Chiefs QB Patrick Mahomes is playing with a high ankle sprain. What is it and what is the recovery timeline?
Among sports-induced injuries, the high ankle sprain has gotten special attention lately
Kansas City quarterback Patrick Mahomes suffered one in his right ankle during the AFC divisional round win over the Jacksonville Jaguars. He continued to play with it, against the Cincinnati Bengals in the AFC championship game and then in Sunday's Super Bowl against the Philadelphia Eagles.
With under two minutes remaining in the first half Sunday, Mahomes was pulled down from behind by T.J. Edwards and appeared to re-injure the ankle. He hobbled off the field after the play and then ran off the field - with a limp - before a 29-minute halftime show that could give him extra time to get treatment or get stiffer.
If the Chiefs need to turn to someone else, Chad Henne will be the first of a plethora of options. However, Mahomes did start the second half.
So what exactly is a high ankle sprain? How can it be treated?
High ankle sprain vs. normal ankle sprain
Let’s start with the anatomy. The ankle joint is formed by three bones: the tibia (shin bone), the fibula (the bone next to the tibia in the outer calf) and the talus (a bone in the foot below the tibia).
A common ankle sprain involves the ligament in the ankle. By contrast, a high ankle sprain involves the ligaments above the ankle joint and can require surgery.
“A high ankle sprain occurs when the ligaments between (the) tibia and fibula become torn or stretched,’’ the Beacon Orthopaedics & Sports Medicine reports. “This type of sprain is more of a rotational injury rather than a roll of the ankle. Unlike a low ankle sprain, a high ankle sprain is more significant of an injury. This type often takes about twice as long to heal.”
High ankle sprains are more common among athletes who participate in high-impact sports and usually result from “sudden twisting, turning or cutting motion while a person is running, jumping or falling,’’ according to the Hospital of Special Surgery, a New York hospital that specializes in orthopedic surgery.
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High ankle sprain recovery time
Recovery from either a normal ankle sprain or high ankle sprain can take weeks to months. But as Mahomes has demonstrated, professional athletes can perform even while they’re recovering – depending on certain factors.
The key factor is stability of the ankle, said David Oji, an orthopedic surgeon who treats athletes at Stanford University with foot and ankle injuries.
“If the ligaments are functioning, as long as his pain and his symptoms are very mild, they can aggressively rehab him and get him back to play,’’ Oji said.
Pain threshold is a factor, according to Oji, who said, “Everybody’s pain threshold is different.’’
Pain seemed of little consequence to Mahomes, who after the Chiefs beat the Jaguars told the media, "I’m not coming out of a playoff game unless they take me out. I’m just going to play. I love this sport too much."
The injury can affect Mahomes' mobility and ability to plant his right foot and throw.
Treating a high ankle sprain
A steroid injection or cortisol injection is a no-no because both can weaken the ligament and decrease healing, according to Oji.
“Injections are contraindicative in these high ankle sprains,’’ he said. “You’ll get short-term gain but long-term it will be detrimental to the athlete.’’
A 2022 study published in Sports Health concluded, "Injections are commonly used by health care practitioners to treat foot and ankle injuries in athletes despite ongoing questions regarding efficacy and safety.''
The basics include resting, icing and elevating the leg, and in some cases, the use of a walking boot, according to the American Orthopaedic Foot & Ankle Society.
''The goals of treatment are to move the tibia and fibula to the correct positions with respect to each other and to heal in those positions,'' reports the American Orthopaedic Foot & Ankle Society. "This allows the ankle joint to function as intended.''
Testing the ankle for competition
Athletes typically go through a series of tests before they’re cleared to play. That includes X-rays and a stress test in addition to work with a trainer and physical therapist, all of which can be done within a week, according to Oji.
“As long as they pass some of those hurdles,'' he said, "a lot of these athletes will be able to perform at a very high level.’’
This article originally appeared on USA TODAY: Patrick Mahomes' high ankle sprain in Super Bowl. Here's what to know.