The pain of sprain not easily tamed

New York Daily News—January 24, 2009

By Dr. Josh Dines and Dr. Rock Positano

There is no such thing as a simple ankle sprain.

More and more frequently, doctors are seeing patients who have incurred "simple" ankle injuries in the past, but are now complaining of ankle instability, arthritis and pain.

Ankle sprains are considered to be the most common orthopedic injury, with an estimated 2 million people per year seeking treatment.

Baby Boomers who start to exercise again are especially susceptible, experiencing ankle pain that may have been caused by old injuries that were never treated initially, and therefore never healed properly; arthritis in the ankle and chronic soft tissue injuries are often the result of having had inadequate or no treatment to begin with.

The typical ankle injury involves an unexpected, sudden loss of balance that results in abnormal twisting of the foot, ankle and the lower leg. There are four types of injuries that may occur after a sudden ankle twist.

In more severe cases, patients may require surgery to repair tendons and ligaments. Most ankle sprains, however, respond effectively to conservative treatment. The more ominous problem is denial by a patient that there is injury to the ankle in the first place, further delaying professional evaluation and treatment.

All too often a patient will turn to a doctor years after the injury, only to find advanced arthritis and soft tissue scarring and damage.

Nothing can ruin a jog in the park, a weekly tennis game, or a round of golf more than a painful ankle. "I thought it was a simple ankle sprain," simply doesn't fly.

This story originally appeared at nydailynews.com.

Drs. Dines and Positano write a new weekly column on sports injuries called X-Ray Vision in the New York Daily News and practice sports medicine at Hospital for Special Surgery. This is the inaugural column.