Cleveland Browns’ linebacker Titus Brown will be sidelined with a high ankle sprain. The Browns have been pummeled with injuries this preseason. Titus Brown will join teammates Eric Steinbach (tackle) and Brandon Jackson (running back) and Jordan Norwood (wide receiver) on the injured list. With a season opener on September 11 against the Cincinnati Bengals, things are not looking good for Cleveland.
A high ankle sprain is an injury to the syndesmosis between the tibia and fibula. The ligaments that attach the tibia to the fibula aid in stabilizing the ankle joint. These ligaments can become sprained or even torn when the leg is forced to rotate outwards with a planted foot. This is a common injury in contact sports, football in particular.
The syndesmosis is composed of the anterior and posterior inferior tibiofibular ligaments. In a sprain, usually only one of these ligaments is injured. The syndesmosis can also be injured in ankle fractures, where the fibula is destabilized and allowed to rotate.
The diagnosis is usually suspected through history and physical examination, and may be confirmed with x-rays and an MRI. MRI may not be necessary for everyone, but can help differentiate between a sprain and a tear of the ligaments. For high-level athletes, MRIs are typically ordered swiftly.
Once the diagnosis is confirmed, high ankle sprains are treated with a period of immobilization in a cast for about 6 weeks. Anti-inflammatory medications and pain relievers may also be used in conjunction with immobilization to relieve the symptoms. Following immobilization, a period of rehabilitation will begin. This generally involves aggressive stretching and strengthening exercises, with a slow return to full weight bearing and activity.
For cases requiring surgery, a screw may be placed across the syndesmosis from the fibula to the tibia. This screw helps immobilize the joint while the ligaments heal, and is left in place for about three months. Patients are instructed not to walk on the leg while the screw is in place, as it could break with motion. The screw is taken out once the ligaments have healed, and an aggressive physical therapy rehabilitation program begins.
As for Brown, no surgery has been scheduled, and he’s been placed in a cast. For Cleveland Browns fans, this is good news, as the linebacker will likely return later in the season. While he won’t be ready for the regular season opener, he may be ready to return to play mid-season.
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