High Ankle Sprains Are Most Vexing

A high ankle sprain. It sounds as mild as it is common. Actually, it’s an insidious and painful injury, one that sidelines dozens of NFL players each season. Unlike a common ankle sprain, which can be stabilized with foam wrap and tape, an untreated high ankle sprain can push apart the two bones in the lower leg, like a wedge splitting a log.

“If you had one in the workplace, you’d probably have surgery, spend six weeks on crutches, four weeks in a walking cast and another four in rehab,” said Dr. Pierce Scranton, former president of the NFL Physicians Society and author of “Playing Hurt: Treating and Evaluating the Warriors of the NFL.”

“You get NFL players back in eight to 10 weeks.”

Those players usually don’t undergo surgery for the injury, which is a disruption of the ligaments that hold the tibia and fibula together and form a socket for the lower ankle and foot. If those ligaments are weakened or even torn, there’s a possibility the whole foot-ankle assembly can be shoved upward and, in Scranton’s words, “blow apart your lower leg.”

The mere act of running creates a force on the ankle roughly 2 1/2 times the person’s body weight, which is about 750 pounds for an average NFL offensive lineman.

If a player opts out of surgery for a high ankle sprain, he might be back on the field more quickly, but he runs the risk the joint will be weaker, or worse, it will harden and stiffen because of calcium deposits.