00:00This is the Injury Report, presented by NYU Langone Health.
00:04J-E-T-S, wide receiver Omar Cooper Jr. is listed week-to-week after an MRI actually gave some
00:11positive results on his sprained ankle.
00:14So, in today's Injury Report, we have Dr. Craig Pilly, MD at NYU Langone, to break down when Geno Smith
00:22can expect his first round wideout back in the lineup.
00:26Doc, appreciate you hopping on with us. We had a great week, one of some New York football, both the
00:32Jets and the Giants won, but the Jets also dodged a bullet.
00:37Omar Cooper Jr. is now listed as week-to-week with the hope that he can return within the next
00:42four weeks.
00:43So, what did the MRI show about the ankle that makes him week-to-week versus just out for multiple
00:51weeks?
00:52Yeah, happy to be here. Thanks for having me back on and super excited for football season ahead.
00:58So, you know, I think a fundamental understanding here starts with what was his injury or what was believed to
01:03be his injury, and it's this idea of a high ankle sprain.
01:06Brandon, as you probably know, this happens in a lot of football athletes, right?
01:10It involves this major stabilizing ligament of the two shin bones in your leg and lower foot, and it's called
01:18your syndesmosis complex.
01:19And there's another ankle ligament as well that can be involved called that medial deltoid ligament on the inner part
01:25of your ankle.
01:26These are the injuries that happen really with the mechanism of getting rolled up on, where that foot is planted
01:31on the field, and then the leg gets twisted while the foot stays trapped beneath it.
01:36So, it effectively causes this foot to twist outward and upward.
01:39It can be pretty nasty injuries, and the biggest question really is, with these injuries, are they stable?
01:44The MRI with a good hands-on physical exam is really helpful to deduce that, and it's not so much
01:50what the MRI shows us, but really rather what it doesn't show us.
01:54In Omar's case, really, it's likely no fracture, no significant involvement of that medial deltoid ligament, and no widening of
02:03the ankle joint under stress.
02:04That probably came with some x-rays as well as the MRI, which can be really helpful to deduce that.
02:10And the NFL's looked at these outcomes in their athletes across multiple years in high ankle sprains and really grouped
02:18them into three categories.
02:19In these isolated, lower-grade, syndesmosis-only injuries, those are injuries that will last about 30 days, about a month
02:28or so, and that's really that week-to-week category for most of these athletes.
02:32As we get a little more severe in advance, we talk about the involvement of that deltoid ligament or the
02:37instability of the ankle.
02:38That's really when those injuries start to get pushed out into the months for recovery, not so much the week
02:44-to-week.
02:44Million-dollar question here.
02:45Let's say you have a patient that's not a first-round wide receiver, but at NYU Langone, we know they're
02:52going to get first-round treatment from you guys.
02:55They come into your office with a high ankle sprain.
02:58How would you treat and rehab that person as opposed to Omar Cooper Jr.?
03:06Yeah.
03:06Well, again, I think it hinges on the type of ankle sprain, right?
03:10If we're dealing with a high ankle sprain like what Cooper has, we'll be slower, we'll be more meticulous, and
03:15we're probably going to immobilize for longer.
03:16A lot of the patients and, you know, otherwise athletes that I see that have this high ankle mechanism, we're
03:21going to be in that boot for, you know, a set amount of time to really let this thing heal
03:25up and kind of scar down and get stable again or feel stable again.
03:30Whereas the lower lateral ankle sprains, again, those ligaments on the outer part of the ankle, more typical to come
03:36walking into the office for most of us at NYU and otherwise.
03:41And these are the roles inward, and those are the ones that we can get active pretty quickly, right?
03:46We work on pain control, we get weight-bearing early and often, and we mobilize that joint with some physical
03:52therapy, neuromuscular and proprioceptive retraining as soon as we can comfortably.
03:57And so, really, there's that very distinct difference between these two types of injuries that we see.
04:02And we see the low lateral ankle sprains.
04:05Those are kind of the bread and butter, right?
04:06That's the moneymaker for us in our line of work, but the high ankles are the ones that we always
04:11have to kind of look out for and be mindful about, and it really can change our management accordingly.
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