Ankle aches could become chronic injuries

Feb. 20, 2003 at 2:23 PM
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ORLANDO, Fla., Feb. 19 (UPI) -- The career-threatening ankle injuries experienced by basketball star Grant Hill and tennis player Martina Hingis highlight the importance for weekend athletes to seek medical attention for nagging aches and pains before they turn into chronic problems, experts said Wednesday.

Many people who suffered ankle sprains during their youth may not have completely healed. They could be at risk for doing more serious damage as they enter their 30s and 40s and initiate exercise programs, two podiatric surgeons, speaking from the annual meeting of the American College of Foot and Ankle Surgeons, told United Press International.

"This is a fairly common problem especially as patients get into their 30s and 40s," said Dr. Bruce Werber, who has a private practice in Warwick, R.I., and is incoming president of ACFAS.

Hill may have done irreparable damage to his left ankle by continuing to play on it after breaking it in 2000. He has undergone three surgeries but continues to suffer from chronic tendonitis.

Hingis had surgery on her left ankle last May and doctors doubted she would be able to play at the professional level again. Her attempts at a comeback have been hampered by the injury and she most recently withdrew from the Australian Open in December, saying she needed more time to recover from the surgery.

If people have been leading rather sedentary lifestyles, they may be unaware of any lingering damage from the original injury, Werber said. But "as they start resuming running or start playing tennis, all of a sudden as they increase the intensity of activity they'll notice," he said.

"They'll feel instability ... like they're ankle is rolling over, they have discomfort," Werber said.

"A lot of the injuries that we see in our older patients are injuries that happened as children" and "that had nonexistent or incomplete rehabilitation," said Dr. Robert Duggan, a foot and ankle surgeon in Orlando, Fla., and sports medicine consultant to Walt Disney World's Wide World of Sports.

"We're seeing injuries more commonly now in young kids," Duggan said. "Then we see another peak when you get to about 30 to 40."

Symptoms include chronic ankle pain, instability and nagging soreness, he said. "Some of the athletes think sore ankles are normal and that's not the case," he said.

The ankle problems can be due to a small crack in cartilage or bone or tears in the tendons that never healed completely, Werber said.

There can also be injuries to ligaments and weakness in the muscles that is secondary to the injury, Duggan said. In addition, arthritis may develop in the ankle joint as a result of a previous injury.

The good news is that doctors may be able to detect and treat these old injuries.

If people are experiencing soreness and irritation in the ankle area, they should see a foot and ankle surgeon and get it evaluated, Duggan said.

Doctors may use X-rays or exploratory surgery to diagnose the problem. Therapy may include anything "from simple home exercises to surgical procedures to correct it," Duggan said.

"There's a whole range of activities ... we can do for them," Werber said.

"A lot of times bracing or orthotics (a pad placed in the shoe to correct improper foot motion) will help," he said. Other options can include cortisone injections and physical therapy, he said.

(Reported by Steve Mitchell, UPI Medical Correspondent, in Washington)

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