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Monday, January 3, 2011

Ultimate Frisbee: Email Advice

Email sent 1/3/11

Dr. Blake,

Happy new year!

I have a question that would probably be a great one for your blog. I joined a competitive beach ultimate league and will be going to a beach tournament in two weeks. I haven't played a lot on sand, so I'm trying to figure out what equipment I need.

First of all, do I need to wear the braces on sand? It seems harder to get injured by the surface, but there's still a risk of stepping on another person, which is how I got the high ankle sprain in the first place. I also sometimes get the sensation that something is 'giving' in my ankle in certain positions (just moving around the house, not in athletics) when unbraced, and I wonder if sand allow it too much freedom.

Editor's Note from Dr Blake: Sasha had a really bad sprain, actually a high ankle sprain which she is getting better from, but I would protect it in unstable environments like this for a year longer than you think you need to. And during that whole year do ankle strengthening emphasizing fast twitch and proprioceptive strength.
Second, if I have to wear the braces, can I wear sand socks as well? Over or under the brace?

Editor's Note: It would be preferrable to wear the Sand Socks against your skin and the ankle brace on the outside. I do know a few patients that wear an extra Sand Sock on the outside to protect the brace from the sand. You would have to get 1 or 2 sizes larger for the outside layer of sock (ie medium inside and large or extra-large on the outside).

 You asked me to report back about my HMO. It was very difficult to get that initial appointment, since they wanted me to go through a general practitioner first (with a 3-week wait for an appointment) and then make an appointment with a physical therapist (another 3-week wait). I did some complaining and luckily got through to the Sports Medicine department, which is entirely separate from the Physical Therapy department. I left a frustrated voicemail for the department supervisor and she called me back offering me an appointment the next week! So I learned early that it pays to be an advocate when you are not the default case the System is expecting. Since I was at the end of my rehab, I had two appointments with a physical therapist (who is herself an elite ultimate player!) to show me more aggressive and sustainable strengthening. And I've been OK since. Wearing braces on both ankles when I play sports, but not when I run or bike or walk. And free of other sprains and pains in that ankle!

Editor's Note: Hooray!! Most patients following an ankle sprain just play lip service to the restrengthening phase from 3 to 12 months post sprain. It is not hard, but takes an effort and discipline, since you are normally feeling great at that level. Sounds like the physical therapist did great by her.
Thanks again for the great care when I had my last insurance. I've recommended you to several acquaintances. And thanks for considering my questions!


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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.