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By contactus
January 10, 2012
Category: Uncategorized
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I’m sure many of you woke up this week as disappointed as I am that the beloved Steelers’ season has come to an unfortunate and abrupt ending this past weekend. While watching the game, or any of the Steelers’ games for the past few weeks, I am sure you may have heard the announcers talk about QB Ben Roethlisberger’s injury, deemed a “high ankle sprain.” Today, we will briefly discuss what exactly that means and why everyone has been so concerned with the QB’s play while managing this injury.

Any time someone “sprains” their ankle, or rolls it excessively to one side or the other, the ligaments that hold the ankle in place get stretched or possibly even torn or ruptured. As you can imagine, or may have even experienced, this causes a great amount of pain in and around the ankle, and it may include swelling and bruising to the ankle. Even after it heals and you return to function activity, the ankle may feel unstable or wobbly, meaning the ligaments are not as strong as they once were.

A “high ankle sprain” means that the injury occurred above the ankle joint level in a ligament called the “tibio-fibular syndesmosis” or “interosseous membrane.” As the name may imply, this is a ligament connecting the two leg bones, the tibia and the fibula that keeps the bones from spreading apart with each step you take.

                                                        

With the twisting or cutting motion that causes this injury, the two bones can be forced into a degree of separation, thus stretching or possibly tearing this ligament (indicated by black arrow below).

                                                                     

This high ankle sprain injury may not become as bruised and swollen as a normal ankle sprain, which can often disguise the severity of the injury. During normal walking, the tibia and fibula are in slight motion, so the ligament in between them is always being pulled on. You can imagine how an injured ligament would then cause severe pain with each step. You can also imagine how much more force and stress, and therefore pain, is placed on the ligament with the running and cutting motions in an NFL game.

The typical treatment is the same as a normal ankle sprain: RICE = Rest, Ice, Compression, Elevation. The problem is that there is no effective brace to reduce motion around the high ankle area, so it takes nearly twice as long to heal this high ankle sprain and requires a more strict adherence to rest (aka-not walking on the injured leg). In extreme cases, a screw can be surgically put in to connect the tibia and fibula and therefore reduce the stress on the ligament to allow the ligament to heal, but you still cannot walk on the leg then, as the normal motion mentioned above could cause the screw to break.

 

It normally takes more than 6 weeks to return to activity, with symptoms possibly lasting up to 6 months, so I suppose we can all be a little thankful that Big Ben suited up at all this weekend. 

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