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Injury Analysis: All About Ankles

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

Sprained ankles are a regular occurrence in the world of sports medicine. The ankle is the most commonly sprained joint and thousands of the injuries are reported daily. If you are a fantasy owner you could easily assume that half of these injuries occurred over the weekend. Before we dive into individual players let's first take a look at the makeup of the ankle and the various associated types of sprains.

Injuries to the ankle are classified in a variety of ways, including severity of damage, location of the injury, or the manner in which they occurred. The most common ankle sprain, and the one most people associate with the term ankle sprain, is a lateral ankle sprain. In this injury, the ligaments on the outside of the foot are injured, usually following excessive inversion from a sharp cut or landing on another player's foot. Like all sprains, they occur in varying degrees of severity.

A Grade I sprain is considered minor with partial or micro tearing of the effected ligaments. Basically the ligament is overstretched but remains intact as a whole. These injuries are considered mild and often cause a player to miss little or no action. A Grade II sprain is more significant and often referred to as a partial tear. The injury is generally more painful and limiting. They are often accompanied by a considerable amount of swelling and require more intensive treatment and rest. A Grade III sprain is a crippling and devastating injury. These injuries result in a loss of function and stability. They often require a long period of inactivity and in some rare cases require surgery. Fortunately they are not very common, even in the NFL.

Furthermore, Grade II or III sprains are more likely to have long-term ramifications, primarily on the stability of the joint and the likelihood of reoccurrence. In these ailments, the ligaments have passed their yield point. Once this has occurred, its strength and integrity remains forever altered, much like a used, outstretched rubber band will never return to its original state. This can be a major issue since once an ankle has been sprained it is more susceptible to being aggravated and re-sprained.

Unfortunately things only get worse if the ankle is considered a high ankle sprain. High ankle sprains or syndesmotic sprains occur at a completely different joint. At the bottom of the leg, where the tibia and fibula join with the talus, sits the distal tibiofemoral joint. A strong ligament known as the interosseous ligament stretches across the joint to connect the two lower leg bones while two additional ligaments, the anterior and posterior tibiofibular ligaments, assist in stabilizing the ankle mortise. A high ankle sprain involves excessive stretching and disruption of these particular ligaments. Unfortunately these sprains are more severe and take longer to heal than a lateral sprain.

With the anatomy lesson over, let's examine the effected players.

Jordy Nelson
After a hamstring strain limited him throughout the week, Nelson was surprisingly in uniform against the Cardinals. His heroic return was brief after he suffered a sprained right ankle early in the first half. Early reports suggest the sprain is a low-grade inversion sprain, meaning he has a chance to return following the Packers Week 10 bye. In the meantime, Nelson will receive treatment on the injured joint and his balky hamstring. With both legs limited, expect to see his practices reps reduced in an effort to have him ready for game day.

Darren McFadden and Mike Goodson
McFadden suffered an ankle injury as well but he suffered the more significant high ankle sprain. X-rays were taken to insure all bones were intact and no fracture was found. In a strange twist, McFadden's replacement also suffered a high ankle sprain as Goodson limped off the field a short time later. Goodson is slated to undergo a MRI on the effected joint. Oakland would not rule either back out for Week 10 but it's extremely improbable that they will be ready following an injury of this nature. Taiwan Jones and fullback Marcel Reece will see an increase in offensive responsibilities and don't be shocked if the Raiders add a free agent running back to their suddenly thin backfield.

Percy Harvin
Harvin was the worst off following Week 9, suffering not only a mild hamstring strain, but also ankle damage at three different spots. The Vikings did not reveal specifics but it sounds like he suffered lateral and medial sprains, in addition to a high ankle sprain. The swelling in the joint is significant and Harvin was using crutches Monday to reduce the amount of weight placed on and through the foot. The receiver said he remains a "longshot" to play this weekend which is a serious understatement. I suspect he sits for at least two games and the Vikings could elect to be even more conservative with one of their most valuable players.

Turf Burns

Jamaal Charles: Charles has passed each concussion exam he has taken and the team has ruled his injury a neck strain. He is likely to be active against the Steelers.

Aaron Hernandez: The Patriots are hopeful to have both of their tight ends on the field following their Week 9 bye. Out with an ankle injury originally suffered in Week 1, Hernandez did not participate in the team's lone bye week practice. Keep a close eye on his availability throughout the week as the always cryptic Bill Belichick will likely remain tight-lipped.

Maurice Jones-Drew: Facing a short week the Jaguars have already ruled out MJD. The news only gets worse as Jacksonville already thinks he will be questionable for Week 11.

DeMarco Murray: Don't expect to see Murray back in uniform this week either. The running back still has not returned to practice and has yet to be cleared by team medical personnel. The situation is beginning to look remarkably similar to the Darren McFadden's saga from a year ago as this midfoot sprain continues to linger.

Tony Romo: Romo suffered a mild back strain in the final play of Dallas' loss to Atlanta but expects to play against the Eagles in Week 10.

Jeff Stotts is a Certified Athletic Trainer, MAT, PES and the Injury Analyst for You can follow him on twitter @RotoWireATC.