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Medically speaking, Patrick Mahomes’ injured ankle swells optimism for Chiefs vs. Bengals

Kansas City Chiefs quarterback Patrick Mahomes (15) talks with linebacker Willie Gay (50) during a workout Thursday.
His injured ankle heavily taped, Chiefs quarterback Patrick Mahomes (15) talks with linebacker Willie Gay (50) during a workout Thursday. Mahomes was a full participant in practice.
(Charlie Riedel / Associated Press)
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Patrick Mahomes wasn’t making any promises, but the Kansas City Chiefs quarterback was optimistic Thursday about the condition of his injured right ankle and whether he’ll be at full speed for Sunday’s AFC championship game against Cincinnati.

Mahomes spoke to reporters before Thursday’s practice, which was due to be more rigorous than the walk-through session the day before. He suffered a right high-ankle sprain in Saturday’s divisional victory over Jacksonville.

“Obviously, I feel like I can still do a lot of things,” said Mahomes, favored to be named the NFL’s most valuable player. “We’ll see as we get closer and closer, and we’ll see during the game.

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“You can’t fully do exactly what you’re going to be in those moments during the game, but all I can do is prepare myself the best way possible, and then when we get in the game you hope adrenaline takes over and you can make those throws when you need to.”

Mahomes was a full participant in practice.

The Bengals beat the Chiefs three times in the 2022 calendar year, by three points each time, including last season’s conference title game. Kansas City is playing host to the AFC championship game for the fifth year in a row.

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Mahomes’ injury happened when a Jacksonville pass rusher landed on his ankle in the first quarter. The quarterback was angry about having to leave the game — he was replaced by Chad Henne — but came back in the second half and completed 10 of 15 passes for 111 yards and a touchdown, closing out the 27-20 victory.

After the game, he fielded calls from several people around the NFL, including Tampa Bay quarterback Tom Brady.

“He’s a tough guy and I told him this the other night,” the seven-time Super Bowl winner said during an appearance by Chiefs coach Andy Reid on the podcast “Let’s Go! With Tom Brady, Larry Fitzgerald and Jim Gray.”

Chiefs quarterback Patrick Mahomes (15) hops after suffering an ankle injury against the Jaguars.
(Ed Zurga / Associated Press)

“I said, `I’m just really happy for you.’ And that’s what champions are made of at the end of the day. I really respect Patrick for how he came out there in the second half and how pissed he was when he got taken out by coach Reid. I’m sure he had a word for you, but to watch him come out in the second half and play great, that was awesome to watch.”

Mahomes was asked Thursday about his conversation with Brady.

“I have a good relationship with him now,” Mahomes said. “He gives me some advice to help me. Why would you not want to learn from the GOAT, man? Any time anybody like that wants to give me advice, I’ll take it in.”

Reid sounded encouraged Thursday about the way Mahomes looked in a walk-through practice the day before.

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“His feet are doing OK right now, so he still can move ‘em,” the coach said. “So he’s not just throwing with all arm.”

Unlike a common ankle sprain, which can be stabilized with a foam wrap and tape, a high ankle sprain sometimes requires surgery. The injury is a disruption of the ligaments that hold the tibia and fibula together and form a socket for the lower ankle and foot.

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If those ligaments are weakened or torn, there’s a possibility the whole foot-ankle assembly can be shoved upward, pushing apart the two bones in the lower leg like a wedge splitting a log.

The mere act of running creates a force on the ankle roughly 2½ times the person’s body weight, which in the case of Mahomes would be about 570 pounds.

“Most people with a high-ankle sprain need at least four to six weeks to recover from that,” said Dr. Daniel Kharrazi, sports medicine specialist and orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “So the fact that [Mahomes has] done it in one week and was walking in his press conference is not common, let’s put it that way.”

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Dr. Neal ElAttrache, team physician for the Rams, said it’s increasingly common to surgically repair high-ankle sprains. The challenge is not only the pain involved but the sensation of instability in the ankle that makes it difficult to play and can sometimes lead to longer-lasting dysfunction.

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“When you have a little bit of instability in the ankle like that, you lose your ability to decelerate and suddenly twist or pivot,” ElAttrache said. “That’s why you saw that even when Mahomes was throwing, he almost wanted to lift his foot off the turf. He didn’t want to plant it and pivot on it. It was amazing, when he was throwing on the run, he would leave his feet to release the ball.”

Mahomes said the injury he’s dealing with now is similar to the one he had during the 2019 season, only it was the other ankle. After suffering that one, he came back the following week and threw four touchdown passes against Oakland.

“He had a couple injuries in college he fought through,” Reid told reporters this week. “In the NFL, with all the games you play, very seldom do you get to this point without having something. That’s just how it goes.”

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