2026 NFL Week 1 Injury Highlight DeZhaun Stribling

De’Zhaun Stribling’s Ankle Injury: What Happened and What Does Recovery Look Like?

NFL football is one of the most physically demanding sports in the world. Players are constantly accelerating, stopping, jumping, cutting, and changing direction. These explosive movements place tremendous stress on the lower extremities, particularly the ankle.

San Francisco 49ers wide receiver De’Zhaun Stribling experienced this firsthand during Week 1 of the 2026 NFL season when he suffered a significant left ankle injury against the Los Angeles Rams.

What initially appeared to be an ankle injury that might allow him to return quickly ultimately required surgery. Stribling is expected to miss approximately 10 weeks as he works through recovery and rehabilitation.

His injury provides a great opportunity to explain what happened, what a deltoid ankle sprain is, how these injuries are treated, and what rehabilitation can look like before an athlete returns to sports.

What Happened to De’Zhaun Stribling?

Stribling injured his left ankle during the 49ers’ Week 1 matchup. He initially attempted to continue playing but later had difficulty putting weight on the injured leg. He was evaluated by the team’s medical staff and eventually removed from the game.

There was initially some concern about a more serious lower-leg injury, including a potential Achilles injury. However, further evaluation confirmed that his Achilles tendon was intact.

Stribling was ultimately diagnosed with a deltoid ligament sprain of the ankle. The injury was significant enough to require surgery, and he was placed on injured reserve. The 49ers have indicated that Stribling is expected to miss approximately 10 weeks.

What Is a Deltoid Ankle Sprain?

When most people think about an ankle sprain, they typically picture an injury to the ligaments on the outside of the ankle. The deltoid ligament is located on the inside—or medial side—of the ankle. This strong group of ligaments helps stabilize the ankle and prevents excessive outward movement of the foot.

A deltoid ligament injury can occur when the ankle experiences significant force, particularly when the foot is forced outward or the ankle experiences a strong twisting or rotational force.

Deltoid ankle sprains are less common than traditional lateral ankle sprains, but they can be more significant because of the amount of force generally required to injure the medial ankle ligaments.

Depending on the severity, the ligament may be stretched, partially torn, or completely disrupted.

How Is an Ankle Sprain Diagnosed?

A physical examination is an important part of diagnosing an ankle injury. A healthcare provider may evaluate:

• Pain and tenderness, swelling and bruising, ability to bear weight, ankle range of motion, ligament stability, muscle strength, walking mechanics, Balance, the presence of other injuries

Imaging may also be necessary. X-rays can help determine whether a fracture is present, while an MRI may be used when there is concern about significant ligament, tendon, or soft-tissue damage.

In Stribling’s case, additional evaluation determined that his injury was serious enough to require surgical treatment.

Does Every Ankle Sprain Require Surgery?

No. In fact, most ankle sprains are treated without surgery. Treatment depends on the severity and location of the injury, the amount of instability, associated injuries, and the individual’s goals and activity level.

Less severe ankle sprains can often be treated with:

• Relative rest, swelling management, bracing, gradual weight bearing, range-of-motion exercises, strengthening, balance training, progressive return to activity

More severe injuries involving significant ligament disruption or instability may require surgical repair or reconstruction. For a professional football player, restoring ankle stability is particularly important because the ankle must withstand repeated high-speed movements, cutting, jumping, and contact.

What Does Rehabilitation Look Like After Ankle Surgery?

Rehabilitation following ankle surgery is a gradual process. The goal is not simply to get the athlete walking again. The goal is to restore strength, mobility, stability, balance, and confidence necessary to safely return to high-level activity.

Phase 1: Protect the Ankle

Immediately following surgery, the primary goals are protecting the surgical repair and controlling pain and swelling. Depending on the procedure and the surgeon’s instructions, the athlete may need:

• A walking boot, crutches, temporary restrictions on weight bearing, elevation, swelling management, gentle range-of-motion exercises when appropriate

During this phase, physical therapy may also focus on maintaining strength and mobility in areas that can safely be exercised.

Phase 2: Restore Mobility and Strength

Once the ankle has adequately healed and weight-bearing restrictions are reduced, rehabilitation becomes more active. The physical therapist may introduce exercises targeting the:

• Calf muscles, foot and ankle, quadriceps, hamstrings, glutes, hip musculature, core

This whole-body approach is important because the ankle does not work independently. The entire lower extremity must work together to control movement.

Phase 3: Rebuild Balance and Stability

Balance is an important part of recovering from an ankle injury. The body’s ability to sense joint position is called proprioception. An ankle injury can temporarily disrupt this system. Rehabilitation may progress from basic balance exercises to increasingly challenging activities, including:

• Single-leg balance, reaching exercises, dynamic balance, perturbation training, single-leg strengthening, jumping and landing exercises

The goal is to teach the ankle and nervous system to respond quickly and appropriately to changes in position.

Phase 4: Running, Cutting, and Agility

Walking without pain is an important milestone—but it is nowhere near enough for an NFL wide receiver. As strength and stability improve, rehabilitation can progress to:

• Jogging, running, acceleration, deceleration, lateral movements, cutting, jumping, landing, change-of-direction drills

The intensity is gradually increased so the athlete’s body has time to adapt.

Phase 5: Sport-Specific Rehabilitation

The final stages of rehabilitation focus on preparing the athlete for the exact demands of their sport. For Stribling, that means progressing toward the movements required of an NFL wide receiver, including:

• Running routes, explosive acceleration, sharp changes of direction, jumping for the football, landing, cutting against defenders, reacting to unpredictable movements

Before returning to competition, an athlete needs to demonstrate that the injured ankle can tolerate these demands without pain, instability, significant swelling, or meaningful strength differences compared with the opposite side.

How Long Does Ankle Injury Recovery Take?

Recovery time varies significantly depending on the severity of the injury and whether surgery is required. In Stribling’s case, the 49ers have projected approximately 10 weeks away from football. However, a projected timeline should not be viewed as a guaranteed return date. Every patient heals differently. Rehabilitation should progress according to objective milestones rather than simply a calendar. A successful return to sport requires the athlete to demonstrate adequate strength, mobility, balance, coordination, and sport-specific function.

What Can We Learn From Stribling’s Injury?

Stribling’s injury is an important reminder that not all ankle sprains are created equal. Some ankle sprains may improve within a few weeks, while more significant ligament injuries can require months of rehabilitation and, in some cases, surgery. It also highlights the importance of having an ankle injury properly evaluated. If you experience significant swelling, difficulty putting weight on your leg, instability, severe pain, or an inability to continue your activity following an ankle injury, don’t simply try to “walk it off.” Early evaluation can help determine the severity of the injury and establish an appropriate treatment plan.

The Bottom Line

De’Zhaun Stribling’s Week 1 ankle injury demonstrates how much stress the ankle can experience during high-level sports. His recovery will involve much more than simply allowing the ankle to heal. Following surgery, rehabilitation will focus on restoring mobility, strength, balance, stability, coordination, running ability, agility, and confidence.

Whether you’re an NFL athlete, high school athlete, weekend warrior, or simply someone who wants to return to normal daily activities, the principles are similar.

The goal of physical therapy isn’t simply to make you feel better. It’s to help you move better, regain function, and safely return to the activities that matter to you.

Recovering From an Ankle Injury?

If you’ve suffered an ankle sprain or are having difficulty returning to sports or everyday activities after an ankle injury, physical therapy can help.

At Portsmouth Physical Therapy, our team works with patients of all activity levels to reduce pain, restore mobility and strength, improve balance and stability, and safely return patients to the activities they enjoy.

Don’t let an ankle injury keep you on the sidelines. Contact Portsmouth Physical Therapy to schedule an evaluation and take the next step toward getting back to doing what you love.