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  • Writer's pictureRandon Hall, MD

Mid-Foot Madness: Expectations on PJ Washington's Foot Sprain

Mid-Foot Madness

As everyone is aware, PJ Washington, Kentucky Wildcat’s sophomore forward is out with a foot sprain. On top of that, after seeing a specialist, he was placed in a cast and will be evaluated again this week to update his status. All we know is that he hurt his foot coming down from a jump, when he felt a pop, against Tennessee in the SEC semifinals. With March Madness upon us, details are light and no one exactly knows what to expect. Well here is my take on all the possibilities that you may see regarding Washington possible return to the court for this years tournament.

What Exactly is the Injury?

First off, what exactly is his injury? Basically Washington either has a sprain of one of the lesser ligaments in the foot or he has a Lisfranc injury from my best estimates. Just as in the ankle, the foot has several supportive ligaments to keep the foot stable while performing sports activities. Honestly, there are too many to name, but basically there are multiple ligaments that connect each bone in the foot to the bones next to it as can be seen in the photo below. 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!

Side View

Midfoot Sprain

Front View

Midfoot Sprain

Lisfranc Ligament

Lisfranc Ligament

To Cast or Not to Cast

Most foot sprains are generally managed with a conservative course of treatment. At first, the process usually involves some form of supportive boot or cast. In my opinion, there really is no difference between the boot or the cast. With the knowledge that we do have, I can only guess they wanted to try everything possible, but in reality, the fact that he has a cast likely will have no ultimate effect on his return. The dilemma you have with the cast is that you can’t do rehab or treatments for the time that the cast is on. I would generally take the boot options for that reason, but there is no right answer. He is 1 week out from his injury and this is typically a 2-4 week injury if it is NOT the Lisfranc ligament. If it is the Lisfranc ligament usually going to be 4-6 or longer if treated non-operatively. I also wonder if a PRP injection was discussed.

Will We See Him Return to the Court this Year?

At this point they will remove the cast this week and evaluate his level of pain and how well he can tolerate walking, running, cutting pivoting. He will get as much rehab and treatments as they can get him and it will really be a “what can he tolerate” type of thing. I think you will continue to see him in some type of boot or shoe until game day. He would be 2.5 weeks out for Sweet 16/ Elite 8 and 3.5 weeks out for the Final Four. If he has a typical foot sprain it is very well possible he is ready for next weeks games and highly probable for Final Four. If it is the Lisfranc ligament I would say it is unlikely that he is ready for Sweet 16 or Elite 8 but definitely possible for Final Four.

As was mentioned in other articles, the ultimate factor is his future health. An all to common issue is that an athlete sustains a more serious injury while compensating for a current one. Obviously no college basketball fan wants to see that.


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