symptoms, the proper running shoe can help prevent shin splints, heel pain, stress fractures and other syndromes of overuse. Early recognition of improper running shoes and replacement can help avoid the need for ankle pain treatment.

Choosing Shoes for Your Foot Type

There are three foot types for every runner which include flat feet, high-arched feet and neutral/normal feet.

Flat-foot runners will not be able to notice an arch when the bottom of their foot rests completely flat from heel to toe. To test for flat feet, dip barefeet in water and walk normally on concrete or paper that will visibly display your foot pattern. The footprint will be shaped like a blob from a person who has flat feet.

High-arched runners can notice a high arch and space on the bottom of the foot. The footprint test will show a footprint that curves inward, which makes the middle of the foot appear skinny.

Neutral or normal foot runners will not appear flat or high-arched. The footprint will curve inward but not by more than an inch and will not appear skinny.

All shoes are made to support these foot styles. After determining which foot type best resembles your feet, runners should check to see if they have the proper shoes. To do this they can observe the bottoms of the running shoes they own now. If the shoes appear to be worn out on the inner or outer soles they are ready for a new pair. Running shoes for each foot type should include:

  • Normal Arch – Flexible shoe with strong midsole
  • High Arch – Stable shoe with strong arch support
  • Flat foot – Flexible shoe with heavy cushioning

When Should I Replace My Sneakers?

Observe the shoes you already use for running and if they match your foot type and the tread of the sole appears to be in good health then you do not need to worry. Like the tires of cars, runners need to keep track of their shoe mileage. After trekking for 600 miles or sooner is the best time to replace their running shoes. According to WebMD, a mistake that runners make often is not replacing their shoes after reaching their maximum mileage rate. If runners do not run enough to collect up to 600 miles, then they should replace their running shoes once a year.

Runners can rejoice and share their passion with fellow runners everywhere to promote healthy footwear. Ill-fitting shoes can lead to unwanted twists and turns of the ankle which lead to sprains, tears and fractures. Determining foot type and replacing worn out running shoes can prevent future ankle pain and injuries. Runners who suffer from frequent ankle pain and stress should visit a podiatrist for proper diagnosis.

Roddy White’s Ankle Ligament Injury

Atlanta Falcons: Roddy White’s Ankle Ligament Injury

A high ankle sprain is a disruption of the membrane between the tibia and fibula, bones of the lower leg. The ankle is the joint that connects these bones together and like all joints the purpose is to stabilize motion. Unfortunately ligaments can overstretch or tear, causing sprains in the ankle joint. The more severe the injury the longer it will take to recover from. Recently, Atlanta Falcons star NFL wide receiver Roddy White was reported as one of the many athletes suffering from this type of injury which limits his playing time possibly for many weeks to come.

In White’s case his sprain is at most a grade-two injury, but even grade-one sprains require several weeks of rest, therapy and rehabilitation to completely heal. Fortunately for White there are a variety of options to treat the ankle ligament injury. Amateur or professional athletes should consider visiting their podiatrist after encountering such an injury to learn which treatment is suitable for recovery. Conservative care is available in forms of bracing and support, physical therapy, medications, lifestyle changes or injection therapy. At the Ankle Pain Institute, their ankle ligament specialists provide support and medical services for anyone suffering with an ankle ligament injury.

Low-Ankle Sprain vs High-Ankle Sprain

There are several ligaments that hold the ankle’s position and support its flexibility. The ankle ligaments can be categorized into two groups when it comes to distinguishing between injuries. Doctors term the sprains into categories, which include:

  • Low ankle sprain: ligaments connected to the tibia or fibula on top or outside of the back heel bones
  • High ankle sprain: ligaments connect the tibia and fibula to each other, known as syndesmotic ligaments.

How Does an Athlete Suffer a High Ankle Sprain?

High ankle sprains require more than a rolled ankle, in this case the high ankle sprain occurs when the tibia and fibula move about as the lower leg rotates outward. This action extends the ligaments that connect the tibia and fibula.

In White’s case, his football injury could have occurred when landing. His toes landing on one side of the foot and the other collapses toward the opposite side, forcing the toes to turn outward.

Ankle Ligament Injury Symptoms
The ankle will feel all sorts of discomfort, but the specifics to watch for are distinct. The ankle will hurt more when the foot is rotated outward.

The person will feel more tenderness above the ankle, the area between the fibula and tibia.

Along with these effects, the injury can be notable if there is pain when the calf is squeezed. It is not always reliable for diagnosis, but in most cases it tests for syndesmotic injuries.

Ankle Ligament Injury Treatments
People who suffer grade-one or grade-two sprains should visit a specialist to determine the severity of their injury and get proper diagnosis, before the recovery process begins. Doctors may recommend conservative treatment for the ankle to heal, and leave surgical treatments as a last resort. At the University Foot and Ankle Institute they recommend the following for treatment:

  • Braces and footwear to minimize pain and stress
  • Physical therapy to improve strength
  • Medication to reduce pain and swelling
  • Physical changes to avoid further damage
  • Injection therapy to reduce pain and increase mobility

Recovering from an Ankle Ligament Injury
A typical mild high ankle sprain can approximate their recovery in as little as six weeks. For professional athletes, such as Roddy White, it is much different since they are treated by the best medical teams and athletic trainers. White’s injury is expected to sideline him until the NFL’s fourth week, if he has no setbacks or other injuries.

Treating Ankle Ligament Injuries in Los Angeles
For more information about how to treat high ankle sprains, visit the ankle doctors at the Ankle Pain Institute in Los Angeles. Take some time off from your activities and reduce stress on your ankle. There are plenty of options to treat your injury, have the ankle specialists determine which one is best for you.

Ankle Instability: Advanced Ankle Ligament Repair Techniques

Treating Ankle Instability:
Advanced Ankle Ligament Repair Techniques

University Foot & Ankle Institute in Los Angeles

After performing over 1000 ankle ligament surgeries, we have taken time to analyze our results and to come up with a treatment regimen that we think is worth sharing.  Over the course of the past 10 years, we have seen a great deal of advancement in the treatment of chronic ankle instability and ankle pain.  The addition use of soft tissue to bone anchors, ankle arthroscopy techniques and diagnostic imaging such has high quality MRI scans has allowed for a better understanding of the causes of ankle pain and their treatment.  University Foot and Ankle Institute is proud to be on the forefront of ankle instability and ankle pain treatment options.

Ankle Instability Explained

Ankle instability occurs usually from a sports related injury or sprain of the ankle.  To say this is common is an understatement.  Ankle sprains are the most common sports injury and are very commonly under treated.  If the injury is initially treated with bracing and physical therapy, rarely is surgery necessary.  However, studies show about 30% of ankle sprains will result in chronic ankle pain, mainly due to ankle instability.  If the ligaments are not protected and held properly during the healing process, the ligament will heal in a loose or lax position resulting in a feeling of giving way in the associated ankle and pain.

Additional injuries may also be noted from ankle sprains and chronic ankle instability.  These include tendon tears, cartilage damage, bone spurs, loose bodies in the ankle joint and scar tissue in the ankle joint.  University Foot and Ankle Institute has defined a comprehensive treatment option for all of these associated findings in conjunction with chronic ankle instability treatment.

Ankle Instability Diagnosis and Work Up

The primary work up for ankle instability and related problems is a history and physical.  Patients will often complain of a “giving way” in the ankle and a feeling of “looseness”.  Swelling is not out of the ordinary and there may be some joint pain and possible tendon pain.

An xray of the ankle can be used to check for loose bone spurs, and possible arthritis changes.  Cartilage damage may also be seen.  In most case, an MRI or magnetic resonance imaging of the ankle allows for a complete check.  The ligaments, tendons, bone, and cartilage are check with an MRI scan.

Conservative Care for Ankle Instability

Conservative options for ankle instability include ankle physical therapy exercises and balance exercises.  Furthermore, functional ankle bracing can be used during activity and sports to increase stability of the ankle and decrease the feeling of laxity or looseness.

Advanced Surgical Options for Ankle Instability

The ideal ankle stabilization procedure allows rapid recovery, resolution of pain and return to full activity.  At University Foot and Ankle Institute, we have worked to meet all these needs and perform 3 different ankle instability surgery  procedures for each patient’s individual needs.

Arthroscopic Ankle Stabilization

The arthroscopic ankle stabilization procedure is done in a minimally invasive manner.  Only 3 one centimeter incisions are necessary and recovery is usually a little faster with the arthroscopic approach.  Two ligament anchors are used to tighten and stabilize the ligaments against the ankle bone and allows for early weight bearing.  The arthroscopic procedure is used in cases of mild to moderate ankle instability.

Open Ankle Stabilization

Our open ankle stabilization procedure is performed in a majority of cases.  It is our go to procedure and often is combined with tendon repairs associated with ligament injury.  The open incision is only about three centimeters and allows for direct visualization and repair of the torn ankle ligaments.  Three ligament anchors are used to repair the ligaments to the ankle bone and early weight bearing and return to activity is often possible depending on the need for adjunct procedures.

Failed Previous Surgeries or Sever Ankle Instability

In severe ankle instability cases, genetic ligament looseness or failed previous ligament repair cases, a tendon graft ankle ligament repair procedure is utilized.  In this cases, a free cadaver tendon is woven through the ankle bones to recreate a ligament much like an ACL reconstruction in the knee.  This allows for a stronger and more healthy repair of the chronically damaged tissue.

Conclusion

In conclusion, there is more than one procedure to stabilize a loose ankle and it  is essential that the surgeon be well versed in all options in order to pick the best one for each patient.  University Foot and Ankle Institute is a premier organization specializing in ankle instability and associated conditions.  For further information, please call 877-677-0011 or visit www.footankleinstitute.com

Ankle Arthritis Pain

Ankle Arthritis: Ways to help relieve ankle pain

Ankle pain is pretty intense, especially when you have no other choice but to walk on it. Treating a sore ankle is simple, but no matter how severe the pain may be you should still see a doctor for medical advice. They will determine the severity of the case and provide effective strategies for pain relief. With careful consideration and proper attention, the affected pain areas will subside and in time comfort will be restored. Those with ankle arthritis often struggle repairing the damage, but it is beneficial for maintaining mobility in the long haul.

Treating Ankle Arthritis

Many forms of treatment are available for ankle arthritis. The ankle joint is the meeting point of bones in the leg and foot. It is responsible for the up and down motion of the foot. Pain in the ankle joint is a result from inflammation or injury to the bones, joint, cartilage, ligaments, tendons or muscles.

Arthritis is the leading cause of disability in America. It is pain within the joint that can occur at any age. With treatment, people with ankle arthritis can manage pain, remain active and live fulfilling lives.

According to the American Academy of Orthopedic Surgeons, common symptoms of ankle arthritis are pain and tenderness, stiffness and reduction of motion, swelling and difficulty walking. Signs and symptoms of the foot vary, but a doctor can base diagnosis using medical history and examination.

What can I do to help relieve ankle pain?

While most patients endure countless recommendations about how to treat pain there are a few treatment options that work best. Sure the comforting words of a mother may tell you to just relax, the pain is in your head and you’re making it worse by thinking about it. What she doesn’t know is that internally the ankle is suffering and needs time to heal. The most common and effective conservative treatments are:

  • Brace and support applications - Bracing immobilizes the ankle and ankle joint. Eliminating the motion, eliminates the ankle from continuing the painful movements of the joint. Custom made braces can be produced to those with abnormal foot and ankle shapes. Supportive shoes, canes and walkers can also prevent pain and reduce stress on the injured ankle.
  • Ice and compression
  • Physical therapy - Physical therapy improves muscle strength, reduces stiffness and pain. Ultimately the goal of therapy is to regain flexibility without restrictions and inflammation.
  • Injections - Injections are placed in the ankle and serve as lubricant for the joint and assists the body to produce more lubrication.
  • Medication - Medication can be administered orally or topically to reduce pain and inflammation. In short-term pain occurrences anti-inflammatory medication, such as Tylenol counteract pain. In obtuse pain situations, the ankle doctor should be notified immediately.
  • Change of lifestyle - The easiest and most affordable solution would be to change the habits and activities that continue to be painful for the ankle. Activities such as walking, running, hiking and rigorous exercise can all cause pain and stress. Replace these activities with less-stressful exercises, such as cycling and swimming. Wear and tear occurs in everyone, but limiting activity can help maintain mobility for a longer lifespan.

If pain and stress on the ankle persist then the last option is surgical procedures to correct ankle arthritis.

Ankle Doctors Serving Los Angeles

Don’t continue to guess your symptoms and hope for the pain to go away on its own. Reduce painful activities and treat yourself with simple techniques to heal the pain. Visit the ankle doctors at the University Foot and Ankle Institute in Los Angeles. Their podiatrists are among the world’s best in foot and ankle care. Living with ankle arthritis is not a struggle you have to live with on your own. Make an appointment with our podiatrists today.

Dance-Related Ankle Injuries

There are two injuries that dancers are prone to; ankle sprains and Posterior Impingement Syndrome. If you are a dancer, give your ankle a rest and exercise your brain on these dance-related ankle injuries.

Ankle Sprains

Dance is a highly demanding activity that pushes the bounds of our natural movement. When we dance we contort our bodies into positions that require extraordinary flexibility, control, power, and endurance. As a result, dance-related injuries are not uncommon. Up to 90% of dancers will experience an injury at some point.

Ankle injuries are the most common traumatic injuries of dancers. Although mild ankle sprains do not result in long-term disability, a significant number fail to heal completely thereby leaving the ankle in a weakened state. When mild ankle sprains are left untreated residual symptoms may persist for years. A pre-existing ankle sprain is the number one predictor for subsequent ankle sprains in dancers.

Most commonly reported symptoms:
•Instability
•Re-injury
•Tendinitis

Ballet dancers place stress on their ankles by assuming prolonged extreme foot positions. For example, when a dancer is en pointe (dancing on their tippy toes) extreme pressure centers on the ankle. This focused pressure taxes surrounding muscles, tendons, and ligaments as the ankle works to stabilize the dancer. As a result, ballet dancers have particularly stressed ankles, which over time weakens the ankle and creates an advanced risk of ankle-related injuries.

Ankle sprains commonly lead to chronic ankle instability. Additionally, by dancing we place continuous and advanced stress on the ankle thereby leading to tendon overuse and tendinitis.

Dancers who have rolled their ankle may suffer a sprain of some degree. Upon rolling the ankle there may have been a “pop” sound, and symptoms of a spain include immediate pain, swelling and bruising along the outside of the ankle. Dancers typically experience such an ankle injury when landing a jump or after a combination of rapid foot movements.

Patients with a suspected ankle sprain are first given a thorough physical exam, and possibly additional tests to rule out more severe injuries (bone fractures, structural alignment issues, and/or tendon and ligament damage).

Initial Therapy:
1.Rest
2.Compression
3.Contrast temperature therapy


Follow-up Therapy:

1.Proprioceptive strengthening exercises
2.Physical therapy including ultrasound
3.3.Diagnostic or therapeutic arthroscopy

Posterior Impingement Syndrome

Anatomy of the Ankle Joint

The ankle joint comprises the lower leg bones (tibia and fibula) and the anklebone (talus), which rests on the heelbone (calcaneus). The anklebone and heelbone form the subtalar joint. There are two small bones (tuberosities) that protrude from the back of the anklebone. In approximately 15% of people one of these small protruding bones is not connected to the anklebone, forming an os trigonum. This disconnect can impair ankle function, resulting in what is called impingement syndrome.

Posterior impingement syndrome is an impingement at the back of the ankle between the leg bone and anklebone. Here, the anklebone becomes pinched between the leg bone and heelbone thereby causing pain.

The added stress of dancing may exasperate this condition resulting in pain and tenderness at the back of the ankle. Straightening and pointing the foot, which pushes the ankle to flex to the very extreme bound of its range of motion, will trigger pain.

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In ballet dancers, continued turnouts of the foot can increase the likelihood of this condition. When dancers who continuously rise up on their toes the foot points toward its downward extreme, which forces the os trigonum to become sandwiched between the leg bone and heelbone.

Diagnosis:
•Thorough physical exam
•Radiographs will show bone spurs as well as an os trigonum

Treatment:
1.Rest
2.Anti-inflammatory Medications
3.Steriod Injections
4.Physical Therapy
5.Possible surgical intervention to remove os trigonum

The ankle doctors and surgeons at University Foot and Ankle Institute want to help keep you dancing. If you are experiencing pain or suspect an ankle injury, contact the official consulting physicians for the Los Angeles Ballet group- University Foot and Ankle Institute of Southern California!