‘TightRope’ Repair for High-Ankle Sprain Gets Athletes Back to Play

When University of Alabama quarterback, Tua Tagovailoa, takes the field at tonight’s college football national championship game, his ankle will be supported by a device that allowed him to return to play just a couple of weeks after suffering a high-ankle sprain. The “TightRope” in his ankle is doing the job of his ligaments while they heal, allowing him to stably move around the turf.

“The TightRope is a belt-and-suspenders type of of device that limits motion between the tibia (shin bone) and fibula (calf bone) at the ankle, essentially taking over the job of the ligament while it heals,” said Christopher Hodgkins, M.D., an orthopedic surgeon with Miami Orthopedics & Sports Medicine Institute. “It’s an aggressive surgical approach that can help professional and collegiate athletes get back to play at between two and four weeks.”

As an early adopter of the procedure who’s been using the device for about six years, Dr. Hodgkins said he saw the genius behind it. But he emphasizes that it’s reserved for high-level, elite athletes.

“While the TightRope is usually the first choice treatment for elite athletes in select cases, it’s not recommended for a non-athlete with the same type of ankle injury,” Dr. Hodgins said. “It’s almost always best to heal without surgery, which is the right treatment for most people who experience this injury.”

A high-ankle sprain is less common than a regular ankle sprain, and is usually a more significant injury that can lead to a long absence from sports. High-ankle sprains happen when a high-energy move creates an excessive twist. This movement very often occurs in football, a sport in which a lot of “cutting,” or forceful, quick stops take place.

“It’s proving to be important in high-level athletes and may very well be the future choice of treatment in every athlete who chooses to have it,” Dr. Hodgkins said.