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Podiatry in Sports: Cardinals’ Moss rehabbing sprained ankle

Although there is still no exact timetable fore his return, St. Louis Cardinals outfielder/first baseman Brandon Moss is said to be working hard to return to the lineup after suffering a sprained left ankle.

Podiatry in Sports: Brandon Moss

Podiatry in Sports: Brandon Moss

Moss, who was hitting .256 with 17 home runs and 40 RBIs prior to the injury, suffered the sprain by stepping awkwardly on first base during a 5-2 loss to the Pittsburgh Pirates on July 5. He has been in a walking boot for the foreseeable future.

“The last few days it has made a lot of progress,” Moss told the Cardlinals’ team website. “That All-Star break was really good for it just to let it calm down, let some of the treatments they did for it take in.”

As of Sunday, Cardinals manager Mike Matheny had not received any dates or a timetable for the return of Moss, who has been wearing a walking boot ever since the injury occurred.

“It’s one of those things you know you can’t play with it, so you’re just at the mercy of letting it heal,” Moss said. “There’s no way you can do anything of use with a sprained ankle. You can’t hit, you can’t throw, you can’t run, so it’s just one of those things you’ve got to let heal.”

While it’s impossible to say exactly when Moss will return without knowing all of the facts, Dr. Ian S. Goldbaum of Delray Beach Podiatry can speculate based on the information that is currently available to the public.

In order to understand his diagnosis, however, it is important to first understand what exactly an ankle sprain is and how they are graded.

Ankle sprains are graded on a scale of 1–3 based on their severity:

Grade 1 (Mild): In mild cases, the ligaments are somewhat stretched, resulting in joint stiffness, muscle weakness or tightness with reduced balance and joint awareness.

Grade 2 (Moderate): In moderate cases, there is significant ligament stretching and sometimes partial tearing. It is far more painful than a mild sprain and can make it difficult to walk.

Grade 3 (Severe): In severe cases, the ligament can completely rupture. There is severe swelling, extensive bruising, and immense pain felt with a Grade 3 sprain. In most cases, a patient will need a screw inserted into their ankle to stabilize the area while it heals.

At this point, Dr. Goldbaum believes that it’s more than likely that Moss is suffering from a Grade 2 sprain. Earlier this season, Detroit Tigers catcher James McCann suffered a slightly less serious a sprain and was out of the lineup for approximately three weeks.

According to Dr. Goldbaum, Moss likely suffered an injury to his anterior talofibular ligament (ATFL). The ligaments on the outside of the ankle, particularly the ATFL, are the most important stabilisers of the ankle joint because of their ability to try and limit you to point your toes and rotate your foot inward.

Lateral ankle sprains such as Moss’ occur as a result of landing with your ankle in a position that your toes are pointed and your foot is turned in, which in turn overstretches the ATFL — a description that matches the movement pattern made when Moss planted his foot on the base.

“That’s the most common ligament that is injured during ankle sprains,” said Dr. Goldbaum, who has over 30 years of experience in the field of podiatry. “They’re really not very thick bands of tissue, which makes them prone to injuries such as this. These types of injuries are usually acute, which means they happen very suddenly.”

As for treatment, R.I.C.E. (rest, ice, compression and elevation) will play a large role in Moss’ recovery. Additionally, ultrasound technology, injections, laser therapy and PRP could be used to expedite the recovery process.

In recent years, platelet-rich plasma (PRP) has also been used far more frequently because of its effectiveness in the treatment of injuries such as ankle fractures and sprains. PRP is plasma that contains more platelets than what is typically found in blood. These platelets contain hundreds of proteins called growth factors, which are very important in the healing of injuries.

“We take the patients blood and we spin it,” Dr. Goldbaum said of the PRP process. “We take out the plasma part, which has all of the growth factors, so we can get it to heal faster. I’m not sure if they used that with (Moss), but that’s a big deal today.”

As for how long he’ll be out of the lineup, Dr. Goldbaum believes that if Moss is indeed suffering from Grade 2 sprain, he’ll most likely be out of the lineup for at least a few more weeks.

“At this point, it’s a week-by-week treatment plan,” he said. “Once he is able to move without the aid of a walking boot, they’ll likely re-evaluate his return time based on how well he responds to physical therapy.”


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