With 10.8 seconds left in the third quarter of a 111-58 blowout victory over the Las Vegas Aces, coaches, teammates, and trainers huddled over Napheesa Collier, who had gone down injured 20 seconds earlier in the game.
The play was as mundane. With a 92-49 lead over the Aces, the Lynx were out and running on a fast break. Natisha Hiedeman went up for a contested layup that missed, and Alanna Smith and Jessica Shepard looked to box out for the offensive rebound. Collier came jogging in to try to assist with the rebound, and her right foot landed on the back of Smith’s ankle.
In most cases, this would just end in an annoying “flat tire.” It’s something plenty of younger siblings have had to deal with as the back of their shoe gets stepped on, causing the heel to pop out. However, it resulted in Collier collapsing with a scream in agony. That led to an entire weekend of Lynx fans holding their breath to find out the diagnosis for the MVP front-runner. Now that the Lynx have disclosed it’s an ankle sprain that will keep Collier out for at least two weeks, we can dive into the details of the injury.
Ankle sprains are one of the most common injuries in sports and are typically classified into three categories, known as grades. Grade 1 is considered a mild sprain in which the ligaments stretch and “slight” tears may occur. Grade 3 sprains are considered complete tears of the ligament and are the most severe. Grade 2 sprains are considered everything in between. They can be anything from partial tears of the ligament to almost complete tears.
That leads to monitoring of symptoms being the best way to diagnose the grade. However, it comes with its limitations. For example, a Grade 2 sprain is considered to have more swelling, more pain, and less range of motion to the ankle than a Grade 1 sprain.
On its surface, that should make diagnosing the grade easier, but pain is different for everyone. Several factors can influence swelling levels, including humidity and the duration of time elapsed before compression is applied. Additionally, the range of motion varies based on factors such as stretching, history, scar tissue, and other variables.
That’s where determining the severity of an ankle sprain is difficult. It’s a very subjective way of diagnosis, meaning the doctor evaluating the sprain often determines the difference between a slight tear and a more severe tear of a ligament, or minor pain and moderate pain. The orthopedic doctor usually has to make the best guess about which grade to assign to the affected ankle. That leads to many misconceptions about ankle sprains and their prognosis, because they are often dependent on the severity of the injury.
A torn ankle ligament that is 60% through is a Grade 2 and requires significantly more time to heal than a 1% tear, which would be considered a Grade 1. In Collier’s case, no grade was provided in the public release or media updates, only that she would be re-evaluated in two weeks.
Luckily, the treatments for ankle sprains are the same, regardless of whether they are Grade 1 or 2. The RICE acronym, standing for rest, ice, compression, and elevation, is often the golden rule. Whether it’s immediately after the sprain or days later, resting the ankle is the most crucial part of the healing process. It’s like folding a piece of paper. After the initial fold, each time you repeat the fold over the same crease, the stability decreases. It’s similar in joints. After the initial injury, every time it bends that way again, stability can decrease, and the tearing can worsen.
Therefore, often after ankle injuries, athletes can be seen wearing CAM Boots, which prevent the ankle from bending while walking, thus preventing further folds on the piece of paper.
Ice helps reduce inflammation and slow the blood flow to the affected area. With ankle sprains, the tear in the ligament allows for blood to flow into the interstitial spaces between spaces. That can cause bruising, but it is also the culprit for inflammation, and the ice slows the flow. It assists in the clotting of tissues, allowing blood to reach where it needs to and provide the necessary nutrients to heal damaged tissue without getting stuck in the spaces between cells in the body.
Compression provides stability to the ankle, similar to an ACE wrap, and also helps push the fluid causing inflammation back into the circulatory system, which in turn aids in the swelling and healing process. Elevation helps that fluid flow back into the core of the body and get redistributed thanks to gravity.
Assuming Collier is following the RICE method, then it’s just a matter of pain management, usually with Tylenol, and a process called hurry up and wait. This process can be the most frustrating. There truly isn’t a lot that can be done to heal a ligament faster. The biology of the ligament tissue means it doesn’t get as much blood flow as a muscular injury, so the healing process can be slow and frustrating. The ankle often feels fine after a week, even in Grade 2 sprains. Still, the person suffering the injury must be cautious and wait for the injury to heal fully.
That’s where I suspect Collier’s injury may be more severe than a common Grade 1 injury, but not severe enough to be classified as a Grade 2 sprain outright. The two-week timetable gives Collier the chance to hurry up and wait for her ankle to heal while also nursing back other injuries she has sustained over the season.
The injury is by no means ideal for the Lynx. They are looking to secure the No. 1 seed in the WNBA playoffs. Still, their six-game lead for the top seed allows the Lynx to have flexibility with Collier as she recovers from a deceptively complicated injury.
