Category Archives: Ankle/Foot

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LaMarcus Aldridge’s Ankle Sprain

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San Antonio Spurs All-Star power forward LaMarcus Aldridge left the game against the New Orleans Pelicans Wednesday night after landing awkwardly while attempting to defend Rajon Rondo’s layup attempt in the first quarter of the game. He re-entered the game briefly before exiting with 7 minutes and 39 seconds left in the first half and did not return. The Spurs have announced that Aldridge has a sprained right ankle.

Ankle sprains are one of the most common sports injuries and occurs when the ligaments which support the ankle stretch beyond their limits and tear. There is a range of severity among ankle sprains, depending on how badly the ligaments are torn.

Most sprains are Grade I sprains, where just a few fibers are torn. They can heal with rest and ice. Moderate ankle sprains are known as Grade II sprains, where more of the structure is damaged, but there still some ligament structure intact and the ankle is still stable. A Grade III sprain is a complete tear of the ligament.

Ankle sprains heal naturally over time. It’s not possible to categorize a sprain precisely into one of the three groups. One can get a sense of the severity of the sprain based on the amount of tenderness, swelling and bruising. A complete tear is diagnosed based on the ankle being loose on exam.

If part of the ligament is intact, it’s safe and even healthy to put weight on it and external support such as a brace, boot or cast is mostly for comfort. Sprains are common among basketball players. With the ankle supported by taping or bracing, it is often possible to return when the ankle is still healing and still sore. Given that LaMarcus returned to the game, it must be a relatively mild sprain that they tried to support.

According to league sources, there is no timetable for Aldridge’s return. If it’s just the ligaments and they are mostly intact, he can resume play when he is comfortable and mobile enough to be effective. Since return to play risks re-injury and could delay recovery, one strategy would be to keep him out of competition until a more advanced stage of healing, in preparation for the playoffs, for instance.

This article was made by Hunter McConnie and David Ring

Achilles Rupture, All Blogs, Ankle/Foot, Football

Richard Sherman’s Achilles Tendon Rupture

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After the Seattle Seahawks’ win on Nov. 9, it was determined that cornerback Richard Sherman had ruptured his Achilles tendon during the game and will miss the rest of the season. Sherman was on Seattle’s injury report the week of Oct. 30 because of his Achilles. It was painful for most of the season.

What causes Achilles tendon rupture?
A normal Achilles tendon is unlikely to rupture. Usually, there is a pre-existing tendinopathy (tendon disease). This tendinopathy is often not painful prior to the rupture. And not all painful tendinopathies rupture. As with other muscle, tendon or ligament insertion site problems (enthesopathies), Achilles tendinopathy is most common in middle-aged people (those ages 35 to 60). Athletes sometimes develop tendinopathy or rupture in their late 20s or early 30s. Patellar tendon, quadriceps and Achilles tendon ruptures are generally problems of an athlete near the end of their professional career (e.g. Kobe Bryant, Tony Parker, etc.).

The media has portrayed Richard Sherman often as a critic of Thursday Night Football because it requires players to play after minimal time off. Did the short interval between the Seahawks’ last game and the Thursday night game cause Sherman’s Achilles injury?
The relationship between activity (painful or not) to tendinopathy is unclear. Patients with painful tendinopathy often don’t rupture. Many ruptures are not preceded by symptoms. Tendinopathy most often occurs in middle-aged patients of varied activity levels and is not clearly related to activity. Rupture is often the result of a stretch to the muscle when it is contracting, called an eccentric load.

Is surgery necessary for an Achilles tendon rupture?
Rupture of the Achilles tendon can be treated operatively or nonoperatively. The tendon heals when immobilized with the foot pointed toward the ground (plantarflexion). This can be done in with a removable splint, with weight-bearing and with graduated motion exercises. Surgery adds risks of infection and wound problems, but is felt by some to speed recovery and limit re-rupture. Studies have shown similar outcomes between patients treated with and without surgery, including similar rates of re-rupture, which is uncommon in general.