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Monday, January 30, 2012
Stephania Bell on Gronkowski, ankle sprains

By James Walker

INDIANAPOLIS -- The big injury news during Super Bowl week is the left ankle of New England Patriots Pro Bowl tight end Rob Gronkowski.

The extent of the injury hasn't been revealed by the Patriots, who would only say Gronkowski is day-to-day. But Gronkowski's father, Gordy Gronkowski, said his son has a high ankle sprain, which is one of the worst forms to the ankle joint.

Assuming Rob Gronkowski's dad is accurate, the AFC East blog caught up with ESPN injury expert Stephania Bell to examine the issues of the injury. Bell provided insight into the challenges Rob Gronkowski potentially faces.

Stephania, besides the location, what are some differences with a regular ankle sprain and a high ankle sprain?

Stephania Bell: Standard ankle sprains tend to be what we call lateral ankle sprains. Many people refer to them as basketball sprains, because it's what you see a lot in basketball when a guy goes up for a shot and maybe lands on another player's foot. His ankle rolls and turns in, which sprains and injures the ligaments on the front and lateral side of the ankle. In a high ankle sprain, the injury is usually a little bit different. The foot is typically pointed outward and is a rotational injury most of the time. If you go back and look at the view of when Gronkowski sprained his ankle, you can actually see some of that when he got caught from behind. It kind of forced his foot to twist so his toes were pointing outward. So that rotational component injures the ligament that basically attaches to the top of the ankle, which is called the "high ankle." It attaches the two lower leg bones where the roof of the ankle is formed.

Players often complain that the injury is very painful. Where does the pain come from?

SB: What makes it difficult functionally is every time you step on your foot, it creates a force that wants to spread those two lower leg bones apart. Every time you take a normal step and your shin bone, if you will, advances over your ankle, which is what normally happens when you step forward, those ligaments are under stress. They are attached there to help prevent those two bones from spreading. When there's injury there, because of the stress on those ligaments, that's why it's so painful. That's why when you saw Ben Roethlisberger's high ankle sprain, he couldn't step into his throws. Why couldn't he step into them? He couldn't put that full weight over the ankle because he couldn't advance the leg bone over the ankle joint without recreating that severe pain. And [Steelers center] Maurkice Pouncey, the reason he couldn't play in the Super Bowl with it is because of the stance he has to get in. That really stresses full weight bearing over that ankle joint.

You mentioned Roethlisberger and Pouncey, who play quarterback and center, respectively. Does Rob Gronkowski have any advantage or disadvantage over those two playing tight end?

SB: I think it's tough for him. Every time he takes a step it's hard to have your normal mechanics. Part of what Gronkowski does is he moves down the field. So everything mobility wise will be compromised. It's going to be harder for him to run. I'm not saying he won't be able to. One thing that's important to emphasize is we don't know the degree of his injury. So it's hard to know what kind of problem it will be. But the bonus the Patriots have is two weeks. Last week I wasn't surprised at all that he didn't practice. The idea is to keep him non-weight bearing, keep him in a boot, protect that area and accomplish as much healing in that area as you can. Really the key is to ensure he has as much maneuverability as possible by the time he gets to the game.