Lakers star LeBron James is out indefinitely following a right high ankle sprain he suffered during the game against the Atlanta Hawks. He rolled his ankle under Solomon Hill and hobbled off the court shortly after. MRI confirms the suspected diagnosis of a high ankle sprain. In this video, I discuss the return to play implications of such an injury and how long this superstar will be out!

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High ankle sprains are more severe that your traditional ankle sprain. They are caused by eversion and dorsiflexion of the ankle (foot tilting out, and pointed up). This type of sprain affects the ligaments holding the tibia and fibula together allowing them to create a stable ankle joint with the talus (ankle bone). With this ligamentous disruption, there is quite a lot of instability in the ankle. These sprains are notorious for needing almost double the length of time to heal then your regular lateral ankle sprain. 

When an athlete suffers such an injury, we do a carful physical exam to ensure there is no associated fracture in the tibia or fibula. We also are careful to assess the ankle joint to ensure there is no gross instability. If the joint is very unstable, the athlete may require surgical treatment. 

The treatment of high ankle sprains is very similar to that of lateral ankle sprains aside from one key consideration. As I discussed above, if the joint if very unstable, surgical fixation with a screw may be required. If the joint is relatively stable, then we make the athlete non weight bearing for a few weeks before progressing along a graduated therapy and return to play program.

Non surgical athletes on average return to play in approximately 4050 days, while those who’ve had surgery return at around 70 days. Now keep in mind that the course of treatment is variable and these tend to be tricky injuries to heal.

Unfortunately, given the mechanism of this injury, its not uncommon for athletes to suffer from chronic ankle pain and lack of stability despite therapy. 

I am a resident doctor training to become a sports medicine specialist. I make videos simplifying sport injuries making them easier to understand and go over how a doctor reacts to these injuries on the sidelines. We will review the anatomy, important things to consider, and discuss return to play. I will also discuss what the injury means for the athlete and their team’s future.

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As an important disclaimer, I am not offering any medical advice on this channel and the views expressed are that of my own and not my employer. I am not involved in the personal treatment of any of these athletes and can only offer my opinions. If you have personal medical questions, please seek the care of your physician. The content I reference is under the Fair Use Guidelines. I provide both educational and transformative material to the content for my audience.

Dr. Sonam
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