We see it time and time again in the NBA, the NFL, the MLB, and the MLS. Players have ankle sprains, rehabilitate, come back, have pain and continued troubles, and eventually undergo surgery.
It’s the way doctors are trained to treat athletes. Despite that, a significant percentage of these players still hurt and can’t return to full play after surgery.
So why do ankle surgeries for athletic ankle problems fail? Four reasons:
- The surgery performed did not address the cause of the problem. Too many players get only ankle arthroscopies to treat the spurs, rather than surgery to treat the cause of the spurs. Spurs form for one reason alone – the body is trying to find a way to stabilize a loose ankle joint. Removing the spurs gives temporary relief and feels better, but it doesn’t treat the problem.
- The surgery did not address all the problems. “All that sprains is not the ankle.” Other joints around the ankle can be a problem. Old high ankle sprains are hard to diagnose with spurs from repeat ankle sprains. The subtalar or the calcaneocuboid joint can be sprained and mimic or accompany ankle instability. Finally, in many ankle sprains people sustain a stretch injury of the nerve that runs across the top of the ankle. This nerve is essential as it gives feedback of the ankle position and when it doesn’t function right, players are unable to tell that their ankle is going to give way until it’s too late.
- Some patients have bad tissues. Some people are excessively flexible, doctors call it Hyperlaxity. They have a collagen imbalance with too much elastic collagen (the substance that allows our tissues stretch and return to the previous shape.) These patients often proudly self identify as “double-jointed.” Instead of being a benefit, this is a problem as ligament repairs fail much more often with these patients.
- Finally, simple bad luck. Sometimes people are in the wrong place at the wrong time and they re-sprain.