# @dr.tlesh on Instagram

- **Type:** Video
- **Original URL:** https://www.instagram.com/p/DdtdbPCxNcf
- **Gondola URL:** https://gondola.cc/posts/70989752-drtlesh-instagram
- **Thumbnail:** https://img.gondola.cc/tr:w-,h-,fo-auto/postThumbnails/ea4700bdfa.jpg
- **Posted:** 2026-09-25T12:30:54.000+00:00
- **Account Owner:** Tyler Lesher (@dr.tlesh) — https://gondola.cc/dr.tlesh

## Caption

Luis Arraez, left ankle sprain, no contact.

The mechanism: planted left foot at full speed, hard cut right to avoid the tag. The foot stays fixed while his body rotates over it. All that momentum becomes rotational torque into the ankle. Classic setup, no contact needed.

The differential: lateral sprain (ATFL) most likely, but the rotational catch and where he grabbed put a high ankle, syndesmotic, sprain on the table. That answer changes the timeline. Achilles gets ruled out on exam, imaging clears an avulsion.

The protocol: exam, imaging, grade it, protect early, load progressively. Early weight bearing beats prolonged rest. Return to sport should be criteria based: full range, strength, hop and change of direction testing, not just time.

References:
Vuurberg G, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence based clinical guideline. Br J Sports Med, 2018.
Gribble PA, et al. Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long term consequences of lateral ankle sprains. Br J Sports Med, 2016.
Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train, 2002.
Williams GN, Allen EJ. Rehabilitation of syndesmotic (high) ankle sprains. Sports Health, 2010.
Tassignon B, et al. Criteria based return to sport decision making following lateral ankle sprain injury: a systematic review and narrative synthesis. Sports Med, 2019.
Fong DT, et al. Understanding acute ankle ligamentous sprain injury in sports. Sports Med Arthrosc Rehabil Ther Technol, 2009.
#athletictrainer #sportsmedicine #athletictraining #mlb #rehab

## Stats

- **Views:** 4,771
- **Likes:** 63
- **Shares:** 0
- **Comments:** 6

## Tags

mlb, rehab, athletictrainer, athletictraining, sportsmedicine

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