Mitch Marner’s injury is worse than initially feared.
The Maple Leafs star winger was listed as day to day when he missed a game against Montreal last Saturday. He also missed Thursday’s game against Philadelphia and, though Marner has been skating, Leafs coach Sheldon Keefe says his return to the lineup will take a while.
“It’s more so than (day to day) at this point,” Keefe said Friday. “He won’t skate tomorrow. Take the day off, a couple days for him to settle, and then start to ramp it back up for next week.”
That means Pontus Holmberg will take over Marner’s spot on the top line with Auston Matthews and Tyler Bertuzzi. And a hand injury to Calle Järnkrok will give Nick Robertson a chance with John Tavares and Matthew Knies.
Keefe did not deny a TSN report that Marner’s injury, suffered last Thursday in Boston, was a high ankle sprain. If so, it’s the third time this season a Leaf has suffered that kind of injury. Timothy Liljegren sat out 17 games. Goalie Joseph Woll missed 35.
“It’s a coincidence,” Keefe said. “Hockey’s a sport where these occur.”
The Leafs have favoured a medically conservative approach in recent years. Players are never rushed back; they might be given more time than needed.
Part of that could be the availability of a roster spot, salary cap machinations or simply the fact that the team is in a good spot in regard to the playoffs and injuries create opportunities for other players.
But, especially with high ankle sprains, it’s in the best interest of the player to take as much time as possible, says Dr. Aly Rendely a physical medicine and rehabilitation doctor at Toronto Rehab, a research facility within the University Health Network.
“Returning to play too early could predispose you to further ankle sprains because, in general, any time you’ve had one ankle sprain, you’re always more predisposed to others,” said Rendely, who has not treated any of the Leafs.
It all depends on the severity of the injury, but Rendely says research has shown that NHL players tend to miss 20 to 22 days on average due to high ankle sprains.
It is a tricky injury to rehabilitate because of its location. A high ankle sprain affects the structures that hold the main shin bones — the fibula and tibia — together just above the ankle.
“So every time you’re taking a step, you’re putting weight through your foot and transmitting that up your leg, those bones want to separate,” Rendely said. “It’s trickier than a low or lateral ankle sprain, where you can immobilize much more easily with a walking boot or a different type of taping.”
That makes it harder to heal.
“The rehab is going to be important, and not rushing it so he actually does have time to really make sure that ankle feels stable to him,” Rendely said. “So that he’s not tentative on that foot, and then thinking about it while he’s playing, because then you’re somewhat predisposed to other injuries if you’re not really skating as your usual self.”
Marner is believed to have suffered the sprain in Boston after a failed wraparound attempt when he fell awkwardly on his leg. He did, however, finish that game. Rendely figures he simply didn’t take his skate off.
“That makes sense,” said Rendely. “You’re keeping the swelling in, as well as the endorphins at that point are probably minimizing the pain to some degree.
“Once you take the boot off, you’re not going to be able to get your foot back in the skate. And as the inflammation cascade occurs over the next six or 12 hours, the pain is going to ramp up as well.”
Notes
Järnkrok is week to week with a hand injury suffered Thursday. He missed 13 games earlier with a broken knuckle … Defenceman Ilya Lyubushkin was given the day off practice after taking a couple of hard hits against the Flyers. … The Leafs will wear their Toronto St. Pats green uniforms on Saturday against the Carolina Hurricanes.