Don’t Be Sidelined by Concussions, ACL Tears, and High Ankle Sprains

High school football season is in full swing, and injuries that can sideline players, like concussions, ACL tears and high ankle sprains, are as much the topic of discussion as final scores.


In the past, players knocked unconscious were required to sit out at least one play, yet recent studies show 96% of concussed players don’t lose consciousness. For this reason, The Georgia High School Association, as well as many schools nationwide, recently instituted new rules regarding players who suffer from head injuries. Any headache, wooziness, confusion or other concussion symptom means players must be cleared by a trainer or doctor before returning to the field. This change is intended to prevent a second or third concussion.

Many schools are implementing measures to avoid the first injury as well. Players have traditionally been coached to tackle by putting their face mask on the football to try to force a fumble, but hitting with the helmet can lead not only to head injuries, but to neck and spinal damage as well. Today, players are taught to keep their heads up, hit with their chests and attempt to punch the ball out. This method does more to prevent head injuries and separated shoulders. As a further precaution, many schools have upgraded to helmets designed to absorb blows better than older gear.

ACL Tears

The ACL (anterior cruciate ligament) is one of four major ligaments that provide stability to the knee joint. These fibrous bands attach bone to bone, and help control excessive motion of the knee joint by keeping the lower leg from sliding too far forward. Of the four major ligaments of the knee, ACL injuries are most common. The majority of ACL repairs each year are performed on athletes under age 25 and female athletes in general.

ACL injuries are common in sports that involve sudden changes of direction, like football and soccer. Most are noncontact injuries that occur during sudden twisting motion or when landing from a jump. Factors contributing to ACL injuries include ground hardness, and grass and cleat type.

Athletes can reduce their risk of ACL injury by performing training drills requiring balance, power and agility. Adding plyometric exercises, such as jumping and balance drills, helps improve neuromuscular conditioning and muscular reactions and ultimately shows a decrease in the risk of ACL injury. Many team physicians now routinely recommend an ACL conditioning program.

ACL reconstruction (surgery to replace the ligament in the center of your knee with a new ligament) is the most common surgical procedure for repairing an injured ACL. It typically provides the best results and fastest recovery. The damaged ACL is surgically removed and replaced with a graft, which often consists of a section of the patient’s own patellar tendon (a large, strong tendon of the quadriceps muscles).

The procedure is typically done by knee arthroscopy. A tiny camera connected to a video monitor in the operating room is inserted into the knee through a small incision and the surgeon uses the camera to check the ligaments and other tissues of the knee. Other small cuts are made around the knee, allowing the surgeon to repair any other damage found.

Leaving a torn ACL untreated can lead to tissue damage and early arthritis. ACL reconstruction may be recommended for a knee that gives way or feels unstable during daily activities, general knee pain, inability to continue playing sports or other activities, or when other ligaments are also injured.

High Ankle Sprain

A high ankle sprain, also known as a syndesmotic ankle sprain, is a sprain of the ligaments that connect the tibia and fibula on the lower leg. These types of ankle sprains are known as “high” because of their location on the lower leg, above the ankle. Unlike common ankle sprains when ligaments around the ankle are torn or receive injury through an inward twisting, high ankle sprains are caused when the lower leg and foot twist out. Anyone can get a high ankle sprain if the outward twisting is present, although it is most common with football and soccer athletes.

High ankle sprains cause symptoms similar to other ankle sprains, but patients often complain of pain when the ankle is turned to the outside or when the calf is squeezed. Trainers and coaches are often concerned about high ankle sprains because they tend not to heal as well as more common ankle sprains.

To treat a high ankle sprain, an orthopaedic surgeon first determines if the injury is stable or unstable. If it is stable, the high ankle sprain can be treated in a cast, usually for a period of six weeks. If the injury is unstable, a syndesmotic screw can be surgically placed between the tibia and fibula to hold the bones in proper position while the ligament heals. Patients will have the screw in place for about three months while the injured ligament heals. It’s important to understand that walking on the leg while the screw is in place, even after the ligament has healed, can cause the screw to break. For this reason, some doctors prefer a second operation to remove the screw before allowing the patient to walk.

When you’re sidelined by injury Dr. J. Lex Kenerly, M.D., Orthopaedic Surgeon, and the staff at the Bone & Joint Institute of South Georgia, can help get you back in the game. The new Bone and Joint Institute of South Georgia, is a 15,000 square foot state-of-the-art facility with on-site X-Ray, MRI and ambulatory surgery center, providing comprehensive orthopaedic care in a single facility.

Dr. Kenerly has expertise in a wide variety of orthopaedic and sports medicine services, treating conditions such as ACL tears, ankle sprains, rotator cuff tears, carpal tunnel syndrome, hip bursitis, heel pain, knee cartilage tears, tennis elbow, trigger finger, bunions, hip replacements, knee replacements, fracture treatment and more. From a sprain to a severe injury requiring surgery, the Bone & Joint Institute of South Georgia is your first choice for the treatment of sports-related injuries.

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