Week 5 NFL Injury Spotlight: Khalil Herbert with High Ankle Sprain

Khalil Herbert suffered a right high ankle sprain in the 3rd quarter against the Washington Commanders last Thursday night.

So what is a high ankle sprain? Well, a high ankle sprain is also known as a syndesmosis injury and occurs between the tibia and fibula of lower leg rather than at the ankle joint. The syndesmosis holds the tibia and fibula together and are commonly injured due to high external rotation forces.

When bearing weight in the leg, the tibia and fibula are spread apart. The syndesmosis prevents the fibula and fibula from spreading apart too much due to force and is a huge shock absorber.

Signs and symptoms include:
⁃ Minimal brusinf and swelling
⁃ Pain at front of shin
⁃ Pain when squeezing lower leg
⁃ Difficulty walking and running

High ankle sprains account for 10% of ankle ligament injuries whereas low ankle sprains represent 90%. High ankle sprains are most common in football players due to high contact.

These injuries are usually diagnosed with the squeeze test of shin and with use of diagnostic imagining such as x-rays or an MRI.

How can PT help patients with this injury. Interventions include:
⁃ ankle mobility exercises (AROM & PROM)
⁃ Single leg static and dynamic balance
⁃ Ankle, knee, and hip strengthening
⁃ instrument assisted soft tissue mobilization to shin and ankle area
⁃ Improvement of gait mechanics so as to not compensate and be at risk for further injury

Herbert will most likely be out for 4-6 weeks due to this injury. He will spend this time rehabbing with more sport specific activities so he can be out on the field as soon as possible.