Note: The following post appears in the August 31, 2011 issue of The Post and Courier.

It’s normal to see NASCAR drivers jump out of their cars after winning a race. And some might be inclined to jump up and down celebrating in victory lane. While that would rarely create a stir for most drivers, it does when the winner doing the jumping recently broke his ankle.

Brad Keselowski entered the month of August ranked 21st in the Sprint Cup standings. On August 3, when he and his team were testing Road Atlanta, he suffered what many observers of the sport speculated would slow, if not end, his season. Instead, his injury might have somehow helped propel him toward the top of the standings.

Keselowski crashed his car, hitting a wall at approximately 100 mph. He walked away from the car after the accident but was taken to the hospital for evaluation. There he was diagnosed with an avulsion fracture of his left ankle. After seeing an orthopaedic surgeon, Keselowski was reportedly cleared by Dr. Jerry Petty, a doctor who evaluates drivers for NASCAR and clears them to race. The driver skipped a Nationwide Series race at Iowa Speedway but raced later that weekend in the Sprint Cup Series race at Pocono.

Four days after his crash, the brash driver won at Pocono despite tremendous pain. He took Motrin to help with his pain, and doctors even reportedly drained fluid from his foot during a delay in the race.

Initially when I heard about the injury, I wasn’t very impressed. The avulsion fracture he suffered likely was a variation of an ankle sprain. Instead of tearing the ligament between the bone on the outside of his ankle and a bone in his foot, which is what a lateral ankle sprain essentially is, Keselowski’s injury pulled the ligament and a small piece of bone off the rest of the bone. Usually when that happens, it is a very small piece, and orthopaedic surgeons treat it just as we do with ankle sprains – brace, ice, and full weightbearing. So being cleared to race isn’t that surprising.

What does impress me, though, is how effective he has been. I honestly don’t follow NASCAR, so I had to research the cars and what a stock car driver would need to do with his left foot and ankle. The racecars in NASCAR have manual transmissions, so he would need his left ankle to operate the clutch. In addition, Keselowski is known for using his left foot for both the clutch and the brake.

The swelling and bruising seen in this image (not Keselowski) is typical for ankle sprains and avulsion fractures.
Doctors have had the driver wear a brace to stabilize his ankle while it heals, which is common for most of these injuries. The brace provides stability while still allowing basic motions. As long as he had the strength in the ankle to firmly press the clutch, I doubt his injury limited that action. The brace did little to help his pain, as Keselowski told reporters after that first race back. “Wearing a foot brace was helpful. (It) still hurt to push the pedal, but it didn’t hurt as bad it would if I wasn’t (driving).”

One major difficulty after ankle sprains or avulsion fractures of the ankle, though, is the loss of fine control and delicate movements. Brace or no brace, athletes often have difficulty with balance and ankle position sense after these injuries. Physical therapy and ankle stabilization exercises can help those abilities return, but it can still take weeks. So Keselowski being able to apply subtle pressure to the brakes and do everything else he needs to do to control the car at top speeds is impressive.

In previous years, the sarcastic driver has made headlines for actions and comments off the track rather than his performance on it, including controversial remarks about female driver Danica Patrick. But in the four races since the ankle injury, Keselowski won at Pocono, came in second at Watkins Glen, finished third at Michigan, and won Saturday at Bristol. He has jumped 10 spots in the points standings.

Keselowski expressed some regret over jumping on his injured ankle after Saturday night’s race. “Stupid is as stupid does,” he quipped. If the hottest driver in NASCAR keeps winning, I doubt he’ll feel much pain.