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High Ankle Sprains in Hockey

Ankle sprains are the most common injury seen in sports. Typically, the ligaments on the lateral or outside part of the ankle are affected. In hockey, the stiffness of the skate helps protect these ligaments, but the force can be translated up above the ankle joint resulting in a high ankle sprain. The tibiofibular ligament and interosseous membrane hold the two shin bones together and are located above the ankle joint. These two structures are at a higher risk of injury in the hockey player. The injury can occur when the skate rotates outwards and a force is placed on the outside of the ankle pushing the ankle into external rotation. The mechanism of the injury usually involves the boards where an athlete collides with an opponent’s skate forcing the ankle into the boards or falling and sliding feet first into the boards.

High ankle sprains can be very painful but rarely result in any instability or require surgery. Recovery time can be anywhere from two to eight weeks. Treatment may include crutches and a walking boot initially to immobilize the ankle and allow a quicker healing time. The athlete should remain either non weightbearing or in the boot until they can walk normally and without pain. Proper rehab will expedite a player’s return and should include range of motion exercises, manual resistance exercises, weight bearing strength and stability exercises and impact/jumping exercises prior to returning to the ice. When returning to skating, start with flow drills and progress to starts and stops and transitions. During the return, an athlete may experience short spurts of pain with certain movements. This is normal and should dissipate over time. If these do not dissipate and improve, the athlete may need to take additional time of and continue with rehab.

Chris Phillips is certified Athletic Trainer and Strength and Conditioning Specialist who spent 8 years in the National Hockey League. Chris currently owns and operates Compete Sports Performance and Rehab in Orange County, California.