In his lecture at the Western Foot and Ankle Conference, Doug Richie, Jr., DPM, FACFAS, FAAPSM dives into the management of ankle sprains and ankle instability. Podiatry Today had the chance to speak with him about his lecture, and Dr. Richie shared some pearls podiatrists can benefit from today.

What do you feel is the most important part of the diagnostic process for ankle sprains and instability?

Dr. Richie shares that a classic maneuver may indeed be the key to accurate diagnosis for these injuries.

“The anterior drawer test is simple to perform and has an accuracy similar to magnetic resonance imaging (MRI) to detect injury to the lateral ligament complex of the ankle joint,” he says.

What do you feel is the biggest challenge podiatrists face in treating the unstable ankle?

He says that DPMs will encounter common misconceptions about the severity and/or most appropriate treatment path for sprains.

“Podiatrists have to battle unfounded myths about the ankle sprain which continue to be propagated by coaches and health care professionals,” he explains. “Patients hear or read these myths and try to direct their own treatment. Patients or parents of patients expect a quick return to sport because ‘it’s only a sprain.’”

What one tip or pearl would you like to share with the audience on your topic that they can enact in their practices today?

Dr. Richie wants clinicians to know that prophylactic bracing prevents ankle sprains with no negative effects.

Anything else you’d like to add?

He stresses that the neglected ankle sprain in the young athlete has a high risk for causing post-traumatic osteoarthritis of the ankle later in life, which he points out is not a benign injury.

“Parents and coaches of young athletes need to be educated so that they can support the implementation of a proper treatment and rehabilitation program for the ankle sprain,” he says.

Dr. Richie is an Adjunct Associate Professor within the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt University in Oakland, Calif. He is a Fellow and Past President of the American Academy of Podiatric Sports Medicine. Dr. Richie is a Fellow of the American College of Foot and Ankle Surgeons, and the American Academy of Podiatric Sports Medicine. Dr. Richie is the author of a new book titled "Pathomechanics of Common Foot Disorders," which is available from Springer at https://www.springer.com/us/book/9783030542009 . He discloses that he is Founder and President of Richie Technologies.