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Bronx Bummer

Written By: DrGayedDPT - Oct• 23•12

Down goes the Yankees! Down goes the Yankees! A rough ending for the bronx bombers this season without question; but no one is feeling the free fall to rock bottom more than beloved team captain, Derek Jeter. Its like an army going to war and finding out their General – the physical and emotional leader – has been eliminated. Tough blow for Yankee nation.

So what exactly happened? He just stepped and all the sudden he broke his ankle?! Seriously?!? Simply put…yes, seriously! There are many factors that could have come into play; but one key thing to look at is not just how it happened but when it happened. For those watching the game, you know that Derek Jeter suffered the injury in the 12th inning. Overtime physical work means extra wear and tear and, ultimately, more muscle fatigue. Muscle fatigue is the most likely culprit in this scenario. I’ll explain…

At the ankle there are many muscles to carry out the demands we place on such a relatively tiny joint. Running, jumping, sliding, hopping, skipping, etc. We ask the muscles of our ankle to move in poetic synchronization to accommodate those tasks across varying surfaces and an athlete is no different. In fact, for a high level athlete you can imagine those ankles get beat up; So is the case for Jeter in the 12th inning of a very long and strenuous game.

If you look at the video closely, Jeter stepped on the left ankle as he was falling forward with such speed and force and it was juuuust slightly bent inwards – we call this motion inversion. The muscle responsible for preventing this motion from happening is the peroneals (2 of them actually; peroneus longus (blue) and peroneus brevis (green)). These muscle oppose the motion of inversion – this is called eversion. After playing such a long game, these muscles could have been fatigued juuuust enough to allow his foot to bend in a few degrees.

What?! That’s enough to break an ankle?! Well yes and no. Yes that’s enough motion to break an ankle but you have to keep in mind his weight was displaced forward over the ankle AND he was running. That is a lot of force and there is, in addition to the peroneal muscles, a ligament that is meant to secure the heel (calcaneal bone) to the leg bone that he fractured (fibula). A ligament connecting the calcaneus to the fibula? Must have some weird scientific name! Yes, it indeed has a weird scientific name – this ligament is called the calcaneofibular ligament. Brilliant!! Yes, very creative indeed.

With the great amount of force and direction applied to the ankle you essentially have a tug of war between the calcaneal fibular ligament and the fibula. And as with all these injuries, something has got to give. In the battle of ligament verse bone…ligament triumphs. The ligament effectively pulls the bone apart – this is called an avulsion fracture. Yes, these ligaments are that strong. If the ligament had given out, we would be talking about a sprain rather than a fracture.

Oooooh! So close to a sprain!! In talking with patients it seems that most people tend to favor the sprain over the fractures. Well, its not always that simple. There are some severe sprains that are extremely tough to recover from. Once a ligament is sprained theres no going back to the way it was for that ligament. In fact, the rehabilitation for severe sprains (if surgery is not needed) is to strengthen the muscles around the sprain to support it the way it would have been supported if the ligament was not compromised. To keep things simple, in the case of Jeter, imagine it was not a fracture and he sprained the cleverly named calcanofibular ligament. Rehabilitation for that would require strengthening the muscles of the ankle, especially the peroneus longus and peroneus brevis. Make sense?

But with a fracture, after the normal healing time of 6-8 weeks, you can have the bone return back to its normal strength; possibly even stronger! Jeter should return after roughly 4-5 months. After 6-8 weeks of allowing the injury to heal, he’ll need about 2 months to rehab it and possibly another 4 weeks to get back to form.

So there is a little good news for the mourning Yankee nation out there. At least the general will return to full strength. Unfortunately by the looks of it, full strength Yankee is not what it used to be.

Time out: 4-5 months

70 %

Chance of Reinjury:
15 %

Performance Upon Return:
99 %

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One Comment

  1. โซฟา ราคา ถูก ชลบุรี

    Bronx Bummer |

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