A sprained ankle is an everyday threat for professional basketball players with nearly 100 ankle sprains occurring each season in the NBA. Basketball players are particularly vulnerable because they make multiple, sharp cuts throughout a game or practice, placing excessive force on the ankle ligaments on both the medial and lateral sides. NBA athletes are also susceptible to ankle injuries when they jump and come down on the foot of another player. While the injury itself may be common, an ankle can be sprained in varying degrees of severity as well as in different locations. To understand the difference in the injuries let's breakdown the specifics surrounding a sprained ligament.
A ligament is connective tissue that joins bone to bone. Multiple ligaments are located on both the medial and lateral sides of the ankle joint that are designed to provide stability to the joint and help anchor tendons. Ligaments have viscoelastic characteristics that allow them to be both viscous and elastic when a stress in applied. Basically a ligament can withstand a stress while rearranging its basic makeup to better provide stability. However each ligament has a specific yield point and failure point. When excessive amounts of stress are placed on a ligament, microtrauma occurs as the ligament nears its yield point. This type of injury is known as a Grade I ankle sprain. A Grade I injury is considered minor with partial or micro tearing of the effected ligaments. These injuries occur frequently in the NBA and may cause a player to miss little or no action.
Most recently Houston's Yao Ming suffered a "mild" left ankle sprain and is expected to miss the next week of action. Brad Miller and Jordan Hill will see a bump in minutes as their teammate recovers. Additionally Dallas' Dirk Nowitzki suffered a Grade I sprain in his team's win over Memphis, but is expected to be ready to take on the 76ers on Friday.
If the external stress is greater than a ligament's yield point, the deformation is irreversible and a more significant damage occurs. These sprains are classified as Grade II and often force the athlete to miss a longer period of time as the ligament partially tears. Grade II sprains are often very painful and have a considerable amount of associated swelling. Houston's Aaron Brooks is nursing what is likely a Grade II sprain and is expected to miss the next four-to-six weeks with the injury. Kyle Lowry will fill in for the injured Brooks and is worth a look in deeper fantasy leagues. However keep in mind Lowry is dealing with a sore back that has limited his production thus far. Brooks isn't alone as Clippers center Chris Kaman will miss at least two weeks with a Grade II ankle sprain as well. DeAndre Jordan will join the starting lineup for the time being.
If the stress is so excessive that it takes a ligament to its failure point, the tissue will fail and tear. These injuries are graded as Grade III sprains result in a loss of function and mechanical stability. The window of recovery for Grade III sprains is substantially longer and in some rare cases requires surgery.
Another issue with ankle sprains is location. A syndesmotic sprain, or high ankle sprain, occurs in a different location than your garden-variety ankle sprain. A high ankle sprain involves excessive stretching and disruption of the ligaments located at the distal tibiofemoral joint where the ends of the lower leg bones, the tibia and fibula, form the ankle mortise. Treatment and rehabilitation for high ankle sprains is the same as for normal medial or lateral ankle sprains but often require longer time to recover. Several players including Miami's Mario Chalmers and Memphis' Marc Gasol have recently recovered from syndesmotic sprains suffered in the off-season and preseason.
An additional problem associated with ankle sprains is the increased likelihood of recurrence. Once sprained, a ligament will never completely returns to its original state. To better understand this concept, imagine a rubber band. A new rubber band is full of spring and easily binds paper together. However following multiple uses, the rubber band will eventually pass its yield point and become overstretched. From that point forward it never manages to return to its original size and shape. Ligaments of the body act in a similar fashion. When an ankle is sprained, the strength and physical integrity of the sprained ligament remains forever altered. Athletic trainers and physical therapists can put an athlete through rigorous exercise protocols deigned to strengthen and stabilize the affected ligament but it will never be the same. Once an ankle has been sprained it is more susceptible to being aggravated and re-sprained. This is why guys like Kevin Martin, Grant Hill, and Rajon Rondo all seem to re-sprain the same ankle.
Ankle ailments aren't the only injury concern in the NBA. Just ask Philadelphia's Louis Williams who is day-to-day after suffering a left shoulder injury in a loss to the Thunder on Wednesday. Williams suffered a sprained acromioclavicular (AC) joint and will undergo further testing to determine the extent of the damage. The AC joint is located where the collarbone attaches to the shoulder blade at a bony protuberance known as the acromion. Like discussed with an ankle sprain, a sprained AC joint can create an instability in the joint and limit the range of motion for the athlete. If the sprain is significant, Williams could be out several weeks and is a big blow for a player off to hot start. Williams is averaging 16.4 points and 3.2 assists through eight games this season. Rookie Evan Turner will see an increase in playing time with Williams sidelined.
Philadelphia will be able to slightly offset the loss of Williams with the impending return of Andre Iguodala. Iguodala has missed the Sixers last two contests with a strained Achilles' tendon. The Achilles is the strongest tendon in the body and is actually the tendon for three muscles, the gastrocnemius, plantaris, and soleus muscles. These muscles work together to point the toes in a motion known as plantar flexion. An athlete suffering from an Achilles strain has trouble planting their foot so expect the normal high-flying Iguodala to be without his usual burst until the injury is completely healed. He is hoping to return Friday when the Sixers take on the Mavericks.
Jeff Stotts is a Certified Athletic Trainer, MAT, PES and the Injury Analyst for Rotowire.com. You can follow him on twitter @RotoWireATC.