The Healing Process of an Ankle Fracture

By Steven Sapoznik for Athletico Physical Therapy

As all NBA fans know, the first major injury of the 2017-2018 season occurred to star The Healing Process of an Ankle Fractureguard of the Boston Celtics, Gordon Hayward. Gordon suffered an ankle fracture 5 minutes and 15 seconds into the start of the season.

Gordon successfully underwent surgical stabilization of his fractured tibia and dislocated ankle and is on the road to recovery that will include many hours of physical therapy in hopes of resuming his professional basketball career. With ankle fractures catching the medical headlines over the last week, Athletico would like to shed some light on the subject.

Fracture vs. Break

Over the years as a physical therapist I’ve often gotten the question, “’What is a fracture and what is a break?’” Most are surprised to hear that they are one and the same. While both are acceptable, ‘fracture’ is the medical term to describe a break of the bone whereas ‘break’ is considered the layman’s term.

Types of Fractures

The ankle joint is made up of the tibia, fibula and talus. Ligaments, tendons and muscles surround these bones to add stability and function to the lower leg. Not all fractures of the ankle are the same. The classification of the fracture depends on the severity and bones involved in the injury. Examples include medial malleolar and bimalleolar fractures. A medial malleolar fracture involves the bony prominence on the inside of the ankle whereas a bimalleolar fracture involves both the inside and outside bony prominence’s of your ankle.

Surgery vs. Conservative Care

The determining factor for managing a fracture with surgical or conservative interventions depends on the extent and severity of the injury. If a fracture is stable and does not involve other structures surrounding the joint, a period of immobilization with modified weight bearing status may be all that is necessary before beginning physical therapy. Conversely, an unstable or compound fracture of the ankle will most likely require surgical stabilization before initiating physical therapy.

Physical Therapy Following Ankle Fractures

Physical therapy is initiated at the time that a fracture is deemed healed, regardless of surgical status. After a fracture and period of immobilization, muscle atrophy, loss of range of motion and difficulty walking on uneven surfaces typically occur.1

Timelines will vary based on individual patients, however standard physical therapy of an ankle fracture typically begins with gentle range of motion exercises, gait training, and strengthening.2 Once ready, balance and proprioceptive exercises are initiated at 4-6 weeks.2 Gradual return to normal activities usually begins around the 6-8 week mark and full return to activities is typically allowed in the 3-6 month range.2

Making a Comeback

While Gordon Hayward may be out for the rest of the season, he will be in a great position to make a comeback with physical therapy treatment in the coming months. The best part about physical therapy is that you don’t have to be the next NBA star to benefit from it. Physical therapists specialize in rehabilitation of conditions of the musculoskeletal system. If you have an injury or unusual aches and pains, schedule an appointment at a nearby Athletico clinic so we can help you feel better and make your comeback. 

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The 6 Main Causes of Dance Injuries

Dance Injuries

Dance injury rates are significantly statistically higher than that of other sports. A study by Wolverhampton University found that professional dancers are more likely to suffer injuries than rugby players.

Statistics show that 80 per cent of dancers incur at least one injury a year that affects their ability to perform – compared to a 20 per cent injury rate for rugby or football players. Whilst not a contact sport or explicitly high-impact, dance training is intensively challenging and highly demanding for even the most conditioned and able athlete. Here we look at the six main causative factors that result in dance injury.

1. Anatomical Causes

Natural physical limitations and constraints may limit the development of a perfectly correct technique. Correct technique – beyond being prerequisite for professional success – is a fundamental element of avoiding dance injury. This is evident in the fact that the communist anatomical cause of potential problems and injuries is limitation of turn-outs (external rotation) of the hips. As such it is vital that the dance student and teacher recognise any potential physical limitations early on, so that the dancer may learn to work within their true physical range.

2. Incorrect Technique

When dancers allow their technique to slip – usually due to fatigue – they put themselves at a much higher risk of injury. Commonly this becomes an issue towards the end of a long tour or performance run. Slipping technique is why, typically, injury rates among cast dancers increase throughout the duration of a tour. Quickly learning and performing new, unknown choreography can also create injury issues, as regardless of the ability of the dancer, they have had insufficient time to become accustomed to the movements and fine-tune their technique accordingly.

3. Poor Coaching

As with all sports and athletic disciplines, expert teaching and coaching for the development of technical knowledge is vital. It is the responsibility of an excellent and highly knowledgeable dance teacher to be able to recognise, and react accordingly to, any anatomical weaknesses, physical limitations or onset of injury evident in the dance pupil. Furthermore it is imperative that they correctly relay and instill the fundamentals of correct technique and advise upon supporting lifestyle and cross-training that ensure optimum health, well-being and physical performance of the dancer.

4. The Floor

The floor is an extremely important environmental factor to the health and performance of a dancer. Purpose-built dance floors are vital in rehearsal and performance spaces. Floors that are not built for purpose do not provide sufficient supportive impact. Sprung wood floors support dynamic movement; reinforced, concrete or non-sprung wood floors create unsupportive and unsustainable support for the joints, which is highly detrimental to the physical health of the dancer in the long term. Lack of spring in the floor can produce many injuries, notably foot problems, injuries in the lumbar region of the spine, and in the muscles which are associated with take off and landing – mainly the tibia and metatarsals, which may result in stress fractures.

5. Temperature

Ambient temperature of rehearsal studio and performance space is of utmost performance in avoiding dance injury. Dancers have to take extra care to not get too cold before or after practice in order to avoid muscular injury. A standard advised temperature for a training and performance space is 68-70 degrees Fahrenheit, and should not be allowed to drop below this range.

6. Excessive Practice

Unavoidably, dancers often adhere to grueling training schedules – a necessary requisite to master the art, and a mainstay of rehearsals for dance productions and tours. Obviously this presents a high risk factor for creating overuse injuries, particularly when a dancer must continue to train at high intensity with an existing injury. Clearly the combination aforementioned factors – excellent physical cardiovascular fitness, diet, training, technique, ability and training environment – greatly reduces the risk of injury under the demanding training schedules of a professional dancer, however dancers at the top of their game still frequently incur significant injury.

By SportsInjuryClinic

Proper Training Shoe Selection; When is Surgery not an Option?; Bone Loss & Osteoporosis

Episode 17.16 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One (01:31): Steve and Dr. Cole talk with Perry Miroballi, the Co-Owner of New Balance Fresh Foam 822v3 Trainer, Pisces with Black & Poisonberryfour New Balance Stores, about proper athletic shoe selection; providing video analysis and foot scans to determine pressure points and arch type; the wide variety of sports specific shoes that are now available from New Balance and the advancements in New Balance shoe technology. More than 500 major league baseball players now wear New Balance Shoes and they now make a golf shoe that is only 7 ounces, the lightest shoe in golf.


Segment Two (12:52): Steve and Dr. Cole talk about a wide range of non-surgical options for pain and orthopedic problems and how the art of medicine serves to determine the right approach to treating injuries.


Segment Three (20:08): Steve and Dr. Cole talk with Dr. Chris Stout, Vice President of Research and Data Analytics at ATI Physical therapy. The discussion centers around bone loss,  osteoporosis and calcium deficiency; the importance of proper life style, exercise and nutrition to minimize the effects of bone loss. Dr. Stout is also on faculty of the College of Medicine at the University of Illinois, Chicago. He has published over 35 books and been translated into eight languages. He founded a 501(c)(3) to work on international humanitarian projects, and subsequently has won five international humanitarian awards and four additional honorary doctorates.

Juvenile Arthritis

Juvenile arthritis is the term used to describe arthritis in children younger than 16 years. Juvenile arthritis is twice as common in girls as boys and the most common type is juvenile idiopathic arthritis (JIA). Juvenile idiopathic arthritis is an autoimmune disorder affecting the joints of the knee, hands and feet. It causes pain, swelling, stiffness, and feeling of warmth in the joints. The probable causes of JIA include autoimmune condition, genetic factors, and environmental factors.

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