Philly.com Sports Doc
Posted: Friday September 19, 2014
Most of us by now have at least heard about, if not seen, RG III’s ankle injury against the Jaguars on Sunday, September 14. The sports media reports that he suffered an ankle dislocation without fracture. This type of ankle injury is very rare as ankle dislocations almost always happen in conjunction with a fracture of the lateral malleolus, medial malleolus and/or the distal posterior aspect of the tibia.
From watching the video of the injury, RG III’s ankle looks to roll inward. It is unclear which direction his ankle dislocated and whether it was an open or closed dislocation but one would assume that there is significant damage to his ankle ligaments, specifically his deltoid ligament.
Treatment for this injury will involve a period of non-weight bearing with cast immobilization. Once the cast is removed, his ankle will be re-assessed for any ligament laxity that may not have healed with immobilization and may require subsequent surgery. If surgery is required, the loose ligaments will either be repaired (sewn together) or reconstructed (other tissue used to replace the injured ligament).
Return to sports after ankle ligament surgery usually takes 3-6 months. If surgery is not required, he will start progressive weight bearing and rehabilitation to regain ankle range of motion/flexibility, ankle and general lower extremity strength, and lower leg balance and motor control. From there, he will initiate sports-specific activities including running. This rehab program is relatively the same whether he undergoes surgery or not. There is less published research on return to sports following ankle dislocation without fracture, but one case study showed a time frame of 6 months in a recreational athlete.
The latest news coming from the team is that he will be casted for about 10 days, will not require surgery, and that he will be back in 4-6 weeks. That time frame is extremely optimistic if it was truly an ankle dislocation. There should be a much clearer prognosis once he is out of the cast and re-evaluated. But until then, make sure you don’t have him in your starting fantasy line up.