Chicago Bears RB Jeremy Langford suffered a sprained right ankle during a walk-through on July 27th. This is actually concerning since Langford has struggled with his recovery after having offseason ankle surgery. Langford is likely dealing with pain, swelling and decreased range of motion. Due to the nature of the event, this was likely a low-impact injury, which is usually ideal, but with Langford’s history of right high-ankle sprain in week 3 of last year, that kept him out of 4 games last year, any re-injury to the same ankle is concerning.

Ankle sprains are very common, especially in football, basketball and soccer, and there are basically two different types: low-ankle sprains (just called ankle sprains), and high-ankle sprains. Low-ankle sprains are the most common of the two, and typically the anterior talofibular ligament (ATFL) is injured. This often occurs when the ankle is planted and then ankle ‘rolls’ inward; stepping on another athlete’s foot or in a hole are also common mechanisms. Damaging the ATFL leads to pain, swelling, decreased range of motion and difficulty putting weight on the ankle. Evaluation of the injury begins with the Ottawa Ankle Rules, which gives pretty clear guidelines about the need for X-rays. Treatment typically responds to the PRICE (Protection, Rest, Ice, Compression & Elevation) principle. Ankle sprains are divided up into 3 stages, stage one takes about 11 days to RTP, stage two about 2-6 weeks, and stage three about 4-26 weeks.

A syndesmotic or ‘high-ankle’ sprain is an injury to 3 different structures, including the anterior inferior tibiofubular ligament (AITFL), the posterior inferior tibiofubular ligament (PITFL) and the interosseous ligament (which is the ligament that connects the two lower leg bones). High-ankle sprains are typically rotational injuries, when the foot is turned outwards in respect to the leg. The pain in high-ankle sprains are usually located in the upper part of the ankle and lower to mid-leg, and are associated with pain with trying to change directions, placing any amount of weight on the leg and ankle, and pain with external rotation of the foot. High-ankle sprains also respond to the PRICE principle, but take longer to heal than lower ankle sprains. Initially requiring a short leg cast or brace for 4 weeks, so RTP is usually 6-12 weeks, depending on whether surgery is needed.

This injury will make Langford’s journey to starting even more challenging, as he was already behind workhorse Jordan Howard, and was competing with Benny Cunningham and Tarik Cohen as the backup and goal-line back. Langford played in all 16 games in 2015, rushing for 537 yards (3.6 YPC) with 6 TDs, chipping in 22 receptions for 279 yards and 1 TD. Then, in 2016 Langford struggled with his ankle injury and played second fiddle to Jordan Howard, managing only 200 yards over 62 rushes (3.2 YPC), 4 rushing TDs, adding 19 receptions for 142 yards but no receiving TDs over 12 games. Langford was already facing an uphill battle for the 2017 NFL season behind Howard, and now with this recent flare of his ankle injury, he is going to see a huge drop in fantasy potential.

Going into the season Langford was presumably the primary back up, Jordan Howard’s handcuff, and is being drafted in the 14th round as the 71st RB in both 14-team standard and PPR leagues. In light of this injury, unless he comes back quickly and something was to happen to Howard, I don’t even think Langford should be drafted. Hopefully this is just a minor injury and Langford can regain his form and return to the field to serve as a nice 1-2 tandem with Howard for the Bears.

This was written for the @TheFantasyDRS by Dr. Jesse Morse. I am a Board-Certified Family Medicine physician, and I am currently completing a Sports Medicine Fellowship at the University of South Florida in Tampa. This information should be used for entertainment only, and not for medical advice. If you have any questions or comments, you can contact me directly at @DrJesseMorse or visit my website at: www.DrJesseMorse.com. Keep an eye out for my next article!