A “Wall” to Overcome for Joseph Woll

On December 7th, Toronto Maple Leafs goaltender Joseph Woll sustained a high ankle sprain in a game against the Ottawa Senators that put him out of the NHL for almost 3 months. As a Toronto Maple Leafs fan, you can only wonder why it has taken him so long to get back to play. With inconsistency between the pipes for the Toronto Maple Leafs, getting Woll back to play is important to the team’s success and playoff push. In this post, I’m going to explore the injury that Woll sustained and the physical therapy management for return to sport.

A high ankle sprain, also known as a syndesmotic ankle injury, usually happens with a forceful external rotation of the foot and ankle and accounts for around 15% of ankle injuries (Feng et al. 2006). This injury most commonly occurs when an athlete quickly pivots internally off a foot planted in external rotation, when a valgus load is placed on the leg while the foot is planted, or when an athlete has fallen, and the foot is forced into external rotation (Sportshealth, 2010). This type of injury leads to instability of the high ankle and potential damage to the anterior inferior tibiofibular ligament. Individuals generally experience pain with weight bearing, swelling, and instability in the syndesmosis (high ankle) (Feng et al. 2006).

Physical therapy treatment usually starts off with a period of protection and immobilization in a walking boot to help stabilize the syndesmosis. Pain and inflammation control can also be initiated to help speed up the healing process. Compression, elevation, cryotherapy, electrical stimulation, manual therapy, and acupuncture can be common treatment techniques used early in the rehabilitation phase to improve pain and inflammation (Sportshealth, 2010). Once pain and inflammation improve, athletes start to progress range of motion and weight bearing tolerance. As the mobility in the ankle improves, strength, and stability training are implemented and progressed carefully by a physical therapist (Feng et al. 2006). Once the athlete can fully weight bear, with improved strength and stability, the return to sport phase begins. The return to sport phase consists of running, jumping, cutting, and a wide range of high intensity strength and stability exercises. This phase of rehabilitation is extremely important to ensure the athlete can safely return to play without risk of re-injury. High-ankle sprains usually take 8-12 weeks to be able to return to sport depending on the sport and athlete role (Feng et al. 2006).

The good news is, Woll is back playing in the NHL.. We can only hope that this is “the year” for the Toronto Maple Leafs!

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