As we talked about on the blog during the playoffs, Mahomes had been dealing with the fallout of a high ankle sprain that he suffered earlier in the playoffs against the Jacksonville Jaguars. He looked uncomfortable during the AFC Championship against the Cincinnati Bengals, and it certainly affected his mobility, which was expected considering a high ankle sprain typically knock athletes out for at least a few weeks. The Chiefs advanced and had two weeks off before the Super Bowl, and Mahomes was able to protect and strengthen his ankle during that time. It was clear that he still wasn’t 100 percent, but he still scampered for 44 yards en route to a Super Bowl victory.

What’s Next?

The next steps for Mahomes will be pretty similar to the steps he followed on the lead up to the big game, in that the two key components of his recovery will be rest and physical therapy. Rest should be easy enough, as the season is over and he won’t need to step back on the field in a competitive game until September. The real key will be continuing his physical therapy.

That’s because ankle sprains involve damage to key soft tissues that help to stabilize the ankle joint. Even if swelling subsides and recovery gets to the point where the ankle is no longer painful, that doesn’t mean that the ankle is stable. Ankle instability is a real concern for athletes after a sprain, especially those athletes that rely on quick cuts, jumps or pushing hard off their feet during their sport. While Mahomes may not be the most mobile quarterback in the league, his ability to move around in the pocket and pick up yards on the ground when the situation presents itself is what arguably makes him the best quarterback in the league. If he’s slowed by this ankle injury because it never truly stabilizes, or he loses confidence in his ankle because it feels unstable, there’s a change that it could linger and affect his play.

Now, with that being said, it seems extremely unlikely that a young, highly motivated athlete who just earned league and Super Bowl MVP honors would ignore an issue that has the possibility to significantly affect his game and his future. Moreover, being a professional athlete, Mahomes has access to some of the world’s best medical care, and he’ll have a team of athletic trainer’s whose sole job this offseason is to ensure that ankle is as healthy as possible entering the 2023 season so that the Chiefs can attempt to defend their crown.

As for Mahomes, while he doesn’t believe the ankle will affect his availability for organized team activities later in the offseason, he did joke that he may not be able to play as much golf as he would like during the offseason as a result of his injury and rehab.

“I’ll for sure be ready for OTAs  and everything like that,” he told reporters on Monday after NFL Commissioner Roger Goodell presented him with the Super Bowl MVP trophy. “Obviously, we’ll have to continue to rehab, continue the treatment that we were doing, and just give it some rest. I think the best thing for it is going to be rest. One thing that might take a hit is my golf game. So I’ll take a few weeks off of that.”

Congrats to Mahomes and the rest of the Chiefs, and here’s hoping that his ankle is back to full strength heading into the 2023 season!

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Mahomes suffered the injury late in the first quarter and missed almost all of the second quarter while being evaluated by team trainers before returning to the game after half time. You can take a closer look at the mechanism of injury in the video below.

Better angle of Patrick Mahomes injury. Concern would be

— Right knee MCL sprain
—Right High ankle sprain pic.twitter.com/TL1iKdohQ2

— Dr. Evan Jeffries, DPT (@GameInjuryDoc) January 21, 2023

Dr. Silverman Comments

This is a classic eversion ankle sprain that involves damage to the syndesmosis (the ligaments that connect the tibia and fibula) just above the ankle. High ankle sprains are less common than a standard inversion ankle sprain, but they tend to be more severe in nature. Oftentimes they are classified based on their severity.

Grade 1 – The syndesmosis is stretched but not torn.

Grade 2 – The syndesmosis is partially torn.

Grade 3 – The syndesmosis is completely torn.

The fact that Mahomes returned to the contest suggests that he did not suffer a Grade 3 sprain, but a Grade 1 sprain is still enough to severely hobble him if he only has a week to heal. The biggest issue he’ll face is stability in the injured ankle.

During normal movement, the shin bone advances over the main ankle bone (the talus) to help move the body forward. However, if the supportive ligaments are injured, the foot will become unstable. An athlete won’t be able to put their full body weight on their ankle, and rotational movements will become an even greater issue due to the ankle’s instability. The injury is to Mahomes’ right foot, which is his plant leg and the one that he’ll hope to drive off of when throwing a pass. This injury will not only severely limit his mobility, but it will also affect his ability to throw the ball as hard because he won’t be able to push off his back foot as easily.

Chiefs Head Coach Andy Reid said that the ankle injury was not as serious as the one Mahomes suffered in Week 1 of 2019 against the same opponent. Mahomes finished that game and put up a great performance in Week 2, but this injury is to his plant foot, whereas that injury occurred on his left foot. Stability problems in an ankle will be more problematic for a right handed quarterback’s right foot (plant foot) than their landing foot (left foot).

High ankle sprains typically take weeks to fully heal, but the Chiefs only have until Sunday. Mahomes has the benefit of having one of the best medical teams by his side, and he’ll get a healthy course of rest, ice and elevation, but there’s only so much that can be done in this short of a time period.

It seems likely that Mahomes will not practice all week and that the team will significantly tape the ankle to provide some extra support on Sunday, but he certainly won’t be 100 percent. His mobility will be affected. Not just when he’s trying to move around in the pocket, but when he drops back to pass or maneuvers to hand off in a stretch run play. The team will likely have him work out of the shotgun to limit stress on the ankle that would occur during a normal 5-step or 7-step drop back, and Mahomes may not have the same arm strength as normal, but his mobility will be more affected than his arm.

Knowing the competitor that he is, it seems all but certain that he’ll play on Sunday, but how effective he’ll be is still up in the air. The likely MVP certainly gives the Chiefs the best chance to win, but the Bengals will have an advantage knowing that they’ll be able to rush without the fear of Mahomes scrambling for a big gain. It’s going to be a chess match, and we’re excited to watch it. Here’s hoping Mahomes can make a decent recovery in the next few days and that he doesn’t cause more damage to the ankle by trying to play through the pain.

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Anyone who watched the NFL playoffs knew that Mahomes’ toe wasn’t 100 percent, as he was often seen hobbling or limping around between plays, but you couldn’t tell anything was bothering him while he was running around making spectacular plays for his team. Now that the season is over, Mahomes turned his attention to that nagging foot injury, and it was revealed that he was suffering from turf toe.

We’ve published pieces on turf toe and how it affects NFL players in the past, but it is an injury that occurs when the big toe joint is forced upwards, causing sprains or tears of the plantar ligaments and tendons. If not addressed properly, this tendon and ligament damage can have long-term consequences for someone like Mahomes who relies on quick and intense foot movements every time he steps on the field.

For that reason, Mahomes opted to have the turf toe injury surgically addressed by an orthopedic surgeon.

Surgery And Recovery

For severe cases, the surgeon will work to sew the ligament, also known as the plantar plate, back into place. Because it’s a thick ligament, recovery takes a fair amount of time. Oftentimes patients will wear a walking boot for around six weeks following the surgery, and even after six weeks weight bearing precautions need to be taken. He’ll undergo some physical therapy as well to help ensure he returns to normal joint flexibility and range of motion since the area has been underutilized for an extended period.

The good news for Mahomes is that the NFL offseason is pretty long, and even though he played into February, he still should have plenty of time to make a full recovery ahead of next season’s training camp. He’s young and he didn’t put off surgery until later in the offseason, which are two things that will work in his favor. I see no reason to think that he’ll be anything less than 100 percent healthy when the 2021 season rolls around, which means the Chiefs will likely be the favorites to come out of the AFC once again.

Here’s hoping his recovery stays on track and one of the stars of the NFL can return to competition with a clean bill of health.

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