Toronto Blue Jays shortstop Jose Reyes is expected to be out for the next three months after severely spraining his left ankle while sliding into second base.
As you can see in the video below, Reyes suffered the injury while attempting to steal second base. It appears as though he thought he could make it without sliding. Reyes attempts to slide at the last second, but he gets caught at an awkward angle. His left ankle sprains when it gets twisted under his body.
Reyes was off to a fast start with his new team, as he was hitting .395 on the young season. It now appears that he’ll be stuck on the bench until after the All-Star break in July.
Reyes said he was disappointed that he won’t be able to help his team out for a few months.
“It is frustrating,” Reyes said. “I love baseball so much. I love to be with my teammates on the field and helping my ballclub. Now I know I’m not going to be there for a little while. It’s kind of disappointing for me.”
Dr. Silverman comments
Similar to when he diagnosed Kobe Bryant’s Achilles tendon injury, Dr. Silverman offers his insights on Reyes’ injury and severe ankle sprains in general.
What happened to Jose Reyes?
As he was sliding, (one, if not the most common time baseball and softball players are injured), the front of his left cleat caught on the ground and his momentum kept him moving forward. A rapid external rotation (twisting outward) force was exerted on his foot while his leg bent forward.
What type of injury did Reyes suffer?
There are two types of injuries he likely suffered. The first is a high ankle sprain. In the leg, the ligaments (Syndesmosis) that bind the tibia to the fibula are split in half. The deltoid ligament (medial side) of the ankle is often torn in high ankle sprains. He also may have suffered what is known as a Weber C Ankle Fracture, which consists of a high ankle sprain plus a fracture of one or more bones in the ankle.
Why did it happen?
Cleats, speed and sliding. You take a guy sprinting to steal second, add a slide, catch a spike on the dirt and boom, there you go.
What treatment will Jose Reyes need?
Generally, high ankle sprains that require three months off need surgical treatment. If the syndesmosis ligament is not stabilized adequately, it won’t heal well and he won’t be the same. While non-surgical treatment is often tried with non-weight bearing, patients are often non-compliant with the doctor’s recommendations, and the natural history of a non-surgically treated Grade III sprain is poor because the ligaments heal in a lengthened state.
How do you diagnose unstable from stable syndesmosis injuries?
There are several ways to do this:
- Full weight bearing radiographs – I do not like this method because it is painful for the patient and notoriously inaccurate in the acute healing phase.
- Stress radiograph – Cruel to do to a conscious patient and best done in operating room.
- Stress ultrasound: Much less stress is required to visualize syndesmosis instability during an ultrasound test. This test also permits evaluation of both the front and back of the joint to determine if it has widened in the front.
What kind of surgery is performed?
In syndesmotic repairs, open treatment includes reducing the tibia and the fibula back to a normal alignment and stabilizing the joint with screws and/or a suture button device. The surgery is done on an outpatient basis and the early recovery is not very demanding or too painful.
How long will Reyes be out?
A non-weight bearing period of six weeks following syndesmosis reconstruction surgery is required. Some partial injuries that are unstable can tolerate earlier stress. Physical therapy begins after six weeks (or after fracture healing as needed). The screws placed across the joint are removed after three months or more following surgery because they can cause irritation or ankle stiffness if left inside the foot. While some doctors let the screws just break over time, I prefer to remove them when the patient has healed to enhance the pace of rehabilitation. Suture button devices rarely need to be removed and work well in fracture injuries.
I wish Reyes the best of luck on a speedy recovery.
Related source: Bleacher Report, USA Today
