Ankle Injuries Article for Southern Standard

Although the UT-Knoxville Volunteers shut out the UT-Martin Shyhawks, 50-0, it was not without a little suffering. In addition to other injuries, two Volunteers suffered from ankle injuries. While Jarrod Shaw, offensive lineman, and Denarius Moore, wide receiver, were questionable, they played against Oregon.

The University of Tennessee Department of Sports Medicine does not release specific injury reports or more specificity beyond: Out, Questionable, Probable, or Active, so lets speculate what injuries these athletes could have sustained.

The most common ankle injury is a “sprain” resulting from a twist in the ankle. The most common are call inversion ankle sprains and is when the heel and bottom of the foot roll inwards. This can happen when a player steps on another foot, the player cuts but the player’s weight is on the outside of the foot, or when the player gets tackled low. Another name for these sprains is lateral ankle sprains. Lateral means outside, most of the damage with ankle sprains is on the outside of the ankle.

Inversion or Lateral ankle sprains have three grades of severity. The severity is dependent on how many ligaments are damaged. If you make the “OK” sign with you hand and then place it on the outside of you ankle with palm in and fingers down, your three fingers are roughly in the places of the three outside ligaments. For any future anatomists out there they are call (from front to back): the anterior talofibular ligament, calcaneal fibular ligament, and posterior talofibular ligament.

There are a couple grading systems for ankle sprains, but for simplicity, grade 1 is when the front ligament is injured, grade 2 is when the front two are injured, and grade 3 is when all three are injured.

Often athletes can get back in the game with a grade 1 ankle sprain, but grade 2 ankle sprains require more time off due to the increased instability. Acute treatment for ankle sprains, whether you are a Volunteer on the field or a Volunteer fan that stepped off the tailgate wrong, is RICE: Rest, Ice, Compression, and Elevation. The next step is getting motion and mobility back. Specific training of the outside muscles with strengthening and balance exercises are crucial to increasing the bodies ability to protect the damaged ankle.

Ligaments unfortunately do not shrink once stretched, so often the strengthening and balance is the most important to prevention and is often overlooked because it is generally after the pain has diminished and people return to general activity.

A couple newspapers reported that Denarius Moore was using a walking boot, a big bulky immobilizer that covers the entire foot and shin, but can be used with walking. This is a form of rest. By allowing the ankle not to have to control shifting while walking, there is decreased stress to the ankle joints.

Although ankle sprains generally pull all at the ligaments on the outside to cause the damage, the inside of the ankle can often have damage because of the compression, which results in swelling and bruising, but does not hurt the stability of the inside of the ankle.

Two other somewhat common results can occur with a lateral ankle sprain: a fracture of the fibula, the outside bone at the ankle, or a “high” ankle sprain. The fracture of the fibula will require cast immobilization or a surgical fixation.

The high ankle sprain is a tear in the ligament between the two bones of the lower leg, the tibia and the fibula. While these bones do spread as our ankle moves, too much will cause a tear. High ankle sprains generally occur with grade 2 or 3 ankle sprains and will require a much longer healing time. If the high ankle sprain is very unstable, it is not uncommon for an orthopedist to place a temporary screw to hold the two bones together to allow for healing.

Because of the quick return to active status, as a spectator in the peanut gallery, I assume that the ankle injuries sustained by Jarrod Shaw and Denarius Moore were grade 1 or 2 with no high ankle sprain involvement.

The Volunteers will see many more ankle injuries this year, lets just hope that they don’t make the grading scale and they get back to the field ASAP. Go Vols!

Zach Sutton, PT
Doctor of Physical Therapy
Master of Exercise Science
Board Certified Orthopaedic Specialist
Certified Athletic Trainer