Dallas Cowboy’s Dez Bryant Injures Ankle
Cowboys first round draft pick, Dez Bryant, suffered an ankle sprain today while in practice. Latest reports are that he has a high ankle sprain. What does this mean for his training camp time?
Ankle sprains are very common injuries. In the US alone, approximately 25,000 ankle sprains occur every day. Not all of these individuals seek medical care. Most walk it off and resume life with little or no consequences. The question is when should you be concerned that you have a serious ankle sprain or something worse and see a doctor. I will get to this question later in the blog.
Most people sprain their ankle with an inversion type injury. This is where the foot rolls in and the ankle rolls out. This stretches and may tear the ligaments on the outer part of the ankle. Outer ligaments of the ankle are always injured in the common ankle sprain.
However, in severe cases, the ligaments on the inner part of the ankle (medial ankle sprain) or between the ankle bones (high ankle sprain) can be injured. The medial sprain will be a topic for future blogs.
A high ankle sprain occurs when the ankle rolls out to the point where the ligaments between the fibula (outer leg bone) and the tibia (inner leg bone) tear. This ligament structure is known as the syndesmosis. This can be a stable or unstable injury. If the ligament is stretched or strained, the ankle is usually stable and does not require surgery. If the ligament is fully torn, the ankle is unstable. This injury pattern requires surgery.
Below is an xray of an individual with an unstable syndesmosis tear.
When an individual has a high ankle sprain, walking and jumping on the injured ankle is difficult. One may experience pain, swelling, bruising, weakness and even a black and blue mark. Usually people have some level of pain with motion of the ankle. Rest, ice, elevation, an ace wrap and antiinflammatories can help relieve some of these symptoms. But if you suspect a high ankle sprain, you should see a physician sooner than later.
Initially, after a high ankle sprain, rest, ice, elevation, an ace wrap and antiinflammatories can help relieve some of these symptoms. If xrays suggest a stable high ankle sprain, the patient is placed in a boot or short leg cast. The individual is nonweightbearing (not allowed to placed any weight on the injured ankle) for 4 to 6 weeks.
If the syndesmosis is torn, surgery is needed. In the operation, the tibia and fibula are put back in their proper position and held in place with screws or a device called a tightrope (see xrays). These patients are not allowed to put weight on the ankle for 3 months.
In either injury pattern, physical therapy is necessary to help regain range of motion and strength of the ankle. Physical therapy has been shown in the medical literature to be very beneficial in preventing what is known as “chronic ankle pain”. Some physicians may want you to use an ankle brace for a short period of time, while others may not want you to use one at all. Rarely is surgery needed.
Most individuals with high ankle sprains are able to return to their lifestyles and activities after 6 to 8 weeks and a lot of therapy. Bryant will miss camp and the start of the season.
For a video animation on ankle sprains, please see the “Education” tab of my website. Click orthopaedics, then conditions, and then “High Ankle Sprain” to see the video.
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