Rory McIlroy misses The Open due to ankle injury – ATFL explained

When a high profile athlete suffers an injury, the world takes notice. Especially when it is Northen Irish professional golfer Rory McIlroy, who opted to sit out of the 144th British Open due to an ankle injury.

McIlroy wearing a boot and crutches posted the photo on his Instagram explaining, “Total rupture of left ATFL (ankle ligament) and associated joint capsule damage in a soccer kickabout with friends on Saturday. Continuing to assess extent of injury and treatment plan day by day. Rehab already started… Working hard to get back as soon as I can.”

Deciding not to play in The Open is a major setback for McIlroy, as he won the tournament in 2014 by two strokes. The world was anxious to see him compete against 2015 Masters Champion Jordan Spieth, as both athletes are playing at the top of their game.

Orthopedist Mark Billante, MD is very aware of this type of ankle sprain, specializing in orthopedic surgery and sports medicine at Baylor Scott & White Health in Round Rock, TX. Dr. Billante was following McIlroy’s story, and thinks it is a sound medical decision to ensure his ankle is properly healed before competing at such a high level.

“The ankle is a very high stress joint,” says Dr. Billante. “If Rory is swinging a golf club hundreds of times a day, an injured ankle can’t take all of that force. I think it’s a good idea, even though it’s the British Open, that he’s going to take time to let this heal.”

What is a total rupture of the ATFL?


McIlroy injured his left anterior talofibular ligament (ATFL), located in the outer section of ankle. In discussing this injury with Dr. Billante, he said it is the most common ligament tear in the ankle.

The ATFL is located on the outer section of the ankle and is simply a sprained ankle or ligament tear.

“There are different grades or levels of injury,” says Dr. Billante. “There are some partial tears or complete tears, but any sprain is a ligament tear. This particular type of injury is the most common of the ligament tears in the ankle.”

He explains McIlroy’s torn ATFL injury is seen in 85 percent of ankle sprains. Even more, 40 percent of all sports injuries are ankle sprains due to the stabilizing function of the joint.

“The ATFL is the weakest of the lateral ankle ligaments,” says Dr. Billante. “When your toes are pointed towards the ground it keeps the foot from coming forward. What happens with a rolled ankle, the foot is downward and gets inverted to the inside, injuring the ATFL.”

Anticipated Recovery for McIlroy

With an ATFL injury, it is always handled on a case-by-case basis. The treatment and recovery plan all depends on the level of severity, known as grades.

If you suffer from a grade I or II ankle sprain, it is important to get the proper rest, ice, compression and elevation (RICE) so your ankle can begin to heal. After the injury, there may be a great deal of swelling, bruising or pain associated with the injury. For a grade III, your doctor may recommend taking weight off of the sprain using a boot or crutches, following up to verify it is healing properly before returning to activity.

“If it’s just the outside of the ankle, often an athlete is able to return to activity somewhere between two to six weeks,” says Dr. Billante.“If McIlroy comes back to early he could risk permanent damage, and I think he has a long career in front of him. Doctors and athletes make decisions on a case by case basis, but it really helps when a high profile athlete does the right thing.”

It can be difficult to be patient through an ankle injury, but the ankle joint takes 1.5 times your body weight when walking, and up to 4 times your body weight when running. As for golf, it can put stress on the twisting function of the ankle, so McIlory is continuing to receive the proper rehabilitation.

“It’s easy to root for Rory,” says Dr. Billante. “He’s such a fine golfer and a fine young man. We hope for a speedy recovery and many British Opens in the future.”

Rory McIlroy misses The Open due to ankle injury – ATFL explained