Fancy passes and flashy assists.
The fast-paced, lateral movement of basketball makes the sport notorious for ankle injuries.
The Phoenix Suns’ Alex Len and Brandon Knight each recently sprained an ankle and missed multiple games.
Ankle sprains are characterized by small tears to the ligaments, the structures responsible for stabilizing our moving joints.
George Gendy, MD, an orthopedic foot and ankle surgeon with The CORE Institute, explains that there are two main types of ankle sprains.
“There’s the low ankle sprain and the high ankle sprain,” Gendy said. “The terms low and high describe the location of the sprain in relation to the ankle joint.”
Low sprains are more common, occur below the ankle joint and are lower energy, meaning players typically return to play sooner. High ankle sprains, which are less frequent, occur above the ankle joint and require a longer recovery period.
The severity of the sprain is often determined by a person’s ability to walk.
“Players usually find that their ankle is swollen, stiff and a little painful for about 24 to 48 hours after the injury,” he said. “High ankle sprains, however, generally take longer to heal.”
The first line of treatment for an ankle sprain is RICE therapy – rest, ice, compression and elevation. When returning to play, taping the ankle or lacing up an ankle brace will provide support to the weakened ankle ligaments. Physical therapy with balance training is often used to help strengthen the muscles around the ankle.
“On average, 95 percent of ankle sprains recover with RICE, physical therapy, and taping or using lace-up braces,” Gendy noted. “Unfortunately, that leaves about 5 percent that require more treatment.”
More severe ankle sprains can lead to a chronic, recurrent, unstable ankle, similar to how an ACL tear leads to an unstable knee. In such cases, the most common complaint is that the ankle feels like it is giving out during cutting or pivoting maneuvers or even during other activities, such as hiking on uneven ground.
“To help diagnose ankle instability, we typically use a stress X-ray, a special type of X-ray that tells us whether the ligaments are functioning,” he said.
When immediate or long-term instability occurs, surgery may be necessary. Similar to other ligament reconstruction procedures, it entails recreating the ligament that helps stabilize the joint.
“Arthroscopic and open ankle ligament reconstructions are excellent surgical options due to their high success rates for stabilizing the ankle joint,” he said. “The procedure typically requires outpatient surgery with an initial recovery time of about six weeks followed by physical therapy.”