Rams’ Cooper Kupp undergoes tightrope surgery, Week 15 a possibility

Rams WR Cooper Kupp will miss the next four weeks after being placed on IR earlier this week. He is set to undergo surgery on his right ankle after suffering a high ankle sprain in Week 10 against the Cardinals.

The injury occurred early in the fourth quarter when Kupp ran out route on 1st-and-10. Backup quarterback John Wolford threw a high pass towards Kupp, who lept upwards in an attempt to pull it down.

As he landed, Cardinals’ CB Marco Wilson came flying in, hitting Kupp in the ankle. Kupp then rolled out of bounds, grabbing for his ankle, visibly in pain. He was helped to the bench by medical staff before being taken to the locker room where he was ruled out.


High ankle sprains are exceedingly common in the NFL, and they are uniquely different from the more frequent low ankle sprain.

The difference between high ankle sprains and low ankle sprains is more than just location. Low ankle sprains are the more common sprain, where the ankle “rolls,” causing damage to the anterior talofibular ligament, posterior talofibular ligament, and/or the calcaneofibular ligament. High ankle sprains involve damage to the syndesmotic ligaments as a result of twisting, or over rotation.

The syndesmotic ligaments hold together the tibia and fibula above the ankle joint complex, and because of their significance in how the rest of the lower leg functions, they often require more attention when damaged. Severe high ankle sprains can require a non-weight bearing walker boot or cast for multiple weeks, and rehab itself can last months.

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Players often opt for surgery in an effort to shorten that rehab process. The most common surgery for high ankle sprains is referred to as tightrope surgery. In the past, high ankle sprains were treated using two metal screws to stabilize the fibula to the tibia. The rigidness of the screws means the ankle’s mobility is limited and a follow-up surgery is required to remove them.

Tightrope surgery fixes this problem by stabilizing the ankle with a flexible, polyurethane cord. Because it is flexible, the ankle can move normally as it heals. Recovery generally takes four to six weeks, meaning – in Kupp’s case – he could return in Week 15.

Our algorithm predicts Kupp should reach Optimal Recovery in 28 days, so he could only end up missing the minimum four weeks after getting placed on the IR. Until then, his Injury Risk is High (33%) and his Health Performance Factor is Below Average (41%).


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