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Doctor's Take: Michael Brantley

Indians fans held their collective breath as star left fielder Michael Brantley was pulled in the middle of Sunday's game with an apparent injury. Fortunately, it had nothing to do with his shoulder as it was announced he had only sustained a sprained ankle. IBI injury analyst Brandon Bowers provides a rundown on Brantley's situation in a new Doctor's Take.

On Sunday, May 7th in a American League Central Division matchup against the Royals, Michael Brantley left in the fourth inning with a sprained right ankle.  The injury occurred while he was running to first base.

What is it?  The ankle is made up of three primary joints, the talocrual joint, subtalar joint and the distal tibiofibular joint.  The talocrual joint is considered to be the true “ankle joint” with the subtalar and distal tibiofibular joints providing other functions of the foot/ankle.  The ankle is stabilized via static and dynamic restraint systems, these systems are ligaments and muscles, respectively.  In the case of an ankle sprain, the aforementioned restraint systems become compromised.  Simply put, a sprain is the over stretching of ligaments which support a joint.  Ligaments that have been over stretched are unable to provide adequate stability to the joint which they support and inhibit the ability of the joint to function properly.  Sprains are graded based on severity, with grade one sprains being the least severe and grade three sprains being the most severe.  Grade one sprains involve slight over stretching of ligaments, grade two involve partial tears of the ligaments and grade three, being the worst, involve complete tearing of the ligaments.  In the case of ankle sprains, “inversion” sprains are the most common and involve the “rolling” of the ankle inward.  Symptoms of ankle sprains include swelling, discoloration (bruising), tenderness to touch and instability. 

How is it fixed?  Management of an ankle sprain is initiated with a period of utilization of the acronym RICE, which stands for rest, ice, compression and elevation.  Rest from physical activity is important in order minimize further aggravation of the ankle, ice is utilized in order to reduce swelling and reduce pain and compression and elevation also assist in the reduction of swelling.  Following a period of RICE, efforts will be made by the rehabilitation team to maintain range of motion and strength of the ankle.  Maintenance of range of motion and strength of the ankle is important in order to improve functional mobility for the individual when it is time to return to sport.  Rehab is progressed to sport specific activities once the individual demonstrates reduction in pain and adequate strength and range of motion.  Clearance to return to live game action is granted once the individual is able to run, field, throw and hit without exacerbation of symptoms.  In more severe ankle sprains, such as a grade three injury, surgery may be indicated. 

My take.  The Indians don’t anticipate Brantley to miss too much game action and it doesn’t appear he will need to go on the disabled list.  Brantley’s ankle sprain appears to be a grade one injury and should not effect his long term health over the course of the rest of the season.  If all goes according to plan and no setbacks occur, I expect to see Brantley back in the lineup late this week. 

We will continue to monitor the status of Michael Brantley as he progresses through the rehab process and will provide the most up to date injury analysis and breakdown as new information becomes available. 

Brandon Bowers, PT, DPT, is a graduate of the University of Toledo, Doctor of Physical Therapy Program and currently practices in Columbus, Ohio.  He is an avid Cleveland sports fan and has experience rehabbing athletes of all levels and from a variety of sports.  Follow Brandon on Twitter for more Cleveland Indians injury insight and analysis:  @blbowers12

The information provided is the professional opinion of Brandon Bowers, PT, DPT and is based on his clinical experience and the most current clinical evidence available.  This information should not be interpreted as or substituted for medical advice for a specific condition or diagnosis.

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