Things have been rough for the NY Jets as of late. Not only did they lose 34-0 to the San Francisco 49ers this past weekend, but wide receiver Santonio Holmes went down on the first play of the fourth quarter with a debilitating foot injury.
See, not all injuries to the foot involved breaking bones. There is a small ligament (the Lisfranc’s ligament) that connects the first and second metatarsals together (the bones that correspond with the big toe and the second toe) that pretty much maintains the structure of what we podiatrist call the forefoot. This ligament is so small yet so necessary, that when it is torn it leads to season ending injuries for even the highest level athletes.
The reason that this is so is because of what we call a keystone effect. Imagine an old Roman arch where the block at the apex of the arch is the “keystone”. If something should happen to this block the entire structure will come tumbling down. Although when this ligament is torn your foot doesn’t just fall apart, it does how ruin the normal motion of the foot. As a result, any weight bearing activity one partakes in with a torn Lisfranc’s ligament becomes not only painful but is unstable thereby putting the rest of your foot and ankle at risk for injury.
Lisfranc’s ligaments are also associated with small fractures of the metatarsals and other bones of the foot and toes. This is because it takes a lot of force and usually a twisting motion in the foot itself to tear this ligament. Often times these fractures go missed by physicians not specifically trained in the foot and ankle which can lead to arthritis.
Santonio Holms may or may not need surgery depending on the extent of the injury. Some Lisfranc’s injuries can be treated conservatively with crutches and a cast. However, the scientific literature shows that without surgery there is an increased risk of arthritis later on.
Surgery to repair a torn Lisfranc’s ligament and any other associate fractures or dislocations generally involves the use of small plates and/or screws inserted into the foot to maintain the overall stability and integrity of the foot. The recovery time is usually 6-8 weeks of non weight bearing either in crutches or a wheelchair and a cast.
Now one might say since the recovery times and treatments of surgical and non-surgical care are pretty much the same, why bother with the surgery then? The reason is that surgical treatment greatly decreases the risk of long-term instability and arthritis.
Should any injury happen to you where you have a lot of pain in the ball of your foot area, please visit your local podiatrist so that he/she can make an accurate diagnosis.
* Photo Courtesy of:sbnation.com