We talk a lot about ankle instability and high ankle sprains on this blog because both conditions are often misdiagnosed or improperly treated. In this article we will compare two recent basketball injuries – a high ankle sprain, and an ankle sprain that is the result of ankle instability.
This is what Ankle Instability looks like:
Bryant’s right ankle is unstable and that is why it rolls. The slow motion action in the video perfectly showcases this condition. When Bryant sprained his ankle more than a decade ago, the ankle rolled inward by a supra-physiologic force (i.e. landing on another player’s ankle, landing on a ball, stepping into a hole, etc.).
In this sprain, Bryant’s right ankle rolls inward (inverts) after Lebron makes him commit to his right and shifts back to his left. All the give way episodes Bryant has suffered happen because the ankle is unstable. Many people have this same problem – they have an ankle that routinely gives out. Bryant has accommodated for this ankle instability for a decade, his latest “foot sprain” is a secondary consequence of his ankle. Not addressing this ankle instability will lead to failure of treatment of the right foot.
This is what a High Ankle Sprain looks like:
Here Austin Rivers drives and plants his left foot. He slips and his right foot twists outward (external rotation). This is a high ankle sprain.
Rivers will likely need surgery to stabilize his syndesmosis – the ligaments that hold the two leg bones together that are injured in a high ankle sprain. It is more difficult to accommodate for a high ankle sprain than for ankle instability. You lose significant amounts of push off power if these ligaments are unstable and arthritis progresses much more rapidly.
Lance Silverman, MD
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