High-ankle sprains pain the '09 Hawkeyes

Contrary to Iowa legend, Hayden Fry didn't invent high-ankle sprains.

It was an unfamiliar term when Fry broke it out in the mid ‘80s. Iowa fans began hearing it a lot. Fullback David Hudson had one in ‘86, followed by O-lineman Bob Kratch in ‘87, tight end Marv Cook in ‘88 and so on.

People thought it was something Fry made up.

They really exist. For the 2009 Hawkeyes, high-ankle sprains have been a real pain in the neck.

“Football isn't built for joints, I know that,” Iowa coach Kirk Ferentz said.

Quarterback Ricky Stanzi was the latest victim. suffering a severe high-sprain to his right ankle in Iowa's 17-10 loss to Northwestern last week. The junior underwent surgery Monday to help make the healing process a little more predictable in hopes for a bowl game return.

“You can deny and you can say a guy is going to be fine, but if a guy's got one, he's got one,” Ferentz said. “It takes a long time to get it right.”

In Iowa's victory over Iowa State on Sept. 12, tight end Tony Moeaki suffered a high-ankle sprain. He missed the next three games.

“It's a tough injury,” Moeaki said. “They don't heal as fast as other injuries, so, yeah, they're pretty frustrating.”

On Oct. 24 at Michigan State, running back Adam Robinson had it happen when he was tackled from behind. He's missed the last two weeks, but might return for No. 15 Iowa (9-1, 5-1 Big Ten) in this weekend's Big Ten title showdown at No. 10 Ohio State (8-2, 5-1). Robinson is Iowa's leading rusher with 629 yards.

“He's improved rapidly. He's climbing the ladder,” Ferentz said. “He might get a crack at it. I don't want to be a pessimist, but I'm a little suspect because of his position. We're only a couple weeks out. I'm not getting my hopes up. I'll take the bonus if we get him back.”

What exactly are high-ankle sprains and why does the recovery take so long?

Dave Williams, director of Performance Therapies P.C., a physical training and rehabilitation facility in Coralville and Cedar Rapids, broke it down for The Gazette.

When you have a high-ankle sprain, you've sprained the ligaments that attach the tibia and fibula, the two lower-leg bones, Williams said. The bones are attached just above the ankle.

“This allows the tibia and fibula to form a mortise and then your talus, one of the bones in your ankle and foot, kind of sits up in that nice deep socket,” Williams said, “and that's what helps give the ankle stability.”

With a high-ankle sprain, the mortise gets disrupted and the ankle ends up sloppy, with a lot of play and give in the joint.

“The ankle just doesn't hold up very well,” Williams said.

The talus becomes a wedge, like when you're splitting wood. It pushes up because your body weight pushes down on it.

“Basically, the talus just pushes those bones too far apart and they're already too far apart because of the ankle sprain,” Williams said.

Performance Therapies provides injury rehab and prevention strategies for several area high schools, including Solon and Cedar Rapids Prairie. Between football and hockey, Williams estimated that his trainers see 30 to 50 high-ankle sprains a year. It happens in basketball and wrestling, but mostly they happen in sports where you plant your foot and it gets twisted.

“The foot twists to the outside of your body,” Williams said. “As the foot twists out like that, called external rotation, basically the bone is just spinning in the mortise and it pops those ligaments. You end up with a loose mortise.”

High-ankle sprains come with grades of severity, with grade 1 being the least severe and three being the most. In general, Williams said, it's a four- to eight-week injury. It's possible to shorten recovery with multiple daily treatments, but tissue heals at a predictable rate and speeding it up doesn't always work.

Bottomline . . .

“You'd much rather have regular ankle sprain than a high-ankle sprain,” Williams said.