Anatomy of an Injury – High Ankle Sprain

Since the board seems to be going a bit nuclear after the Wisconsin game, I felt it would be a good time for a productive diary that highlights what one of our players is going through. 

It seems that one of our receivers suffered a high ankle sprain towards the end of training camp.  If you don’t know what a high ankle sprain is, and how it differs from a regular ankle sprain it might be a bit frustrating watching him in the game on Saturday and trying to figure out exactly why he wasn’t utilized as much, or why he was still so limited.

 

Ankle sprain vs. high ankle sprain.

Take a look at the picture below, and you will see the ankle from 2 distinct views.  The top part of the picture is from the medial (inside) of the ankle and shows the Deltoid ligament, which is a very, very strong ligament in the ankle.  In fact this ligament rarely tears, and will instead cause other injuries to occur if it is overstressed (more on this in a bit).

 

The bottom part of the picture is the lateral ankle (outside view), which as you can see consists of 3 different ligaments, the Anterior Talofibular, Calcaneofibular, and Talofibular ligament.  These ligaments are easily stressed in what we will call a “standard ankle sprain”, also known as an inversion sprain. 

So to put it simply, an ankle sprain is an injury to the ligaments of the outside of the ankle by rolling onto the outside of the foot.   A high ankle sprain, on the other hand is an injury to the inside of the foot by rolling your ankle to the inside.  It’s much less common because of how strong the ligaments on the inside of the ankle are.

 

What happens during a high ankle sprain?

When you have a standard ankle sprain, any one (or a combination) of the three ankle ligaments on the outside of the ankle are stretched and injured.  This results in ankle swelling and pain that can vary depending on severity, but usually with a lower grade sprain you can be back in 1-3 weeks with a brace or tape because what your defending against is the general stability of the ankle.

 

High ankle sprains are not that.  In fact, because the inside ligaments of the ankle are so strong, an injury to that side of the ankle causes the top bone of the ankle to forcefully jam itself in between to two bones of the lower leg (the tibia and fibula). 

This isn’t going to feel good.  Imagine having a split piece of wood and hitting it at the split with a hammer.  The wood is going to split more and all that stuff in the middle is going to go everywhere.  It’s a mess. 

This is essentially what happens with a high ankle sprain.  By jamming to top bone (the talus) up into the lower leg, all the soft tissue and “stuff” between these two bones forcefully seperates and can tear, thus creating the injury. 

 

How long does a high ankle sprain take to heal?

4-6 weeks, depending on the demands of your position.  For lineman it’s less because there’s less cutting/change of direction involved.  For skill players like running backs and receivers its more.  Even coming back at 4 weeks they are likely to be limited in both A) cutting/change of direction ability and B) explosive athleticism.  

 

How does a high ankle sprain affect performance?

The ankle is critical to everything involved with explosive movements.  That’s because as you move to sprint, jump, and change direction you need that joint between the top ankle bone and lower leg to transfer force from the hips into the ground to push off.  If that joint is stiff or limited, then you lose power. 

So look, at 4 weeks your most likely looking at playing at or around 70%.  That would be like playing with a leg and a half.  Or sort of like replacing your Ferrari with the car from the Flinstones.

 

Conclusion

High ankle sprains are bad, and feel bad.  They limit performance in all things explosion, especially in changes of direction.  Your going to see any player that goes through this become progressively less limited in their duties as they heal, but you most likely won’t see things that require a large amount of explosive movements (such as returning kicks) until that player has returned to 100%.

 

Hope you all found this somewhat interesting.  Have a great day.  Cheers!