Will 49ers' De'Zhaun Stribling need an ankle procedure? Surgeons explain factors at play

\n\n\n Wide receiver De'Zhaun Stribling holds his leg after being injured during the second quarter of a game between the San Francisco 49ers and Los Angeles Rams at the Melbourne Cricket Ground stadium in Melbourne, Australia on Friday, Sept. 11, 2026 (Thursday, Sept. 10 in California). (Sydney Low/For the S.F. Chronicle)\n \n\n
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Those of us who didn't attend medical school probably don't realize that our ankles have a deltoid ligament.

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But plenty of San Francisco 49ers fans became aware of the band of tissue on the inner part of the ankle when the NFL Network reported that promising rookie wide receiver De'Zhaun Stribling suffered a sprained deltoid ligament in last week's season-opening win over the Rams.

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Stribling, the 33rd overall pick in April's draft, will reportedly be sidelined for a minimum of one month, and the injury could ultimately require surgery. The possibility that a procedure could be required is an indication that Stribling is dealing with something that could be more severe than a high ankle sprain, a dreaded injury that rarely requires surgery.

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"Not all ankle sprains are the same," said Dr. Kenneth Jung, a foot and ankle surgeon who is a consultant to the Los Angeles Rams. "With most ankle sprains, (surgery) is not even coming up in conversation."

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To be clear, most deltoid ligament sprains heal on their own. And that could be the case with Stribling. But the nature of the injury is why athletes are sidelined for at least a month - with some recoveries requiring up to six weeks - if surgery isn't required.

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Jung and Dr. Nicholas Strasser, a foot and ankle surgeon who is consultant to the Tennessee Titans and Vanderbilt University, explained that the deltoid ligament is a stronger ligament than the two ligaments on the outside of the ankle that are associated with low and high ankle sprains. As a result, it requires more force to damage the deltoid. And more force means more trauma to the ankle.

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"It's a pretty strong ligament, and so a little more energy is required to create an injury there," said Jung, who works at Cedars-Sinai Orthopaedics and Sports Medicine in Los Angeles. "And when there's a higher-energy injury that occurs, it makes sense that it's a little bit of a longer recovery, as well."

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Said Strasser: "A Grade 2 sprain on a standard ankle sprain is usually not a huge deal, outside some treatment in the athletic training room. With a Grade 2 injury on the deltoids, it can be more substantial. Oftentimes patients can have more pain, soreness and swelling that persists a little bit longer."

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What will determine whether Stribling needs surgery? Both surgeons discussed his ankle's stability.

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Jung said Stribling would have already had a procedure if he had "gross instability," but it's likely premature to say whether rest and rehabilitation will restore whatever instability Stribling is experiencing. Stribling's stability will be determined by how the fibers in his torn ankle heal.

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"If they heal a little bit stretched out, or in a way that it just doesn't have enough support to it, that could lead to surgery," said Strasser, an assistant professor of orthopedics at Vanderbilt. "Especially because it's on the inside part of the ankle and you're often cutting and pushing off that a little bit more. The stress in that area is a little bit more extreme."

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If Stribling needs surgery, his recovery would last three to four months, which would sideline him for most or all of the regular season. That alternative timeline lends itself to the 49ers instead waiting to see whether his ankle can heal non-operatively.

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It's also possible Stribling is facing a harder recovery because he continued to play last week after he was initially injured. Stribling was hurt with about three minutes left in the first quarter when he was drilled by Rams safety Kamren Kinchens at the end of a 5-yard completion to tight end Luke Farrell. Stribling stayed in for the next play, a 3-yard run by Kaelon Black, but he began limping shortly after the snap and hopped directly to the sideline.

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After he was ruled questionable to return, Stribling came back with 14:47 left in the second quarter. On the eighth snap after he returned, Stribling collapsed while making an inside cut on a pass route. He was placed on a cart to reach the locker room after he required assistance getting to the sideline.

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"Sometimes you can get small tears, you could even say partial injuries, and then, obviously, they've got adrenaline going," Jung said. "They feel pretty good. They want to push. And a partial tear can become something more serious."

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This article originally published at Will 49ers' De'Zhaun Stribling need an ankle procedure? Surgeons explain factors at play.

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