Tuesday, November 11, 2008

Tony Parker Blows Out His Ankle

Did you see the video of Tony Parker’s ankle injury in the game against the Miami Heat? Nasty! It made my ankle hurt! Looks like the San Antonio Spurs will be without him for a while. Ankle sprains can take 4 to 8 weeks to heal; and that’s assuming he doesn’t need his ligaments repaired and didn’t break anything. Preliminary reports say bad sprain, but that could mean anything. Watch the video and you will wonder if 4 weeks is enough to recover from that!

Ankle sprains are actually one of the most common sports injuries, especially in basketball. Many players actually suffer from chronic instability due to multiple ankle sprains over a period of years and little or no true rehab. Many younger athletes return to sport as soon as the swelling goes down and they can get their shoes back on and laced up. This is way too early! An ankle sprain actually messes up the proprioception in your ankle so your brain has trouble understanding where your ankle is in space. This makes you more unstable and prone to reinjury.

If you have an ankle sprain, you should be evaluated by a sports medicine podiatric foot and ankle surgeon if you have localized pain, swelling and bruising, as well as inability to walk more than 5-7 steps comfortably. Many a foot fracture has been missed in the emergency room when x-rays were taken only of the ankle and not the foot. The fifth metatarsal is often broken with the same mechanism of injury of an ankle sprain, so the foot should be evaluated as well. If severe ligament injury is suspected, an MRI can evaluate the grade of injury. This is really what decides whether surgery is needed for full recovery.

Treatment for ankle sprains really depends on the degree of severity, which can only be determined by your doctor. Initial treatment always includes “R-I-C-E” therapy – Rest, Ice, Compression, and Elevation. Pain and edema is usually controlled with NSAID’s (non-steroidal anti-inflammatories) like ibuprofen. Bracing or casting coupled with non-weightbearing on crutches may be needed in more severe injuries to rest and stabilize the ankle while it heals. Return to pain-free ROM and stability is the goal. Surgery is only recommended in Grade 3 severe injuries in athlete’s or in those patient’s who have had multiple ankle sprains and suffer from chronic ankle instability. Long-term ankle instability can often be avoided with an aggressive physical therapy program. Bracing should only be used in the short-term during rehabilitation because long-term bracing actually causes atrophy and decreased ROM.

Physical therapy is needed for all ankle sprains. The goals of physical therapy should be to regain full ROM, strength and yes, your friend and mine: proprioception. Regaining strength as well as overall balance training are the keys to successful rehabilitation of an ankle sprain. A maintenance program of ankle strengthening, stretching, and proprioception exercises helps to decrease the risk of future ankle sprains, particularly in individuals with a history of multiple ankle sprains or of chronic instability.

Bottom line: if you happen to try to imitate Tony Parker and fall down and go “Boom” playing basketball or any other sport, have your ankle sprain evaluated by a podiatric foot and ankle surgeon. Delaying treatment and rehabilitation can lead to life-long instability and a really bad jump shot!

No comments: