We've Seen How Tricky These Can Be

By Abby Sims
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Tom Coughlin was quoted as saying “Hopefully, it’s an ankle and he is coming right back,” in reference to Giants leading tackler Antrel Rolle, who was carted off the field Monday after sustaining an injury while going up for high pass and landing awkwardly.

The safety reportedly had difficulty bearing weight on his right foot and winced when trainers palpated the ankle, both signs that Rolle isn’t a sure bet to bounce “right back”.

The MRI will reveal whether the player suffered a fracture as well as provide more information as to the location and severity of the ligament(s) sprained. Coughlin would be wise to recognize that the consequences of even an isolated sprain should not be minimized.

A Grade 2 sprain – which is essentially a partial tear – requires sufficient healing time in order to maximize function and reduce the incidence of re-injury. At three weeks post injury the involved tissue is only at about 30 percent strength, while at the three-month mark, the strength of the involved tissue is approximately 80 percent of normal. Placing full demand on weakened tissue promotes re-injury.

In addition, after a sprain, the stability of the joint is likely to be compromised. For a high ankle sprain, which affects the ligaments connecting the two bones in the lower leg, the course of recovery is often more protracted than for more typical inversion sprains (which affect the outer ankle).

Someone who sustains an ankle injury will also evidence related losses in strength, balance, and proprioception (position sense). These changes aren’t localized to the foot and ankle region. For instance, during the acute phase of recovery, reduced weight-bearing and an avoidance of pushing off forcefully while walking generally contributes to weakening of the gluteal muscles as well as the hamstrings, muscles that are also active at push-off. When one part of the chain is affected, signals to the other parts of the chain take a hit. Opposing muscles may also be triggered to go into overdrive to compensate. Loss of strength of the calf muscles and those muscles in the region of the sprain is the more obvious consequence of an ankle sprain.

All of these must be addressed in rehab, along with soft tissue techniques to promote healing and minimize scar tissue. If a joint is immobilized in the early phase of recovery of a more severe injury – such as a fracture or Grade 3 sprain (which is a complete rupture) – the joint and those around it may subsequently require manual therapy to restore full mobility once movement is encouraged. In the latter phases of rehab, power and agility are also stressed to restore full competitive function.

We’ll wait to pass judgment on Rolle’s condition until we learn more.

However, as for saying only “an ankle”? No big deal?

There are so many athletes who might disagree — starting with Derek Jeter.

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