Steelers running back Le'Veon Bell will be sidelined for possibly another month with a Lisfranc injury in his foot. It's a complicated and detrimental injury, so we turned to an expert to help us understand it.
Dr. David Geier is the chief physician for the Family Circle Cup women's pro tennis tournament. He also has served as a medical consultant for the U.S. Women's Soccer and is the head physician for many high schools and recreational sports leagues.
A graduate of the Medical University of South Carolina, he completed his residency at the Campbell Clinic in Memphis and a sports medicine fellowship at Washington University, where he served as team physician and also assisted in the orthopedic care of the St. Louis Rams.
We asked him a few questions:
Can you explain in layman's terms what a Lisfranc injury is and why it seems to require an extended recovery time?
A Lisfranc injury is an injury to a ligament that stabilizes the midfoot. The injury can vary in severity from a sprain of that ligament to a partial tear to a complete tear of that ligament and the supporting ligaments. X-rays of the foot can show any displacement of the bones in this area.
If x-ray show the bones well aligned, the MRI might only show a sprain of the ligament. These mild injuries can often be treated with a cast or a walking boot until the ligament heals. If there is any displacement - even a mild amount - surgery is often needed to line up the bones and hold them in place with screws until the ligaments heal. It is thought that instability in this part of the midfoot, if left untreated, can lead to long-term degenerative changes, especially in running athletes.
The timeline provided for Le'Veon Bell's recovery would be roughly seven weeks from when he was injured. In your experience, is that enough time for an NFL running back to recover to a point he could participate at a high level?
The typical progression an orthopaedic surgeon uses to return an athlete to sports can be a slow one. After the orthopaedic surgeon feels the midfoot has healed enough to tolerate walking, he usually allows the athlete to bear weight in a walking boot.
The player then progresses to walking out of the boot. When he can walk comfortably in normal shoes, he is allowed to start jogging. He can then progress through drills before returning to practice and ultimately to competition. That progression varies based on the severity and treatment of the injury needed.
Also each athlete progresses through those steps at different speeds depending on how quickly they regain motion and how much pain they are having.
Do you feel a running back in particular is either more inclined for this kind of injury, or will it take longer for a running back to recover from this, as opposed to, say, an offensive lineman?
These injuries can affect athletes of all sports. Running backs in football do seem to suffer Lisfranc injuries frequently. These injuries often occur due to a twisting force directed at the midfoot, so it makes sense that running backs would suffer them. The midfoot region bears a lot of stress with pushing off and changing directions. Lisfranc injuries theoretically could be more difficult for a running back who requires quick changes of direction and powerful ability to push off.
Is it possible, even without any specific set-backs occuring, a player who suffers a Lisfranc injury could be sidelined for longer than two months?
It isn't uncommon for return to play to take 3-4 months, but it depends on the severity of the injury and how players respond to treatment and progress through the rehab process.
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