The New York Jets have been without their Pro-Bowl center, Nick Mangold, for the last 4 weeks as he sprained his ankle during the Week 7 match-up with the Ravens. This article will delve into how someone sprains their ankle and the timetable for recovery.
What is a sprained ankle?
A sprain is a tear in a ligament (connective tissue that connects 2 bones together). In the ankle, there are three ligaments located on the lateral (outside) portion of your ankle. When one sprains an ankle, the ankle rolls out thereby placing additional stress on at least one of these ligaments. Depending on the severity and the mechanism of injury, a grade will be assigned based on tear (Grade I - minor tear, Grade II - moderate tear, Grade III - completely torn). The most common ligament damaged from a sprained ankle is the anterior talofibular ligament (ATFL) however it is not uncommon to tear the calcaneofibular ligament (CFL).
What is the timetable for recovery?
Depending on the severity of sprain, the timetable varies for return to sport. Typically, a Grade 1 takes 3-4 weeks for recovery and Grade II takes about 6-8 weeks. If a Grade III sprain occurred, we’d would know by now as Mangold’s season would likely be done. Initially, Mangold was placed in a boot to make sure that the ankle is immobilized and no additional damage to the ligament(s) in the ankle. Depending on how quickly the ligament heals and the swelling reduces, he will slowly wean off the boot and back into regular shoes. This has already happened however Mangold explained last week that he suffered a setback because he tried to do too much during practice and went back into a boot. For this reason it is hard to predict how much longer Mangold will be inactive.
Nevertheless, once Mangold is back out of the boot, rehabilitation will focus on improving ankle strength while assuring there is not a strength imbalance between the hips, knees, and ankles. When a ligament is damaged, it is likely due to lack of stability in the joint from weakness in the surrounding muscles. In addition, weakness in the hips and the knees could contribute to why someone sprained their ankle. The body is like a giant chain so every link of the chain has to work appropriately to not throw off the rest of the chain. If one has weak hips, it places the knee (and consequentially the ankle) in a poor position making the leg susceptible to injuries in either of those joints. For this reason, it is imperative that recovery not only addresses ankle strength, but strength in the other joints of the leg. Mangold will transition back to football-related activities with proper mechanics as each joint will act together accordingly.
Ankle strength is the most important aspect of rehab however because once a ligament is sprained, the likelihood of re-injury increases. When a ligament is sprained, the ligament is stretched out; instead of like a rubber band and returning back to its original length, the ligament remains in the stretched position and relies on strength of the muscles to compensate for the decreased stability. As strength improves, focus of treatment sessions will shift towards balance and then ultimately power as an offensive lineman needs to be explosive off the snap to adequately pass/run block. Exercises will progress from focusing on one-joint to movement patterns that involve multiple joints and movement patterns.