Sports injury recovery can't be rushed
Researchers report in the American Journal of Sports Medicine, that too many athletes treat ankle sprains lightly, and return too quickly to the game.
Complete rehabilitation leads to fewer complications down the road,” say researchers. “Based on our review, we recommend that athletes with a sprained ankle complete supervised rehabilitation before returning to competition,” says Stephen B. Thacker, MD, of the National Center for Injury Prevention, and one of the study’s authors. “Keeping an injured player out of play is a short-term compromise on team performance. But it’s a long-term benefit for the team because the athlete will be in better condition.”
ANKLE SPRAINS and STRAINS
No one wants to sit on the bench, least of all Olympic hopeful Angie Cummins. When she turned her ankle running on vacation in Mexico last summer, her first thoughts centered on her rowing career.
“I didn’t really care about the pain,” says Cummins. “Immediately, I wondered, how is this going to affect me? That’s all I could think about. How long is it going to take me to get back into rowing?”Cummins suffered the most common kind of sprain. The ligaments on the outside of the ankle stretched when her foot suddenly turned inward. “I went down,” she explains. “And I jumped back up thinking I’d just walk it off. But I fell again, like there was nothing there.”
The ankle is actually a series of joints between the two lower leg bones and the heel, which allows the foot to rock in and out. It’s supported by ligaments, which bind one bone to another.
“Think of your feet as the foundation of a house,” says Cummins’ athletic trainer Vinny Comisky. “If the foundation of your house isn’t stable, the rest of the building will fall into disarray.”
Comisky further explains that a sprain causes pain in one specific area. “By contrast, strains occur when you hurt muscle tissue or tendons that connect muscle to bone. That pain covers a larger area, like a sore back or tension strain in your shoulders.”
TAKE TIME TO REHABILITATE
Sports like basketball, volleyball, soccer and football often cause both sprains and strains. They pose unique risks for players’ ankles making sprains common. Players jump a lot, and often land on one foot. Or they make sharp, cutting moves. Everyday life presents plenty of risks too, as people navigate wet surfaces, uneven ground, curbs and stairways. Many who turn their ankle minimize the injury, and try to limp it off. But that’s a costly idea according to experts.
“The next thing you know, your knee is sore,” says Comisky. “Or you start to get a sore back or headaches. And your ankle can lose stability.”
Researchers report that the most common risk factor for an ankle sprain is a history of a previous sprain. That’s why complete rehabilitation pays off. “It takes time,” says Comisky. “But those who rush recovery may risk another sprain, a broken bone or even surgery.” Similar to bone fractures, the healing rate for a sprain is about six to eight weeks. Severe sprains can take longer to heal.
RICE METHOD
The American Academy of Family Physicians, describes the RICE method for treating sprained ankles -- rest, ice, compression and elevation. They strongly recommend staying off the injured ankle, and advise applying ice to reduce swelling and pain. Compression or wrapping the ankle with a strip of elastic cloth gives support, but wrapping too tightly slows circulation.
Keeping the foot raised decreases pain and swelling too, and it’s best to elevate the ankle at the same level as the heart. Lying on a couch with pillows under the foot is better than sitting in a chair with the foot on a footstool.
PREVENTION
The recent study appearing in the American Journal of Sports Medicine recommends the following guidelines:
Athletes with moderate to severe sprains should wear an ankle brace for at least six months.
Pre-season conditioning should be planned to optimize performance and prevent injury.
Strength, flexibility and balance should be emphasized during the preseason and season to reduce injuries.
Stretching and warming up should precede all intensive practices or games.
Ankle braces do not compromise athletic performance and are more effective than taping, which can loosen up after 10 minutes of play.
Coaches should be sensitive to fatigue, since tired players may be at greater risk for injury.
“Reinjury could be worse than taking time for recovery,” says Comisky. “I would suggest that it’s better to err on the side of caution. After you feel better, begin slowly. Give the ankle a little rest as you get back into your activities. If it hurts, it’s telling you something. Maybe sit down, and ice it for 20 minutes, and see how your body reacts. Going step by step is the best way to gradually regain full function and stability.”
