Lane Johnson High Ankle Sprain: Detailing His Limitations

Eagles All-Pro right tackle Lane Johnson has been battling through a high ankle sprain that he suffered during the Eagles 23-21 week five loss against the Vikings.  The injury nearly kept him out of the Eagles Thursday night win against the Giants (he was a game-time decision) but he was able to play through it, even though he did re-aggravate it during the game (no surprise, more on that later).  He is currently expected to play against the Panthers.

The high ankle sprain may partly explain Lane Johnson’s relatively lackluster performance this season, at least against the Vikings and Giants.  In the former game, he was beaten easily on an outside to inside change of direction that resulted in Carson Wentz getting hit on the release and Linval Joseph taking the fumble to the house:

lane johnson
Credit – NFL on Fox

During the Giants game, Lane Johnson also struggled with quick changes of direction and had problems maintaining leverage, like this play where he couldn’t hold up against a bullrush and created a dirty pocket for Carson:

lane johnson
Credit – NFL on Fox

To understand these struggles and Lane Johnson’s current limitations, lets start with a detailed look at the injury itself:

I. Lane Johnson High Ankle Sprain

High ankle sprains suck, straight up.  They affect what’s called the “tibia-fibula syndesmosis” which refers to four distinct ligaments that sit between & connect the tibia (shinbone) and fibula (that bone on the outer part of your lower leg):

lane johnson
Credit – MountainWestFootAnkleInstitute

*Note:  One of the four ligaments, the inferior transverse ligament, is not pictured.

A high ankle sprain is differentiated from a the typical “low ankle sprain” by location.  The latter affects the ligaments lower down the ankle and closer to the foot:

lane johnson
Credit – Complete Anatomy ’19

Whereas the high ankle sprain occurs higher up the ankle and affects the aforementioned tibia-fibula syndesmotic ligaments that sit above the ankle joint:

lane johnson
Credit – Complete Anatomy ’19

These tibia-fibula syndesmotic ligaments  – think of ligaments like rubber bands that are tensioned and help the joint stay in place during movement –  passively keep the tibia and fibula (and therefore the ankle) stable when the ankle is dorsiflexed:

lane johnson

and particularly when the foot is externally rotating (rotating outwards):

lane johnson
Credit – Vikas Vedi

If the ankle joint dorsiflexes and/or the foot externally rotates outside its normal range of motion, these ligaments stretch, tear (sprain), and in severe cases, rupture (full tear).  This most commonly occurs during a combination of both – a high force trauma that causes both dorsiflexion and external rotation.

In football, that combination usually happens when an ankle gets rolled up on and the leg/ankle is forcefully rotated outwards against a planted foot or toe, like this:

lane johnson
Credit – NFL

Depending on how many ligaments are damaged and to what extent, the sprain is classified into a grade one, two, or three sprain:

lane johnson
Credit – Epainassist

Although no official information has been revealed on the severity of injury (and likely never will be), I’m pretty sure Lane Johnson has a grade one high ankle sprain because anything more severe usually results in significant instability in the lower leg and ankle, with surgery indicated.

Generally, high ankle sprains aren’t very common as they make up roughly six percent of all reported ankle sprains whereas low ankle sprains are the highest reported injury out of all injuries.  However, due to the prevalence of high speed contact in football, which often occurs around the ankle/foot, it comes as no surprise that football players suffer a much higher rate of high ankle sprains, second only to hockey players.

We can add Lane Johnson to that list and we’ve seen the injury overtly affect his play the last two weeks.  Lets dig deeper into that…

II. How a high ankle sprain affects Lane Johnson in-game

First things first, a high ankle sprain is really painful.  Whenever Lane Johnson has to move dynamically, the area is stressed which results in pain.  He’s really gutting through this injury to stay on the field (I don’t tend to be a fan of that mindset but it is what it is).

As a right tackle, the high ankle sprain is even more troublesome because the position has specific demands that put a constant high level stress on the tib-fib syndesmosis. First and foremost, he constantly has to deal with delivering or absorbing huge external forces from defensive lineman, linebackers, etc.

Lane Johnson
Credit – Philly.com

That sustained leverage requires constant stabilization throughout the body, including at the ankles.

Further, as a right tackle he’s tasked with blocking edge pass rushers who want to bullrush him.  That forces him stick his foot in the ground to curb their momentum which puts the ankle into a loaded dorsiflexion position:

lane johnson

Additionally, he often has to rotate that ankle outwards to deal with a speed rush or change of direction.  That’s usually occurring while he’s engaged with the defender which means extra load at the ankle.

If you recall, the key function of the tib-fib syndesmosis is to keep the tibia and fibula stable during dorsiflexion and external rotation. When they’re injured, they can’t handle as much stress and therefore Lane Johnson’s ability to leverage, absorb force, and rotate are limited.  His struggles late in the Vikings game and into the Giants game are no surprise.

However, he’s chosen to play with it so the injury is no excuse and other NFL teams will continue to attack him.  So what can Eagles fan expect from Lane Johnson as the season rolls on…

III. What To Expect from Lane Johnson Going Forward

Usually, a grade one high ankle sprain is immobilized for up to three weeks (click here and here for more info), and the research shows that football players tend to miss two to four games on average after a grade one injury.

Lane Johnson, on the other hand, continued to play on it during the Vikings game and then played four days later vs the Giants.  I have to believe the Eagles medical staff would have shut him down if if there was any reasonable chance he could injure it further by playing.

Regardless, they’re likely taping that ankle up something serious. Here’s one way to do that:

Unfortunately, even if the injury cannot get worse, it’s really difficult for ligaments to heal if you continue to play and put huge stress on it like Lane Johnson is doing week in and week out.  I’d wager that the injury will continue to linger, at minimum, until the Eagles week 9 bye when Lane can finally let it settle down for an extended period of time.

That being said, I don’t see Lane Johnson returning to 100% until the off-season when the ligaments can have enough time to heal fully and he can rehab it appropriately.  In the meantime, it wouldn’t surprise me if he does begin to acclimate and adjust to the injury which may result in better play on the field (for Carson Wentz sake, if nothing else) but there’s always the potential for re-tweaking it.

Regardless of what happens, it’s no easy feat to do what Lane Johnson is doing and I hope this piece gives you some insight into why and the limitations he’s currently playing with.

Thanks for reading and until next time.  If you liked the piece, subscribe to the email list on the sidebar, join our facebook group, and follow us on twitter or IG to never miss an update.

Posted in NFL

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