Thursday, December 15, 2011

Roethlisberger Suffers High Ankle Sprain

Ben Roethlisberger and the high ankle sprain

Last week in the football game between the Pittsburgh Steelers and the Cleveland Browns, Ben Roethlisberger the quarterback for the Steelers was tackled in such a way that he suffered an injury to his ankle. Using slow motion analysis of video online, it can be seen that “Big Ben” was planting his left foot trying to escape tacklers when he was hit from behind and from the left essentially trapping his left foot on the ground with the inside of the foot against the ground. His left knee then hits the ground and creates a rotational base as he was hit from the right by another opponent. The top of the left shoe can be seen clearly as he falls on his left side effectively making the lower part of his foot and leg point 180 degrees from normal (or backwards).

Amazingly he walked off the field and returned and completed the game later. Reports of his injury over the past week include that he has a grade 1 high ankle sprain. He is in a walking cast boot and may compete against the 49ers on Monday night.

Big Ben’s injury differs from the usual ankle sprain because of the mechanism of injury. Normally ankle sprains are on the outside (lateral aspect) of the ankle and involve tearing of the lower ankle ligaments. Big Ben’s injury involves the ligaments that hold the leg bones together. The term ankle sprain can be used to indicate anything from a minor injury or an actual tearing of the ligaments.

From my analysis of the injury from one perspective of video on the internet it appears to me that it is amazing that the ankle was not dislocated at the time of injury and that it is likely that the ligament was ruptured or torn. In normal adults, ligament healing will usually take about three weeks and will need protection during this time. I would anticipate a significant amount of pain would be present if an individual were to try to weight bearing without significant support of the ankle before it is healed.

Big Ben is getting the best of care by getting an immediate X-ray and then an MRI. Many times normal ankle sprains will require both of these studies as well. Support and protection are requirement for normal healing of ankle sprains as well.

So, the take home point is:

1. Don’t attempt to walk off ankle sprains

2. Start Rest Ice Compression and Elevation

3. Get professional help and imaging

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