ANKLE SPRAIN: WHEN CAN I PLAY AGAIN

By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Recovery and return to play after ankle sprains will vary depending on the severity of the injury, and the injured athlete’s unique healing response
  • Sport specific reconditioning after an ankle sprain often takes much longer than you think
  • For the common Grade 1 sprain, I typically see return to play with a brace at 1-2 weeks after injury
  • For the common Grade 2 sprain, I typically see return to play with a brace at 4-5 weeks after injury

There’s never a good time to be injured. As we come up to the end of many winter sports, SwollenAnkle_2players often have their eyes on championships or important tournaments. When an injury happens one of the most important questions the young athlete wants to know is “when can I play again?” Usually their point of reference is the newsfeed on some professional athlete’s injury, and the answer from the news media is almost always “2-3 weeks.” The reality, however, is that full recovery as I outline below can often take much longer than that. Let me outline the general phases for injury recovery, and finish with some rough timelines for return to play after ankle sprains.

Treating the Injury

The treatment phase involves the healing of the injured part. For an ankle sprain, this may involve a brace, sometimes crutches, and typically “RICE”: rest, ice, compression, and elevation. Ankle sprains are classified by physicians in “grades”, ranging from Grade 1 (mild) to Grade 3 (severe, with complete ligament tear).

Rehabilitating the Injury

Once the treatment for the injury has started, the next phase of recovery begins. This will often involve referral to a qualified physical therapist or working with your athletic trainer. The physical therapist and athletic trainer are highly trained in techniques to restore function of the injured ankle, develop a plan for sport-specific training, or suggest equipment modification such as bracing. For many injuries we’ve learned over the years that early involvement by an athletic trainer or physical therapist speeds up return to play.

Conditioning the Injured Athlete for Return to Play

Here’s the part that can take some time, often much longer than you initially realize. Let’s say you’ve had a significant ankle sprain. You were treated in a brace for 2-4 weeks, and then you started getting some movement skills back for another 2-4 weeks. Now we’re up to 4-8 weeks from the time of your injury, and you know what you haven’t been doing- practicing or playing sports. Getting yourself fit will take a few more weeks (or even months, if you’ve been out a long time). In this phase we will usually rely on the trainer to start sport specific conditioning drills designed to safely return you to play.

Putting it All Together- How Long Until You Can Play Again?

ssd.bannerI’ve broken the process into “phases” above, but the reality is that there’s a lot of overlap between the phases. For example, treatment and rehabilitation will be going on at the same time and will overlap, and rehabilitation and conditioning will also overlap. Additionally, each person responds differently to injury and healing. So each situation can vary quite a bit with the specifics of your injury, but here are some very rough guides based on real world experience from my orthopedic practice.

  • “Mild” or Grade 1 ankle sprain: Brace or Ace wrap for 3-5 days, Return to play with ankle brace 1-2 weeks
  • “Moderate” or Grade 2 ankle sprain: Brace 2 weeks, Rehab and conditioning 2 weeks, Full return to training 4-5 weeks after injury
  • “Severe” or Grade 3 ankle sprain: Boot or brace 3 weeks, Rehab and conditioning 4-6 weeks, Full return to training 7-9 weeks after injury
  • “High Ankle” or syndesmosis sprain (highly variable return times): Boot or cast 3 weeks, possibly crutches as well, Rehab and conditioning 6-12 weeks, Full return to training 9-15 weeks after injury

WEIGHT LOSS: DIETS DON’T WORK-MCTs DO

Quick weight loss

While you may have lost some weight dieting, were you able to keep it off for good? If not, you’re in the majority. This is because diets are fundamentally unsustainable.

To lose excess body weight healthfully and permanently, it takes patience and quality upgrades to your eating and exercise habits.

The good news? Lasting weight loss IS attainable when you:

  • Dedicate yourself to a nutrient-dense diet
  • Increase your activity level
  • Let go of counting calories and focus on creating healthy habits that last

We understand this is a slow progression and tough to stick to, which is why we created our MCT products to help expedite the process and promote quick weight loss.

(Also, see founder and health counselor Karen Malkin’s individual weight loss program offerings.)

FIGHT FAT WITH FAT

The idea that eating healthful fat makes you fat is a myth. Eating refined carbohydrates, sugar, trans fat, and highly processed vegetable oils makes you fat!

The body is an adaptive organism regulating hormone secretion and enzyme production in response to the food we eat.

So, when you ingest more MCTs, your body becomes more efficient at mobilizing fat stores as energy.

As a result, even in the presence of some carbohydrates, the body will begin breaking down its own fat to power ordinary, everyday functions. (Which means quick weight loss!)

Here are some compelling studies that show how incorporating MCT Oil can help you lose the weight and keep it off:

  • MCTs given over a 6-day period was shown to boost metabolism by 50%
  • Metabolism may remain elevated for at least 24 hours after eating a meal that includes MCTs
  • During a high-calorie diet consisting of either 40% fat as MCTs or 40% fat as LCTs, the MCT group burned almost 2x the number of calories in the LCT group
  • About 1-2 TBSP of MCT oil per day resulted in a lower endpoint body weight than did the same amount of olive oil during a 16-week weight-loss program. Also, those in the MCT oil group trended towards greater fat loss and less abdominal fat mass than those in the olive oil group
  • After eating a meal containing MCTs, normal-weight individuals increased their energy expenditure by as much as 48%, while overweight participants increased theirs by as much as 65%

CLICK HERE TO LEARN MORE ABOUT MCT

Want to get on the road to quick, lasting weight loss?

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The Gift of Bone -Twice!

By Matt Arrasmith, tissue recipient

m-arrasmithLike most boys in middle school, sports were my passion.  I played baseball, basketball, football, ran cross-country and enjoyed pretty much anything where I was active.  When I was in the seventh grade, I began to experience knee pain – but as most teenage boys would be told, it was shrugged off as just growing pains. As the years passed, the pain continued to get worse and finally my parents took me to the doctor where they did an x-ray of my knee.  At first it appeared that nothing was wrong, but thankfully my doctor delved deeper. Little did I know, my world would be turned upside down.

I had just turned 15-years-old, in March of 1996, when I was diagnosed with bone cancer in my leg.  My parents and I were told the particular type of cancer I had, chondrosarcoma, does not respond to chemotherapy and the most common treatment is amputation. This was devastating news. To say that we were matt-grad2stunned was an understatement. This would have meant as a 15-year-old athletic young man, my left leg would have been amputated at the hip.  My life would never be the same.  It is pretty rare that this cancer is contained within the femur but I was told that my tumor was contained. Because of that silver lining, my doctors recommended a brand new procedure.

They suggested that the six-inch portion of my femur containing the tumor be taken out and replaced with donor bone. I underwent three surgeries, including a 12-hour procedure, and then spent about a year on crutches. Today, after a total of six surgeries on my leg, including one in 2011 where I received a second amazing gift of donor bone, I am still walking and enjoying life. And, unfortunately while playing certain sports is no longer an option, I still have my leg!

m-arrasmith-dartsI took part in the 2016 Transplant Games of America, playing Texas Hold ‘em poker, bowling and golf, thanks to the generosity of my donor. It was an awesome experience, meeting people from across the country who have been touched by organ, eye and tissue donation.

I am thankful to all of the doctors that helped drastically change my life. But I am most thankful to my two bone donors – I was incredibly lucky to have had the option of using donor bone to save my leg – and my life as I know it. Won’t you say “yes” to organ, eye and tissue donation?

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Hip Replacement: Patient Education Digital Flipbook

The DJO Surgical Hip Replacement, Direct Anterior Approach Patient Flipbook is an interactive, digital magazine that can be viewed on digital devices such as iPads and other tablets, laptops and smart phones. The Flipbook is designed to be flipped through like a magazine but with interactive image pop-ups, patient testimonial videos, and surgical procedure animations.

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VIEW THE FLIPBOOK

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