Photo: Getty Images
Photo: Getty Images

Already without the services of Anthony Davis, the Lakers are now down another All-Star forward.

LeBron James will be out indefinitely after suffering an ankle injury during a March game against the Hawks. Los Angeles may fall in the Western Conference standings with Davis and James out, but the main concern is having the dynamic duo ready for the 2021 NBA playoffs as the team chases back-to-back titles.

What is LeBron James’s injury?

LeBron James grimaces after suffering an injury during the Lakers’ game against the Hawks. Photograph: Marcio José Sánchez/AP
LeBron James grimaces after suffering an injury during the Lakers’ game against the Hawks. Photograph: Marcio José Sánchez/AP

On Saturday, LeBron James went down with an ankle injury. The injury is more striking given that he recently voiced his distaste for this month’s All-Star game, which he believed put more wear on players who had already had a shortened offseason due to the Covid-19 pandemic.

Nevertheless, he made it through unscathed – or at least until the second quarter of the Los Angeles Lakers’ game against the Atlanta Hawks on Saturday. While trying to grab a loose ball, he collided with Hawks forward Solomon Hill. James’s right leg began to roll in, but then his ankle forcibly rolled outward, which can be a recipe for a high ankle sprain, The Guardian reported.

How serious is the wound?

To understand what a high ankle sprain means, first it’s important to define the difference between a tendon and a ligament. A tendon is how a muscle attaches to the bone it needs to move. Muscles are meaty structures but not very strong. In order to pull a bone, the muscle transitions into a thick rope-like structure called a tendon that then inserts into the bone so that the body can move. A ligament, on the other hand, is like a tendon in its rope-like consistency, but it isn’t attached to a muscle. It simply runs between bones to help stabilize a joint. The ACL in the knee is a well known example.

So when James rolled his ankle outward, he stretched or tore the ligaments in his ankle. In his case, it wasn’t the ligaments that stabilize the ankle to the foot, but instead the ligaments that connect the two leg bones together. This ligament runs up and down the leg below the knee to the ankle like a broad sheet and is called the syndesmosis. That’s why it’s called a “high” ankle sprain – it’s not by the foot, but higher up on the leg bones.

When James was taken to the locker room, reports are that he received x-rays and an MRI. It’s rather important to note if anything was seen on the x-rays, because that could mean he needs surgery. If the bones appeared wider apart on x-ray, that is usually a much more significant injury than one that needs a higher tuned MRI to see. An ankle joint that is widened from a syndesmosis injury can’t heal back in place on its own. If it widens with stress, it also may need surgery.

Surgery entails placing hardware across from one leg bone to the other. This was traditionally done with the screws for a long time, especially if there are broken bones involved. The screws are strong, but the downside is sometimes they can break so often they are removed with a second surgery. A more sports-friendly technique evolved in which a small rope is attached between the two bones to help recreate the stability and motion of the ligaments. It may not be as stiff as screws, but it doesn’t need to come back out.

If James needs a tightrope-type surgery, he may be out between four and six weeks, but some nagging ligament injuries can last up to 12 weeks, which means he would not be back until well into this season’s playoffs. Not all players studied, though, are million-dollar franchise players destined for the hall of fame. So these numbers may be thrown out the window if an athlete feels they need to get back sooner. A classic example of this was when Terrell Owens played wide receiver for the Philadelphia Eagles. He suffered a high ankle sprain towards the end of the 2004 season and needed surgery. Just seven weeks later, his team played in the Super Bowl. He returned against doctors’ advice for the big game and had nine catches for 122 yards.

How long will LeBron James be out?

Photo: Getty Images
Photo: Getty Images

The short answer: It's too early to know when James will be able to rejoin the Lakers' starting lineup. The average missed time for a high ankle sprain over the last seven 82-game seasons has been approximately 10 games, according to injury expert Jeff Stotts. However, Stotts noted that a quicker return is possible, according to Sporting news.

From his 2018 breakdown of Klay Thompson's high ankle sprain:

The timeline of recovery for ankle sprains widely varies based on a number of factors including the severity of damage, the involved joint and any other accompanying injury. Treatment for a high ankle sprain is the same as a normal medial or lateral ankle sprains but generally take longer to heal. A big reason for this extended recovery time is linked to the disruption of overall stability and potential widening of the ankle mortise.

Los Angeles has unsurprisingly struggled when Davis and James sit, but the Lakers aren't nearly as concerned with their seeding as they are with having a healthy roster heading into the postseason. They will likely be extremely cautious when it comes to James' recovery timeline.

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LeBron James stats for 2020-21 season

25.8 points per game

8.1 rebounds per game

8.0 assists per game

1.1 steals per game

3.8 turnovers per game

34.5 minutes per game

51.3 percent shooting

36.7 percent 3-point shooting

69.9 percent free throw shooting

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