Ankle injuries affect just about everyone at some time in their life, but they occur most frequently in people involved in sports, especially those between the ages of 15 and 24. With spring sports in full swing, the likelihood of an athlete suffering a sprain may increase, along with other foot and ankle injuries. Ankle sprains occur in an average of 25,000 people per day, and more than one million people per year come to emergency rooms for ankle injuries. While rest, ice, compression, and elevation (aka RICE) will work on minor injuries, major injuries will need the help of experts.
Ronald Derr, D.O. is a board-certified orthopaedic surgeon specializing in foot and ankle surgery. He earned his medical degree from Ohio University College of Osteopathic Medicine, and completed residency training in orthopaedics at Ohio University-Doctors Hospital in Massillon, Ohio. He went on to complete a sports medicine fellowship at the American Sports Medicine Institute in Birmingham and a foot and ankle fellowship at Good Samaritan Hospital in Cincinnati. He is a member of the American Foot and Ankle Society, American Osteopathic Academy of Orthopedics, Tennessee Osteopathic Society and Tennessee Medical Association. Dr. Derr has been an integral part of the Bone and Joint practice since 1996 and currently serves as team physician for Ravenwood High School.
Williamson Source: One of your specialties is sports medicine related to the foot and ankle, what does this entail?
Dr. Derr:I work with lots of ankle sprains, Achilles’ tendon ruptures, fractures and tendonitis. In immature kids, we see lots of overuse growth plate injuries. Mainly we see a lot of foot and ankle overuse injuries because people are not giving their bodies the time needed to rest and recover after sports activity.
WS: Ankle sprains are the most common foot/ankle injury, what causes them?
Dr. Derr: Ankle sprains are a twisting injury. In sports where participants jump, run, move from side to side or in some other way that they might land on their ankle or foot incorrectly, a sprain is possible. They may land on uneven ground, trip on their own feet or another player’s foot that causes them to twist the ligaments beyond comfort level. These sports activities may include basketball, volleyball, tennis or track, to name a few.
WS: Are there different levels of sprain?
Dr. Derr: There is a three-level scale for sprains. Level One is when the ligament has been stretched, but there are no tears. It is actually the most uncomfortable. Level Two is when the ligament is partially torn. Level Three is when there is a complete tearing of the ligament. With each level of damage there is more instability. If a sprain keeps the participant down for more than a couple of days, then it is important for them to see a healthcare specialist.
Forty percent of those who suffer from a bad sprain will have pain afterwards, often from a deeper injury that has happened to the joint or bone.
WS: What other types of injuries do you deal with as spring sports ramp up?
Dr. Derr: Stress injuries and overuse injuries. People push their bodies beyond their limits and beyond the threshold of normal use. They may get stress fractures or injuries where they may not see a break or a crack, such as a bone bruise or tendonitis.
You will see stress injuries in runners, especially as they are building up towards a big goal like a marathon. Their body may not be accustomed to what they are pushing it toward because they are ramping up training too quickly.
In spring sports, especially track, you will see leg pain, shin splints and stress injuries. This is because there has been little to no pre-training such as running or appropriate exercise in the off season to prepare for the competitive season. Getting too intense too quickly, instead of leaving time for the body to recover, increases the likelihood of injury.
WS: How can athletes (and others) prevent these injuries?
Dr. Derr: One of the best things athletes can do is cross train. Start with low impact activities, such as biking, swimming, rowing or running in the water. Many workout facilities with pools have flotation devices that allow for aqua training. These low impact exercises minimize wear and tear on the body’s function while building up strength and resistance. These exercises are also recommended for people who are trying to get back into a healthy lifestyle with exercise.
WS: What foot and ankle issues do you treat other than those related to sports?
Dr. Derr: I work with all foot and ankle injuries – hammer toes, bunions, arthritis, fractures, chronic tendonitis, nerve impingement, boney tumors, soft tissue tumors, Achilles tendon injuries and adult painful flatfoot deformities. Some of these injuries occur while playing sports and others are more chronic in nature and can occur over time.
WS: How can people minimize foot and ankle injury?
Dr. Derr:
These are a few ways that foot and ankle injury can be minimized.
- Participate in activities that take place on more balanced surfaces where feet and ankles are less likely to get twisted. Also, activities that go straight ahead instead of side to side will create less injury. For example, biking, cycling, running and swimming are safer than tennis or pickleball.
- Wear updated shoes. The more worn a shoe, the less shock absorption, stability and comfort it has.
- Start an exercise routine with high repetition, low resistance exercises then build from there. Acclimate into a sport; don’t go from zero to 100 mph.
- If you know you have a chance of an injury, wear a brace or tape your ankle. Braces are best, as support from taping loses effectiveness after 30 to 45 minutes.
- Maintain a healthy weight.
WS: What are the biggest innovations in foot and ankle treatment?
Dr. Derr: Minimally invasive bunion surgery avoids large incisions, meaning that fewer soft tissues are damaged, creating less pain and less foot swelling. It is performed with a burr instead of a saw to cut the bone. This allows the bone to be removed through tiny incisions instead of using traditional techniques. Recovery time is minimized.
Also, total ankle replacement surgery is an option versus ankle fusion. Being able to maintain ankle mobility means less stress on the other foot joints and bones over time.
There are innovations in biologicals that help with healing of joints and soft tissue injuries. One is Platelet Rich Plasma (PRP). Blood is taken from the patient’s arm, then it is sent through a centrifuge and the plasma is separated. It is then injected into the damaged joint or muscle. Platelet activation plays a key role in the body’s natural healing process, speeding it up.
WS: Any parting advice on how to minimize foot and ankle injuries for those who are starting a spring exercise routine?
Dr. Derr: I just want to reiterate to start slow. People need to acclimate into an exercise program. Don’t jump into a Boot Camp or strenuous exercise program after doing nothing for a long time. Take a slower pace, cross train, and go slow with activity progression.
If you are suffering from foot or ankle pain, contact Bone and Joint Institute.
To learn more about recovery from sports and other foot and ankle injury, contact Ronald Derr, D.O. at (615) 791-2630. Or schedule an appointment online.
