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Dr. Josh Dines and Dr. Rock Positano

Dr. Josh Dines and Dr. Rock Positano

Posted: February 4, 2010 02:15 PM

Super Bowl May Hinge On Ankle....

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We are all closely watching the recovery of Defensive End Dwight Freeney in anticipation of the competitive New Orleans Saints and Indianapolis Colts Superbowl Showdown. Dwight is reportedly "coming along" with a sprained right ankle and will hopefully but ready for action on February 7th.

An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. In the ankle joint, ligaments provide stability by limiting side-to-side movement at the joint between the end of the shin bones ("tibial plafond" and "fibula") and the ankle bone ("talus"). The most frequently seen sprain occurs when weight is applied to the foot when it is on an uneven surface, and the foot rolls over on the outside. Because the sole of the foot is pointing inward ("inversion" injury) as force is applied, the ligaments stabilizing the lateral - or outside - part of the ankle are stressed. Less commonly, the ankle can twist outward ("eversion" injury), resulting in injury to the other ligaments on the inside of the ankle joint ("deltoid" injury). The severity of the ankle sprain depends on whether the ligament is stretched, partially torn, or completely torn, as well as on the number of ligaments involved. Higher-grade injuries with complete disruption of the ligaments often result in an inability to bear weight on the leg and are accompanied by significant swelling and bruising around the ankle. Athletes will typically recall a specific traumatic event and will be focally tender to palpation along all of the injured ligaments on the inside and/or outside of the joint. Severe "inward" sprains ("inversion") may also injury the tendons on the outside of the ankle ("peroneal tendons") and even stretch and irritate the lateral nerves of the ankle and foot ("superficial peroneal nerve").

Any ankle sprain requires prompt medical attention. The sooner treatment starts for a sprained ankle, the greater the chance to prevent chronic pain and long term instability. Many of the problems resulting from sprains are due to a failure to recognize the potential severity of the injury. The fundamental tenets of treatment are rice, icing, compression, and elevation. The vast majority of ankle sprains will heal without surgery, although certain "high ankle sprains" or those with associated fractures may require surgical treatment. Surgery may also be indicated for athletes with recurrent ankle sprains and persistent instability that prevents a return to competitive sport.

We hope that Dwight, Peyton, and the rest of the Colts squad is healthy and ready for what will certainly be a competitive and exciting match up with the Saints.