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  • Randon Hall, MD

Injury Report 101 – Foot & Ankle

If you have ever gotten an injury report update on your fantasy player or favorite team and have no idea what to make of it, this is the resource for you. After a few years of tracking and analyzing NFL injuries here is a comprehensive cheat sheet to understanding everything injury report related.


Foot Injuries


We will definitely see reports of Turf Toe or “toe sprain” throughout the season. Basically this is an injury of the large knuckle of your big toe. It can be anything from a sprain of that joint or disruption of the capsule of the joint requiring surgery. Even the mild cases can be disruptive as this joint plays an enormous role in cutting, pivoting and sprinting.



(Modified) Case courtesy of Dr Matt Skalski, Radiopaedia.org. From the case rID: 35716

We have already seen several reports of a Jones Fracture in the foot which is always difficult to treat. If you recall Greg Olsen had this injury last year which was a recurrence from the year before. The issue here is these are usually stress fractures that eventually break all the way through. They are notorious for prolonged or incomplete healing. In the NFL, usually the decision is made to place a screw within the metatarsal bone to compress the fracture site, speed healing and reduce risk of re-fracture.


(Modified) Case courtesy of Dr Yi-Jin Kuok, Radiopaedia.org, rID: 18349

Routinely there are vague reports of a Mid-Foot Sprain. Just as in the ankle, the foot has several supportive ligaments to keep the foot stable. There is one particular ligament that is crucial to sports participation called the Lisfranc ligament. When a foot injury occurs to these stabilizing ligaments this is referred to as a foot sprain. To be clear: An a foot sprain is the same thing as ligament damage to the foot! Mild foot sprains can dramatically affect change of direction and explosive movements but usually heal quickly. On the other hand Lisfranc ligament injuries can take several months to heal and occasionally need surgery when severe.


Ankle Injuries


Most common injury to the ankle is a simple ankle sprain. Routinely reports state that “will undergo MRI looking for ligament damage”. To be clear, an ankle sprain IS by definition ligament damage. Therefore every ankle sprain has “ligament damage”. It is basically a matter of degree which the MRI can help with although in the real word it is not usually necessary.


When a reports states there is a high ankle sprain that is really telling us which ligaments are involved. Typically a classic ankle sprain just involves the ligaments on the outer ankle, but a high ankle sprain involves the ligaments that connect the lower portion of the leg bones. Generally speaking the return to play is longer with a high ankle sprain. In rare cases, high ankle sprains can require surgery, which is similar to the tight rope procedure Tua Tagovailoa had prior to the national championship.


(Modified) Original Photo by Laurel F., Creative Commons

More concerning injuries of the ankle can include a true ankle dislocation where the ankle joint comes completely out of place. If the ankle joint is reset with no damage to the blood vessels this is not the worst injury to have. Usually the ankle is immobilized followed by rehab with return in a few months. On the other hand if there is a fracture associated with the dislocation, the diagnosis is much more concerning usually requiring surgery with hardware and a return at about 6 months. You may be familiar with this type of injury from Gordon Hayward of the Boston Celtics.



(Modified) Case courtesy of Radswiki, Radiopaedia.org, rID: 11159

Lastly, the dreaded Achilles tendon rupture. The diagnosis is usually made on the field and confirmed with an MRI. Be careful, as can be reported as a calf injury and easily confused for a gastroc muscle tear. The calf muscle tear is going to be located higher up on the leg and have a relatively quick return 4-6 weeks. Whereas an Achilles tendon rupture is going to be a season-ender with a return to play anywhere from 6-12 months.

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Copyright 2017 The Sports Source, LLC

Dr. Randon T. Hall

A sports medicine physician with a passion to educate. My mission is to provide clear, concise and up to date education to athletes and sports fans for a better understanding of sports related health issues.

 

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