NASHVILLE — Considering how his season ended last fall, it's easy to assume the worst when a player like Ryan Tannehill goes down with an ankle injury.

Tannehill missed five games in 2022 with a high ankle sprain that eventually required season ending tightrope surgery. Now six games into 2023, the 35-year-old Tennessee Titans quarterback is dealing with a similar injury.

But ironically, Tannehill's high ankle sprain and surgery from last season may actually help him return to play faster this time around.

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In the latest edition of AtoZ Sports Doc Talk, I sat down with Dr. Geoff Watson from Bone and Joint Institute of Tennessee to get more details on Tannehill's injury. Dr. Watson is a board certified orthopedic surgeon specializing in treatment of the foot and ankle, including total ankle replacement.

During our illuminating discussions, Watson helped me gain better understanding of a high ankle sprain and the tightrope surgery Tannehill had back in December.

As Watson explained it, a high ankle sprain refers to the ligament that holds the tibia and fibula together. That ligament is called the syndesmosis, and when it gets torn or stretched, external rotation of the foot or ankle becomes very difficult. For a quarterback, particularly a right-handed quarterback who is pushing off his right ankle, that can make it very painful and challenging to step into throws.

Depending on the severity of these sprains and how well supported the ankle is, high ankle sprains can sometimes require surgery. Titans fans and Tannehill learned that the hard way last season when the veteran QB underwent tightrope surgery and he was shut down for the season.

"You take the two bones that are there, you put them back in the relationship they should be in, and you drill a tiny hole between both of the bones. It flips a button on the outside of both bones and there’s a suture that runs in between those two buttons," said Watson of the process that takes place during tightrope surgery. "The role of that ligament is to prevent those two bones from separating. So if you’ve got those buttons on the outside sandwiching that together, that is sort of recreating what the ligament is doing for you. You’re kind of using that eight layers of suture to recreate and do what the ligament does."

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According to Watson, because Tannehill has already had the surgery once in the same leg, he already has a "permanent suture" to stabilize the ligaments and would not need to reset it. Another surgery in the same ankle is pretty much off the table.

For Tannehill, getting back on the playing field is just a matter of scarring taking place. The best way to catalyze scarring is through immobilization, hence the cast Tannehill has on his right foot/ankle.

But perhaps the best and most surprising news Dr. Watson shared during our conversation was the fact that Tannehill should be able to return faster than normal because he already had the surgery on his right ankle and has that suture in place.

"As long as that suture is still doing the work it’s supposed to, you've got to think that it’s probably a quicker return. It’s like having a little rebar in there that’s still somewhat functional," said Watson. "I would think that timeline would be a little bit quicker without having looked at his MRI."

Watson said Tannehill would probably have to do some sort of functional test to see if the suture is still doing the work it's supposed to in his right ankle. But provided that's the case, it could actually be a quicker return than usual.

The Titans have a bye week in Week 7 and take on the Atlanta Falcons at Nissan Stadium in Week 8. Tennessee is desperately trying to string a couple wins together and getting QB1 back sooner than expected could provide a big boost.

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