The Doctor Is In: TJ Watt Can Play Through Ankle Injury

T.J. Watt

Coming into their Week 4 matchup against Green Bay, the Steelers defense had a challenge on their hands trying to slow down reigning NFL MVP Packers QB Aaron Rodgers. The prior week, Pittsburgh struggled to mount a pass rush in a loss to the Bengals at home without superstar OLB T.J. Watt and his partner in crime on the opposite side Alex Highsmith, as both starting outside linebackers were sidelined with groin injuries. Getting them both back gave the team a chance at an upset win.

Unfortunately, T.J. sustained an ankle injury in the first quarter. Although he remained in the game and played well, he was clearly limited and unable to create the chaos for the opposing offense that fans saw him achieve the first week in Buffalo.

Watt appeared to be injured in the first defensive series, following a Steelers TD on their opening drive. Here’s how it played out:

  • Watt dropped into coverage in the first and second downs and was mostly a threatening observer as Rodgers made short passes to the opposite side of the field.
  • On 3rd and 1 from the Green Bay 31, Watt had his first contact on a rushing play but it was uneventful, with S Terrell Edmunds making the tackle.
  • The next two plays, a rush to the left and a pass to the left, were unremarkable for Watt as well.
  • With a new first down for the Packers, Watt made the tackle on WR Davante Adams, but it was clean and he popped right up.
  • On 2nd and 3 at the Pittsburgh 34, RB Aaron Jones rushed to the left and was swallowed up by Alex Highsmith and DE Cam Heyward. Watt seemed to get tripped up by the turf monster, twisting his left ankle.
  • ILB Devin Bush sacked Rodgers on third down, forcing a Packer punt.
  • When Watt returned to the field for the next defensive series, his left ankle was heavily taped.

Following the game, Head Coach Mike Tomlin did not mention Watt specifically in the list of new injuries but mentioned the vague “bumps and bruises” sustained by some players. In his own media session, Watt maintained that he felt “good enough to play”.

It’s a pretty good bet that Watt had a visit with the MRI machine once he got back to Pittsburgh. If we don’t hear anything about it when Tomlin gives his Tuesday presser, we can assume that no significant ligament damage was found. So it’s possible that T.J. Watt won’t even show up on the injury report, but I would suspect that his version of “bumps and bruises” is a low ankle sprain that fortunately is mild in severity. A low ankle sprain is much less challenging than a high ankle sprain, as I described here, which has a longer recovery time.

Mild ankle sprain is a fairly generic term, so let’s take a quick look at what that means while we wait for updates.

Quick ankle anatomy:

Figure 1

A nice summary from the American Academy of Orthopaedic Surgeons:

  • Ligaments are strong, fibrous tissues that connect bones to other bones. The ligaments in the ankle help to keep the bones in proper position and stabilize the joint.
  • Most sprained ankles occur in the lateral ligaments on the outside of the ankle. Sprains can range from tiny tears in the fibers that make up the ligament to complete tears through the tissue.
  • If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. Over time, this instability can result in damage to the bones and cartilage of the ankle joint.

A twisting force to the ankle, common is sports like football that require cutting when running, can cause a tear of one or more ligaments. The lateral ligaments are more commonly injured.

Figure 2

A mild ankle sprain is termed a Grade 1 ankle sprain (of a possible 3) and means:

  • Slight stretching and microscopic tearing of the ligament fibers
  • Mild tenderness and swelling around the ankle

The initial treatment is the usual: RICE (rest, ice, compression and elevation).

If Watt isn’t on the injury report this week, we can assume it’s a Grade 1 sprain and nothing worse. In that case, typical recovery time is a week or two, which is a lot faster than the dreaded high ankle sprain (which can sideline a player for up to eight weeks). More importantly, the Steelers best defensive player can almost certainly play through this injury. And T.J. Watt at 70-80% is still a more powerful force than most other linebackers in the league.

“Melanie H. Friedlander, M.D., F.A.C.S. is a doctor at Association of South Bay Surgeons in Torrance, California. Dr. Friedlander enjoys all aspects of general surgery, but her primary areas of focus are breast surgery and advanced laparoscopic surgery. She recently adopted an advanced, minimally invasive technique that reduces scar size in thyroid surgery. Dr. Friedlander is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the Society of Laparoscopic Surgeons. She developed and published many scientific studies in highly esteemed medical journals.”

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