Recurrent Ankle Sprains And Patrick Mahomes’ Injury: When Surgery May Be Necessary

Ankle sprains are a common yet significant injury among athletes and active individuals. For someone like Kansas City Chiefs quarterback Patrick Mahomes, who suffered a high ankle sprain in early 2023, these injuries can mean the difference between playing at peak performance or sitting on the sidelines. In this blog, we’ll discuss recurrent ankle sprains, what it means when these injuries keep happening, and when surgical intervention might be the best option for long-term recovery and stability.

Understanding Ankle Sprains and Their Recurrence

Ankle sprains occur when the ligaments that hold the ankle together are stretched or torn, usually from a twisting or rolling movement. When these ligaments don’t heal correctly or they tear fully after an initial injury, it increases the risk of recurrent ankle sprains. Chronic ankle instability can develop, causing the ankle to feel “loose” and making it more susceptible to further injury with each sprain. This can lead to:

• Pain and swelling: Persistent discomfort and inflammation, even with minor movements. Patients often present with a complaint of mild discomfort and swelling localized to the ankle joint even up to 18 months post-injury. Many will have attempted a number of unsuccessful conservative treatments by the time they present to the office.
• Weakness and instability: Difficulty maintaining balance or completing activities without fear of twisting the ankle again. When a patient develops chronic ankle instability secondary to rupture of the lateral collateral ankle ligaments, the ankle will give out easier, especially if other muscles, like the peroneal tendons, are not strong enough to help support the ankle. Patients will complain that they cannot do many of their daily activities or exercise without the ankle giving out on them.
• Decreased mobility: Limited range of motion or flexibility, which can impact athletic performance and daily activities. Decreased mobility can result secondary to scar tissue formation or improper biomechanics that have developed as a result of the injury.

Patrick Mahomes’ Injury and Ankle Sprain Challenges

Mahomes’ high ankle sprain was particularly challenging, given that the high ankle ligaments are located above the ankle joint, making them more resistant to healing due to their limited blood flow. Despite the Chiefs’ efforts to manage his injury conservatively, Mahomes’ ongoing strain highlights the reality that for professional athletes—or anyone with a physically demanding lifestyle—a high ankle sprain can lead to ongoing issues. Although Mahomes was able to return to the field, these injuries can predispose players to chronic ankle instability and potentially more severe injuries in the future if not managed effectively.

Non-Surgical Treatments: The First Line of Defense

In most cases, initial treatments for ankle sprains focus on conservative options, including:

1. Rest, Ice, Compression, and Elevation (RICE): This basic approach can reduce pain and swelling. It can and should be initiated immediately after the injury occurs.
2. Physical therapy: Strengthening and stability exercises can help improve ankle function and prevent future sprains. This is a vital part of recovery and can prevent the need for more aggressive treatment later on.
3. Ankle bracing or taping: Supportive measures can stabilize the ankle, especially during physical activities. A lace-up style ankle brace can provide support the ankle needs while still allowing a patient to compete in their respective sport. Taping is another alternative, though it will need to be applied during each practice and game.
4. Anti-inflammatory medications: These can alleviate pain and swelling.
5. Multiwave Locked System Laser: MLS Laser technology is great at reducing pain and swelling associated with acute and chronic ankle sprains. This non-invasive, pain-free treatment stimulates cell regeneration and blood flow to the affected area for faster recovery times.

While these methods are often effective, they might not be sufficient for those who experience recurrent ankle sprains or develop chronic ankle instability.

When Surgery Becomes Necessary

For people like Mahomes who require high-level performance—or anyone with repeated ankle sprains—surgical intervention may become necessary. Surgical options typically focus on repairing or reconstructing the damaged ligaments to restore stability and prevent further injury. Some common surgical techniques include:

• Broström procedure: This procedure tightens and repairs the lateral ankle ligaments to improve stability. During the procedure, our foot and ankle surgeons make a small incision near the ankle, assess the damaged ligaments, and either stitch them together or reinforce them using nearby tissues to create a stronger, more stable structure.
• Ligament reconstruction: In cases where the ligament is too damaged, a tendon graft or suture material may be used to replace it. A preferred method for our foot and ankle surgeons in repairing the ligament is using Arthrex’s InternalBrace™ Ligament Augmentation Repair system, which reinforces the weakened ligaments through a minimally invasive technique. This system involves small anchors and suture tape to secure the ligaments and create a robust support structure within the ankle. The procedure can be performed on its own or as an augmentation to the Broström repair, depending on the patient’s needs.
• Arthroscopy: This minimally invasive procedure can remove any loose fragments or debris and address cartilage damage within the ankle. This procedure is often performed in conjunction with one of the aforementioned procedures.

When to Consider Surgical Intervention

For those suffering from chronic ankle instability or repeated injuries despite conservative treatment, it might be time to consider surgery. The following signs can indicate that surgical repair may be the best option:

1. Ongoing instability: If the ankle frequently rolls or twists, even during simple activities. This is never normal and should be evaluated by one of our podiatrists.
2. Persistent pain: Pain that does not subside or gets worse with regular movement.
3. Reduced range of motion: Limited ability to move or flex the ankle fully, affecting sports performance or daily life. Decreased motion can impact an athlete’s ability to remain competitive in their sport and should be evaluated.

In Mahomes’ case, surgical repair could potentially be considered if he continues to experience recurrent ankle sprains or persistent instability. For athletes and active individuals alike, surgical intervention can lead to improved performance, less pain, and a reduced risk of future injuries.

Recovery After Ankle Ligament Surgery

Post-surgical recovery often includes a period of immobilization to protect the repaired ligaments, followed by physical therapy to rebuild strength and mobility. With proper rehabilitation, most individuals can return to their sport or active lifestyle. However, it is essential to follow post-surgical instructions closely to achieve the best outcome.

Moving Forward with Confidence and Stability

If you’re experiencing recurrent ankle sprains or chronic ankle instability, it may be time to seek a professional evaluation. At Bayshore Podiatry Center, we specialize in diagnosing and treating ankle injuries, including advanced surgical solutions when conservative treatments aren’t enough. Our goal is to help you regain stability, prevent future injuries, and get back to the activities you love with confidence.

For a comprehensive evaluation of your ankle health and to discuss treatment options, including surgical intervention, contact us today.