Titus Brown out with High Ankle Sprain

Cleveland Browns’ linebacker Titus Brown will be sidelined with a high ankle sprain. The Browns have been pummeled with injuries this preseason. Titus Brown will join teammates Eric Steinbach (tackle) and Brandon Jackson (running back) and Jordan Norwood (wide receiver) on the injured list. With a season opener on September 11 against the Cincinnati Bengals, things are not looking good for Cleveland.

A high ankle sprain is an injury to the syndesmosis between the tibia and fibula. The ligaments that attach the tibia to the fibula aid in stabilizing the ankle joint. These ligaments can become sprained or even torn when the leg is forced to rotate outwards with a planted foot. This is a common injury in contact sports, football in particular.

The syndesmosis is composed of the anterior and posterior inferior tibiofibular ligaments. In a sprain, usually only one of these ligaments is injured. The syndesmosis can also be injured in ankle fractures, where the fibula is destabilized and allowed to rotate.

The diagnosis is usually suspected through history and physical examination, and may be confirmed with x-rays and an MRI. MRI may not be necessary for everyone, but can help differentiate between a sprain and a tear of the ligaments. For high-level athletes, MRIs are typically ordered swiftly.

Once the diagnosis is confirmed, high ankle sprains are treated with a period of immobilization in a cast for about 6 weeks. Anti-inflammatory medications and pain relievers may also be used in conjunction with immobilization to relieve the symptoms. Following immobilization, a period of rehabilitation will begin. This generally involves aggressive stretching and strengthening exercises, with a slow return to full weight bearing and activity.

For cases requiring surgery, a screw may be placed across the syndesmosis from the fibula to the tibia. This screw helps immobilize the joint while the ligaments heal, and is left in place for about three months. Patients are instructed not to walk on the leg while the screw is in place, as it could break with motion. The screw is taken out once the ligaments have healed, and an aggressive physical therapy rehabilitation program begins.

As for Brown, no surgery has been scheduled, and he’s been placed in a cast. For Cleveland Browns fans, this is good news, as the linebacker will likely return later in the season. While he won’t be ready for the regular season opener, he may be ready to return to play mid-season.

Central Florida Foot and Ankle Center, LLC.101 6TH St. NW. Winter Haven, Fl. 33881 863-299-4551http://www.FLFootandAnkle.com

Lions’ Leshoure Out with Achilles Rupture

Detroit Lions rookie running back Mikel Leshoure will be out for the season following an Achilles tendon rupture sustained during practice on Monday. The Lions drafted Leshoure in the second round from the University of Illinois, and were hoping to have him take turns carrying the ball with Jahvid Best. Of Leshoure, Coach Jim Schwartz said "He’ll have surgery very soon, probably tomorrow, and he’ll be back. He won’t be back this year, but he’ll be back. And he was doing very well."

Achilles tendon injuries can be a career-ending injury, which certainly takes some air out of the tires of the Detroit Lions, who sports pundits are predicting to have a turn-around year. In a systematic review of statistics from the NFL, Parekh et al showed that 36% of skill-players (running backs, wide recievers, defensive backs, cornerbacks, and linebackers) never returned to play professionally.

The study analyzed the power ratings of the players who did return to play professionally. Power ratings are statistics used to measure a player's level of play, such as rushing and passing yards. Of the 64% who returned to play (21 players total), all showed a significant decline in their power ratings as well as the number of games played. This 64% is slightly lower than the previously reported 71% of patients returning to full activity following surgical repair of Achilles tendon ruptures. This difference may be attributed to size, weight, strength, and overall physical demand of professional football players when compared to the average young athlete.

The study by Parekh et al looked at the three seasons before injury and the three seasons following injury, and averaged statistics for the players over those three years. It was found that the power ratings fell by average of almost 50%, and that the amount of games played fell from 11.67 to 6.17. This suggests that even if a player is able to recover from the injury and return to their previous level of play, they may never regain their original quality of play.

Current treatment regimens hinge on surgical repair of the ruptured tendon. While studies have shown promising reults with conservative non-surgical treatment combined with aggressive rehabilitation protocols, the incidence of re-rupture is lower in surgically repaired Achilles tendons, and the time to full recovery is also faster. Surgeons are trending towards earlier, aggressive physical therapy regimens following surgery instead of the six to eight weeks of immobilization previously set as the standard of care.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Better Workout – Running or Walking?

Whether walking or running provides a better workout is a debate that could go either way, and could be discussed for hours. Advocates of each can point out the benefits of their exercise method of choice. In the end, the truth is that either form of exercise is generally good for you, and the choice should come down to which you are more comfortable with. Regardless of which side you’re on, here are some tidbits about each that might help you make up your mind.

Yes, running will burn more calories that walking. However, this is only true when you compare them based on the amount of time each activity is performed. When you compare them based on distance, the amount of calories burned is the same. For example, running for twenty minutes will burn roughly twice as many calories as walking for twenty minutes. However, running three miles and walking three miles will burn the same amount of calories.

Running or jogging can work different muscles than walking, and can work them harder. This is because more force and strain is placed on the muscles while running. However, walking allows your body to be a state of elevated cardiovascular demand for a longer period of time, which will actually help improve cardiovascular health over time, perhaps even more so than running.

Generally speaking, runners are more prone to injury because of the increased demand on the muscles of the lower extremity during activity. This can lead to overuse injuries such as tendinitis and stress fractures. But, for young and healthy people, running provides a great source of exercise and can help train for other sports. It also provides the “runner’s high” that avid runners talk about, which you won’t be able to get from walking.

For many people, though, walking is a great source of exercise. Particularly in older populations and overweight people beginning an exercise program, walking is generally the first form of exercise initiated. It is often recommended for weight loss in obesity, to prevent arthritis, and as an adjunct treatment to osteoporosis. Of course, speak with your doctor before starting any new exercise or walking program.

Walking and running can both be incorporated into a successful exercise program. Podiatrists can be a great source of information for those beginning a walking or running program, particularly if you are experiencing any foot or ankle problems. Sometimes the use of orthotics or even simple exercises for the lower extremities can help prevent some of these problems.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com