OCI Named “Good as Gold” for Community Service

RRR Good as Gold Edit

Dr. Romanelli at the Good as Gold Ceremony April 23, 2014

Thank you to the University of Illinois Springfield and the Springfield Junior League for including the Orthopedic Center of Illinois in the inaugural Business Honor Roll class at the Good as Gold Ceremony April 23!

OCI was given this prestigious award in response to the commitment of our employees to volunteer in the community, our on-going sponsorship of charitable events and organizations, and the impact of the OCI Foundation on education and local non-profit

The Springfield Good as Gold Ceremony is a joint effort between the Junior League of Springfield and UIS to honor community volunteers who improve Springfield through their service and dedication. This event annually recognizes the priceless volunteers who are truly worth their weight in gold for making a positive different in our community.



Why Ankle Pain and Sprains Won’t Heal

By O.B. Idusuyi, M.D.
Board Certified Orthopedic Surgeon

A sprained ankle is one of the most common orthopedic injuries. In the United States more than 25,000 such injuries occur every day. Although most of these resolve completely, chronic residual ankle symptoms still persist in about 20% to 40% of treated patients. In the following article, I will outline potential causes of persistent pain after an ankle sprain

ankle diagram

Fig. 1

What is an Ankle Sprain?
A sprain is actually an injury to the ligaments of the ankle joint, which are elastic, band-like structures that hold the bones of the ankle joint together and prevent excess turning and twisting of the joint (Fig 1). During normal movement, the ligaments can stretch slightly and then retract back to their normal shape and size. Sprained ankles often result from a fall, sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface. The anterior talofibular ligament is one of the most commonly involved ligaments in this type of sprain. Approximately 90% of ankle sprains are inversion injuries.

Diagnosis of Ankle Sprain
Patients who sustain ankle sprains will experience pain or soreness over the injured ligaments, loss of function, swelling, bruising, difficulty walking, and or stiffness in the joint. These symptoms may vary in intensity, depending on the severity of the sprain. A severe sprain may be diagnosed in patients who report hearing or feeling a popping sensation, followed by immediate swelling and the inability to walk or finish their athletic endeavor after an inversion injury. In evaluating your injury, the orthopedic surgeon will obtain a thorough history of your symptoms followed by a lower extremity examination. X-rays or other advanced imaging studies may be ordered to help determine the severity of the injury.

The goal of treating an ankle sprain is to prevent chronic pain, instability and disability. The first phase of routine ankle sprain treatment consists of rest, ice, compression, elevation, and usually the use of anti-inflammatory medications. We recommend an air cast for a low-grade ankle sprain while severe sprain requires a longer immobilization walking boot or a short leg cast for three weeks.

The amount of therapy that a person can handle will depend on their level of pain and the grade of sprain they experienced. It is not recommended to return to sports or extreme physical activities until hopping on the ankle is achieved without pain. Wearing high-top tennis shoes may also help prevent ankle sprains if the shoes used are laced snug and if the ankle is taped with a wide, nonelastic adhesive tape.

Residual Pain after Ankle Sprains

ankle 2

Fig. 2

Ankle pain not responding to treatment, stiffness, locking, swelling, giving way or numbness may persist several months following an ankle sprain. A careful patient history and physical examination is needed to assess the presenting complaint, mechanism of injury, level of activity, and exact location of the issue.

The orthopedic surgeon must rule out missed diagnosis and associated injuries at the time of initial ankle sprain (Table 1). A partially treated or untreated ankle sprain may lead to chronic ankle instability, a condition marked by persistent discomfort and a “giving way” of the ankle. Weakness in the leg may also develop. Improper or insufficient rehabilitation may lead to impaired neuromuscular control, impaired propioception and postural control.

Tbale 1Persistent pain with catching or locking in the ankle joint could be related to damage to the cartilage with intraarticular loose bodies within the ankle joint or an osteochondral defect (Fig. 2). Pain on direct palpation of bony prominences in the leg ankle and foot may indicate missed fractures at the time of initial injury (Table 1). Palpating for the area of maximal tenderness along the tendons and directly over the syndesmosis can rule out peroneal tears and chronic high ankle sprains. In teenagers with persistent ankle pain and recurrent ankle sprains, the foot should be examined for stiffness of the joint below the ankle to rule out “tarsal coalition” – a condition characterized by abnormal fusion of foot bones.

Burning or shooting pain, numbness and tingling may indicate stretch injury on the cutaneous nerves surrounding the ankle either from significant twisting at the time of initial sprain or from chronic swelling of the ankle. In my experience, this condition leads to a prolonged recovery requiring 9 to 12 months for complete resolution of symptoms.

Magnetic resonance imaging (MRI) evaluation is particularly useful in demonstrating chondral injury, bone bruising, radiographically occult fractures, sinus tarsi injury, tendon tears, degeneration, and impingement syndrome.

The initial management of chronic ankle instability is a robust structured program of functional and prophylactic rehabilitation. Failed rehabilitation is an indication for surgical repair

While ankle sprains are very common injuries seen by orthopedists and general practitioners alike, appropriate three-phase functional rehabilitation can provide excellent results with a minimum of co-morbidities. When symptoms persist after several months, the examining physician must assess for potential missed diagnosis, inadequate ankle rehabilitation and associated injuries.

If you are experiencing ankle or foot pain, call (217) 547-9100 today to set up an appointment with one of our specialists.


Community Education: “Management of Shoulder and Knee Problems”

CWM RJH VertThursday, April 17 • 6:00-7:00 p.m.
Abraham Lincoln Memorial Hospital
Steinfort Conference Center
200 Stahlhut Drive, Lincoln

Do you avoid activities you enjoybecause of shoulder discomfort or knee pain? Join orthopedic surgeons Rod Herrin, M.D., and Chris Maender, M.D., to learn about a spectrum of problems from sports injuries to arthritis, including rotator cuff injuries, shoulder instability, ACL injuries, meniscal tears and more. They will also discuss treatment approaches including surgery, medications, injections and physical therapy to get you back toenjoying your favorite activities—free of pain.

Reserve your seat today! Call (217) 605-5008.
Refreshments provided.