Welcome to Ask a Doctor!
Every week we’ll be asking our CarePoint Health doctors some questions that we’d all like to know the answers to. Let's introduce Doctor Thomas Azzolini! Dr. Azzolini is chief of podiatry at Hoboken University Medical Center. With spring here and summer around the corner we're sure you are doing more exercise. This week, we are asking him questions about ankle sprains to keep those feet moving!
Q: How does an ankle sprain occur?
A: Ankle sprains occur when the foot twists inward or outward under the weight of the body with a force that the ankle ligaments are unable to resist and are therefore injured. High ankle sprains involve tearing of the ligaments that hold the two leg bone together above the ankle. This twisting motion can be initiated by stepping on uneven or slippery surfaces, wearing shoes that are loose, high heeled or otherwise unstable and playing sporting activities with aggressive motion and jumping such as basketball, soccer, tennis and volleyball. Instability from previous sprains can lead to recurring sprains and chronic instability.
Q: Who is susceptible to chronic ankle sprains?
A: People who are more susceptible to ankle sprains include those with inherent ligamentous laxity, rigid high arched feet, low muscle tone or balance issues and inadequate healing of previous ligament or tendon injuries. Ankle sprains are most common in male patients between the ages of 15-24 and females over the age of 30.
Q: What does an ankle sprain feel like?
A: Patients who have suffered an ankle sprain will frequently experience swelling and possible black and blue formation to the inside or outside of the ankle. They will have pain when standing walking or moving the ankle but are generally still able to walk. They will relate sharp pain to the ankle or foot at the moment of the sprain and with severe sprains will often describe a popping or tearing sensation. They may feel unstable when walking following the sprain.
Q: How do doctors diagnose the condition?
A: The initial diagnosis of an ankle sprain is made through physical examination. Pain is noted at the damaged ligament by pressing the area directly overlying ligament and by putting the ankle through a range of motion. Simple x-rays taken in the office or hospital setting can rule out fractures and help assess joint alignment. MRI testing can confirm the damage to ligaments and tendons that was suspected during physical examination. An MRI can also reveal damage to cartilage and subtle fractures that are not seen on plain x-rays.
Q: What treatment options are available?
A: Treatment for grade one sprains where the ligaments are only stretched or inflamed involves conservative treatment and consists of ice application, compressive wraps, elevation, ankle supports, anti-inflammatories and physical rehabilitation. These conservative treatments will often fail to allow adequate healing of grade two or three sprains where ligaments are partially or completely torn. Innovative surgical procedures are now available for the repair of damaged ligaments through small or even minimal incisions. These procedures utilize new technologies that enhance the stability of the repair and speed healing. This allows for early rehabilitation and a quick return to physical activity. A new technology harvests components of the patients own blood that are then used to trigger an aggressive healing response with no risk of infection or rejection as the patient’s own cells are utilized. These procedures often take only minutes to perform and can frequently be done under local anesthesia or simple sedation.
Q: Where can I find more information?
A: I will be glad to answer your questions regarding ankle sprains or any other ankle and foot pathology. Patients can contact me at Info@njfootcare.com.
Dr. Thomas Azzolini’s deep knowledge and experience in foot and ankle surgery is a result of decades of research, training and practice in the field. Dr. Azzolini is Board Certified by the American Board of Podiatric Medicine and the American Board of Podiatric Surgery. He has served as the Chief of the Podiatry Division and the Director of Podiatric Surgical Residency Training at Hoboken University Medical Center for nearly 20 years. He is a Fellow of the American College of Foot and Ankle Surgeons the American College of Foot and Ankle Orthopedics and Medicine. His practice, Ankle and Foot Specialists of Hoboken, is located at 59 14th Street, Hoboken, New Jersey, 07030, and the office can be reached at 201-222-5200.