Ups and Downs in Chicago: All Ankle Sprains Aren't The Same

On election day, Chicago residents should be pretty excited about their senator's chances to become the next president of the United States. They are not happy, however, about the status of their Chicago Bears' starting quarterback. This past Sunday, Kyle Orton suffered, what is being called, a high ankle sprain.

Ankle sprains are amongst the most common injuries suffered by athletes but not all sprains are the same. We often hear about "high ankle sprains," and, at this point, even the casual sports observer knows that that is an ominous diagnosis. In common ankle sprains, it is the ATFL (or, anterior talofibular ligament) that most frequently gets injured. It leads to pain and swelling on the outside of the ankle. Treatment involves rest, ice, compression, and elevation (RICE). Athletes are typically back to sport in as little as a few days, though sometimes it may be a week or two.

The difference with high ankle sprains is the set of ligaments involved. The syndesmosis is a group of ligaments located above the ankle joint that hold the two bones of the lower leg (tibia and fibula) together. With running or cutting, common movements in sports such as football, the tendency is for the bones to spread apart. This is resisted by the syndesmosis.

Injuries to the syndesmosis usually occur from a sudden twisting injury. Unlike common ankle sprains where the pain is usually localized to the ankle, with syndesmotic injuries, the pain often radiates up the leg. When it gets injured, even waling can be painful, so running is out of the question. What is more frustrating for athletes is that these injuries often don't look bad in terms of swelling or bruising.

Treatment is usually the same as for common sprains (RICE) with one exception: time. High ankle sprains often require 4-6 weeks before athletes are back in the game. And, sometimes, surgery is required to stabilize these injuries. Hopefully for Orton, he falls into the 4 week group.