Buffalo Bills LeSean McCoy Injury Discussion

On Sunday afternoon against the Miami Dolphins, running back LeSean McCoy had his ankled rolled on when he was being tackled. He was injured on the way down after being tackle. It doesn’t appear that the tackle really had anything to do with it but the way his foot was . His x-rays were negative, thus the diagnosis being an sprained ankle.

It’s tough to see exactly what type of ankle injury occurred, even from multiple angles. It could have been an inversion sprain or an eversion sprain.

Anatomy Review:

The ankle joint is made up of the tibia and fibula and the tarsal bone: talus. It’s known as the talocrural joint. The joint itself is functionally a hinge joint, which primarily allows the movement of flexion and extension (also known as dorsiflexion and plantarflexion).

The ankle is held together by a series of ligaments and by several muscles that cross the joint. The lateral ligaments are more commonly sprained compared to the medial ligaments. The medial ligament is thicker and more robust compared to the lateral ligaments. The lateral ligaments (anterior talofibular, posterior talofibular, and calcaneofibular) are smaller and thinner, which make them innately weaker.

What makes ankle injuries a challenge is the more you sprain your ankle the longer it takes to recover.  Because the ligaments don’t heal quickly and don’t return to normal length after an injury, stability thus needs to come from the surrounding muscles.

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What Could I Do?
At this point, we are doing everything we can to manage the inflammation and the pain. The goal is to get him ready in one week to play in playoffs. That’s it. Progress will be determine by his ability to bear weight, load weight onto his ankle, walk, jog, and cut.

A simple test I use for ankle sprains in the clinic is just the weight shift test. I pre-test – treat – post-test.

There’s going to be a lot of manual work. We’ll work the ligaments of the ankle and then we’ll work muscles of the lower leg as well, via Active Release Technique or Graston. All which play an important role in the stability of the ankle. He’ll also receive treatment with ultrasound, electrical stimulation, massage. He’ll be protected by a walking boot when moving around as to protect it when he’s not receive treatment.

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My Take: I think he will be playing against Jacksonville on Sunday. It helps that he will get an extra day of treatment because they play on Sunday instead of Saturday. While he will probably be “slowed” due to the ankle injury, because the ligaments provide stability to his ankle. With McCoy’s running style, stability in his joints are key to his ability to move as quick as he does.

I don’t think he’ll necessarily be limited. He’s going to shoulder the workload for the Bills.

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