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How serious a threat are Steph Curry's ankle injuries to his career?

How serious a threat are Steph Curry’s ankle injuries to his career?

Call it a tweak or a slip or a mild sprain. But really, call it like it is, time to worry. When Steph Curry folded his ankle against the Pelicans on 4 December, there was concern. Barely a month later, after a slip and a tweak in a shootaround, that worry turned into something else, real concern about the long-term health of one of the NBA’s finest players.

For basketball players, in an occupation that has them jumping and cutting in a forest of long legs and feet, ankle sprains are almost part of the job. For Curry and the Warriors, after two ankle surgeries and countless sprains, the two recent injuries represent something much more serious than wins and losses. While Curry has played in 78 games or more each season since 2011-12, there was a time when his right ankle problems put his NBA future in doubt.

Curry isn’t alone in his ankle sprain woes as the injury accounts for 15% of the injuries in the NBA, more than twice the frequency of any other injury. “Ankle sprains are the most common injury in the NBA,” says Dr Richard Ferkel, the surgeon that performed Curry’s second ankle surgery, “primarily because NBA players put a huge amount of stress on their ankles with all of the sharp cutting and jumping,”

In fact, just in the last week, Anthony Davis, Brandon Ingram and DeAndre Jordan have all suffered ankle sprains. Unfortunately for those players, and any rec league hooper that suffers the injury, recovering from the initial injury isn’t the problem, that’s usually only a matter of days or weeks.

Unlike other commonly torn ligaments in other parts of the body – ACL in the knee or UCL in the elbow – a strain or tear of the ankle ligaments can heal, leaving surgery to reconstruct the ligament as the last resort.

According to Ferkel, director of the sports medicine fellowship at the Southern California Orthopedic Institute, a full recovery comes down to patience – rushing back to the court can lead to re-injury – good rehab and protecting the ankle when on the court. “For players that have sprained their ankles, I recommend both taping and bracing, though some players are hesitant to use them in fears that it will restrict mobility,” emphasizes Ferkel.

However, after each sprain the ankle becomes more likely to re-sprain, to the point that the ankle starts to roll in weird ways – simple jogging, shooting or walking down the street – with little provocation. The ankle ligaments, once strong and stable through the crazy side-to-side stresses of basketball, become as weak as tissue paper.

That’s the situation for which Curry had to have the Tommy John surgery of basketball, ankle stabilization surgery, in 2011. The surgery, performed by Dr Bob Anderson in Charlotte, repaired the instability of Curry’s right ankle that had resulted from the frequent ankle sprains. The surgery, using a technique called the modified Brostrom repair, sewed together the stretched out ligaments of Curry’s right ankle, restoring the stability.

Though ankle sprains are common, this ankle stabilization surgery, at least in NBA players, is not. According to Ferkel, who has performed foot and ankle surgeries on hundreds of NBA players, most of the NBA players with loose ankles are able to use strength and coordination as a substitute for the mechanical stability of the ankle ligaments. “We don’t do a high number of ankle stabilization surgeries on NBA players,” says Ferkel, “Primarily because they are so athletic and strong they can overcome the looseness.”

However, some can’t get past repeated sprains and need surgery. Dion Waiters of the Miami Heat, out again with another ankle sprain, is reported to be contemplating ankle stabilization surgery in the off-season. For those that do have the surgery, like Curry, the success rate is well over 90%.

Though the Warriors reported that Curry’s December MRI indicated his right ankle was stable and structurally intact, continued sprains could very well threaten the long-term health of his ankle joint. Every sprain, warns Ferkel, comes with the risk of collateral damage to cartilage and other structures, leading to problems months or even years later.

After all the doubt that comes with his recent injury, can we be sure that Curry’s ankle will hold up to the stresses of an NBA season? Well, three games into his return, including a Monday game against the Cavaliers, and Curry has dealt with the challenges well, even throwing down his first dunk of the season.

From here forward though, it’s certain that the Warriors will be playing close attention to the health of Curry’s right ankle. Championship hopes might well be resting on how the repaired ligaments hold together.