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Colts General Manager Chris Ballard says there’s no single cause of quarterback Andrew Luck‘s ankle injury, but instead the injury has been building over time.

After the Colts said for weeks that Luck injured his calf, Ballard described Luck’s injury as “pain right below his calf” and an injury to the “posterior ankle.” Ballard said it’s been an issue for Luck for a long time.

“I think it’s a cumulative thing, through the years,” Ballard said. “Andrew’s had some ankle issues with his left one for a while, and I think it’s just kind of a cumulative thing.”

Ballard said the Colts gave Luck treatment in May but that treatment was unsuccessful. Now the Colts are facing the probability that Luck won’t play at all in the preseason, and the possibility that if he’s playing in Week One, he’ll be playing at less than 100 percent healthy.