After a weekend where notable players like Vikings QB JJ McCarthy and Steelers LB Alex Highsmith sustained high ankle sprains, the difference between a high ankle sprain and a more common low ankle sprain is an important topic. High and low ankle sprains are very different injuries and can have very different recovery times.
High Ankle Sprains
A high ankle sprain is a stretching or tearing of one or more of the ligaments that hold the bottom end of the lower leg bones together. There are 2 long bones in the lower leg, the tibia and the fibula that run from the knee down to the ankle. Most of a person’s weight goes through the tibia, but the lower end of the fibula plays a key role at the ankle. At the lower end of these bones there are ligaments at the front and back of the lower leg and a membrane between the bones (sort of like the webbing between a frog’s toes) that attach the tibia and fibula together, stopping them from spreading apart. The biggest predictor for how long it takes to recover from a high ankle sprain is how far up the webbing-like membrane the injury extends. For a low-grade sprain, where the damage is just at the very lowest part of the lower leg and the bones don’t show any sign of spreading apart, athletes may be back on the field in 2-3 weeks. Considering McCarthy finished the game on Sunday and the Vikings have listed McCarthy as week-to-week, the hope is that this is just a minor setback that doesn’t keep him on the sidelines long term.
Low ankle sprains
A low ankle sprain, more commonly referred to simply as an ankle sprain, is damage to the trio of ligaments on the outer side of the ankle that attach the bottom of the fibula to the bones of the foot. These ligaments stabilize the ankle and prevent it from rolling inward. Keys to returning from a low ankle sprain are managing swelling, regaining strength and range of motion, and adding additional support like a brace or tape. Mild (grades 1 and sometimes 2) sprains may be back on the field in 1-3 weeks, more severe sprains are looking at 6-12 weeks for return to play. The biggest risk with low ankle sprains is for limited mobility on the field when they return, decreasing production and making the player vulnerable to further injury. This week these ankle sprains seemed to hit the defenses the hardest with guys like Bengals DE Shemar Stewart and Jets LB Jermain Johnson II not returning to their games.
As a fantasy owner, the trickiest thing about players with ankle injuries is the massive range in severity. Paying attention to updates like whether the player is running at practice or not can be one of the best indicators for an athlete being close to a return. Knowing that a history of ankle injuries may lead to repeat injury may also play into long term decisions in keeper or dynasty leagues.
