He broke the news that he suffered a high ankle sprain after the game, but Mahomes finished the game after trainers taped up his ankle. The Kansas City Chiefs quarterback fell awkwardly on his ankle during a playoff game against the Jacksonville Jaguars on January 21, 2023. It has been one of the biggest talking points in the discussion about Patrick Mahomes’ right ankle, leading up to Super Bowl 2023.
During the game, if any problems arise, it is expected that he will be ready to play at the Super Bowl kickoff, but injuries can limit performance and cause a few issues. Elite-level rehabilitation and treatment provided by teams help players like Mahomes, an NFL quarterback, to recover and reach their fitness level. However, ankle sprains are serious and painful injuries. When I saw Mahomes go down during the game against the Jaguars, I cringed, as I had a similar injury myself while playing high school football. As a surgeon specializing in ankle injuries in sports, I can provide the necessary expertise.
What is an ankle sprain?
The tibia, or lower leg bone, and the smaller fibula, which is situated on the outside of the tibia, consist of the ankle – two substantial leg bones – and several robust ligaments that connect the leg bones to the foot and provide stability to the entire region.
Ankle sprains can range from severe to moderate or mild, and the severity is determined by the location on the graded scale. These sprains occur when the ligaments that hold the ankle together are stretched or torn due to abnormal rolling or bending of the ankle joint.
The most common type of ankle sprain typically occurs when the foot rolls inward or experiences inversion, leading to the occurrence of low ankle joint sprains that involve the ligaments on the outside part of the lower ankle.
Mahomes suffered a high ankle sprain, similar to the injury caused by the defensive player of the Jaguars when he fell and tackled Mahomes, causing his foot to roll outward and stressing the ligaments of his ankle. High ankle sprains are less common than low ankle sprains.
Walking it off or needing surgery
There is a significant disparity in performance and recovery time between a minor grade I sprain and a severe grade III sprain. Bringing home the Lombardi Trophy requires a certain level of comfort and the ability to impact Mahomes’ overall performance, both of which can be affected by joint issues caused by walking difficulties, swelling, and varying levels of pain resulting from sprained ankles.
High ankle sprains are more often serious injuries. The majority of these injuries result in severe pain, swelling, and bruising of the ankle, as well as a complete tear of the ligaments. Initially, it is very difficult to jump or run, and even standing on the ankle is very challenging. If not treated properly, this injury can lead to pain, weakness, and instability that limits the function, especially for elite athletes. High-quality ligaments in a healthy ankle provide more stability.
An encouraging indication is typically when a sportsman can make a comeback and resume playing in the same match or shortly thereafter. Taking a break from running and jumping is crucial during the initial days following the injury. The majority of individuals require a period of rest and therapy to alleviate the swelling in the ankle following a grade II sprain. Judging from the injury video and my background in treating professional athletes, it is safe to say that Mahomes endured at least a grade II, or moderate, sprain.
Treating high ankle sprains
Therapy can assist in expediting this procedure, but elevated ankle sprains necessitate a lengthier period for recuperation and recovery compared to other categories of sprains, in general.
After a few days, the majority of individuals return to their usual routines after some rest. Typically, this indicates they have a minor injury and won’t need an extended break from physical activities if the ankle remains steady and the individual can engage in running and jumping with minimal discomfort. I commence by conducting a physical examination to assess the stability of the joint when a patient presents with a complaint of a sprained ankle.
The research shows that in cases where the ankle is moderately unstable, the healing process can be expedited by immobilizing the ankle and providing patients with pain-reducing drugs such as ibuprofen, which are non-steroidal anti-inflammatory drugs. Additionally, following the well-known “RICE” method of rest, ice, compression, and elevation is essential to reduce swelling and pain, especially in more serious injuries.
Prior to returning to play, gradual sport-specific drills are conducted. This usually includes low-impact training such as therapy pool sessions and stationary bike rides. In order to reduce swelling and focus on stability and strength training, I will begin transitioning my patients into this program for about four to seven days. After the initial rest period, elite athletes and most patients can start putting weight on their ankle while still wearing a boot. Additionally, I also recommend that my patients keep their injured leg off the ground.
In these instances, the most optimal choice may entail a surgical procedure that utilizes screws, plates, and other equipment to secure the fibula and tibia together. This method aims to provide ankle support, particularly when the ligaments are completely torn or severely injured to the extent that natural healing is unlikely, as seen in the most severe cases of grade III high ankle sprains.
Luckily for Mahomes and football fans across the United States, his injury doesn’t appear to require immediate surgery, at least for now.
Given the moderate severity of the injury, his fitness, and the high quality of care he is receiving, I expect that Mahomes will be prepared to play an exhilarating game come kickoff on Super Bowl Sunday. Research indicates that the majority of athletes with high ankle sprains typically resume their sports activities and perform at a comparable level to their pre-injury performance.