Residency Insight -- A PRESENT Podiatry eZine

Jay Lieberman, DPM, FACFAS,
Director of Podiatric
Medical Education,
Northwest Medical Ctr.

The Foot Injuries of Professional Athletes
Injuries and their implications, as perceived
by the Armchair Quarterback, Jay Lieberman, DPM

March/April is an exciting time in sports. We have March madness, the NBA playoffs, the Stanley Cup, and the onset of major league baseball.

In the background of all this, is the NFL combine and the NFL draft.

College football players from all over the country are analyzed for personality, upbringing, honesty, and loyalty. Legal infractions, i.e. drug use or gang violence, are scrutinized. You see, a history of violence is tolerated if the intention is to draft a linebacker (see Joey Porter) but not a quarterback. Cecil Collins is wonderful example of how character issues can prevent someone from succeeding in the NFL. Cecil Collins (American football) - Wikipedia, the free encyclopedia.

Looks are important if you are drafting a quarterback. The guy can have poor throwing mechanics and be inaccurate, but if he looks like a matinee idol and routinely thanks God and his teammates for his success, then you can overlook just about anything (see Tim Tebow).

The number one pick in the country was Oklahoma’s Sam Bradford. At the end of last season, he injured his right throwing shoulder. This represented the second time in one season that he had injured this same shoulder. Sports Illustrated reported that a repair was performed utilizing an “absorbable synthetic braid.”

How would this affect his ability to throw and fulfill the promise of being a Pro Bowl quarterback? Chad Pennington injured his shoulder in a similar way. While Pennington was always considered a better than average quarterback, teams would “stack the line” because they knew he was only accurate within thirty yards. Trent Green also had shoulder problems, but won a Super bowl for New Orleans Saints. The Miami Dolphins thought Green’s injury was a risky proposition and, therefore, signed Dante Culpepper to be their quarterback of the future. Culpepper was only recovering from ACL and knee reconstruction.

Ricky Williams is a great talent but failed multiple drug tests because of Cannabis use. Sherman, Shore, and Lieberman once met him on a plane flight. He was far from being an animated conversationalist. He has a documented history of “social anxiety disorder.” Frankly, I am not as worked up about Cannabis use as I am Cocaine. The Dallas Mavericks had a very talented seven foot center named Roy Tarpley. He failed the leagues substance abuse policy three times and was banned for life because he had a love affair with Cocaine.

As far as shoulder injuries and substance abuse problems, I have to leave the prognostication to the “experts,” but sitting in my armchair, I love to analyze the ramifications of foot and ankle injuries to major athletes past and present.

Last season, Ronnie Brown sustained a fracture/dislocation of Lis Franc’s joint that required surgery. I suspected that he would never be the same running back. The Dolphins did not draft a running back in the early rounds, so I suspect Ronnie will be okay.

At the end of the regular season, Dwayne Wade injured his “calf muscle”. The press reported he heard a “snap”. In Miami, we were all holding our breath. Muscle tear? Plantaris rupture? Or the dreaded Achilles tendon rupture? He came back after a four game absence and was his usual incredible self, but in game three of the series between the Celtics and the Heat, he re-injured his calf. It turns out all he had was severe muscle cramping (I think he really had a plantaris tear). The next game he scored 46 points.

PLAYING POSSUM?

In the WNBA, Washington Mystics guard, Alana Beard will miss the entire 2010 season because of an ankle injury. The news reported that she will undergo “ankle arthroscopy and ankle tendon repair.” Is she having a posterior tibial reconstruction for flat foot, lateral ankle stabilization, or surgery on her Achilles tendon? Her come back depends on which procedure she is having. Larry Bird’s career ended after surgery on a retrocalcaneal spur. Earl “The Pearl” Monroe’s career ended after surgery on an infra calcaneal spur.

In the sports news, a fascial strain equals plantar fascitis. Not a bad prognosis. But a fascial sprain equals a fascial tear and the player is usually out three to six weeks.

Terry Kirby, a running back for the San Francisco 49’s, had turf toe throughout his career. I tend to see this as an acute injury. If he had it throughout his career, didn’t he have more of a functional hallux limitus? Would you draft a running back that had turf toe throughout his college days? Shaq O’Neil had “hallux limitus”. He underwent a chielectomy. Problem solved. I suspect it is not as much of a concern for a basketball player as it is for a running back.

Now let’s say you were asked to evaluate players in the NBA or NFL draft.

Bill Walton suffered repeated stress fractures in his feet throughout his career. The press called him soft. Could you play at a NBA level with a stress fracture? Would you draft a player with a history of same?

I treat an offensive lineman from a local college with a cavovarus foot. In the past, I have treated him for stress fractures along the base of the fourth and fifth metatarsals. Years later I can still see evidence of the fracture line. He gets a thumbs down from me.

I once played three on three basketball against Reggie Jackson at the 92nd Street Y in Manhattan. Boy did he pronate excessively. I would have given him a thumbs down. I guess one never knows. Charles Oakley, former power forward for the NY Knicks, had bunions with chronic dislocation of the second MPJ. The recurrent capsulitis was a real problem. Experts discussing the problem on talk radio worried that Oakley would not be ready come playoff time. One caller recommended elective amputation of his toe. It sounds crazy, but they were playing Miami in the playoffs and he needed to be ready quickly. In the off season he had surgery to correct the problem.

Tim Bowens had a great career as a nose tackle with the Miami Dolphins. He could stop the run and rush the quarterback with the best of them. Miami stunned the football world when they took him in the first round. He was missing his left hallux and second toe. How did he do his job? I will never know.

Tom Dempsey holds the record for the longest field goal in football history. He played his whole career with congenital absence of the right forefoot.