New York Knicks forward Kristaps Porzingis suffered an ankle injury Wednesday night against the Miami Heat. And it didn’t look pretty.
When I saw it happen initially, I thought the worse. It looked ugly. And as many of you know, although some injuries look severe sometime they just don’t end up that way.
By all reports, his x-rays were negative and right now it is only being classified as a “sprain.” Reports say he was available if need to come back into the game last night. He is getting an MRI to determine if there is any soft tissue damage.
The Ankle. We’ve seen a lot of different sort of ankle injuries in the time I’ve been doing this (which is all of 2 months). Inversion ankle sprains are the most common type of ankle sprains, which is what Kristaps suffered last night.
Inversion Ankle Sprain: The most common type. Usually caused by a combination of ankle inversion and plantar flexion. Can sideline an athlete anywhere from 1-2 weeks.
High Ankle Sprain: There is involvement of the anterior tibiofibular ligament. That ligament is a syndesmosis joint above the ankle joint itself. This ligament holds together the fibula and tibia on the anterior inferior (front-bottom) side. The recovery is much longer since there is further damage and can sideline an athlete from 4-6 weeks (maybe even 8).
Eversion Ankle Sprain: These type of ankle sprains are rare. The mechanism of injury involves a valgus force on the ankle itself to damage the medial ligaments (Deltoid) of the ankle itself. While rehabilitation will consist of generally the same exercises, eversion ankle sprains can take longer to heal, especially depending on the valgus force placed on the ankle.
Ankle injuries are not only classified by the type of injury (inversion, eversion, high) but also by the severity of the injury itself.
Grade I: A stretch of the ankle ligaments involved. The athlete is often able to recovery quickly from them and return to sport within days to a week (dependent on treatment and pain tolerance)
Grade II: An incomplete tear of the ankle ligaments involved, often associated with ankle instability the patient is feeling.
Grade III: A complete tear of the ankle ligaments involved, heavy swelling, and potentially other damaged structures
What Could I do?
As long as x-rays are able to rule out fracture, dislocation, or avulsion then we can begin to work immediately on the ankle to help mitigate pain. The idea of inflammation and swelling can be a controversial one because inflammation is not a bad thing, yet many healthcare providers jump to the idea of immediately trying to reduce inflammation. We’ll use a lot of manual techniques such as IASTM, A.R.T, joint mobilizations, and taping.
The soft tissue we’ll be working includes the ligaments and capsules, muscles such as: gastrocnemius, soleus, tibialis anterior and posterior to name a few. We want to get to tissue healthy and soft tissue work is one avenue to do that.
But regardless, what we are trying to do is reduce pain and get range of motion in the ankle. You may be asking, why do you want range of motion in an ankle that appears to have a whole lot of it in the injury it just sustained. Well that’s a great question, we want to restore range of motion in the correct plane of movement. Restoring that range of motion will then allow us to create stability and strength in the ankle much sooner.
For me, I want to see if the athlete can bear weight. If they can’t bear weight, we’ll do stability exercises and range of motion exercises seated with no weight on the ankle, but if they can bear weight we’re going to move in that direction quickly to build strength in the ankle. The ligaments and soft tissue now have more laxity, so creating stability in that ankle is important.