Washington Redskins receiver Pierre Garcon was plagued by a nagging foot injury throughout the 2012 season, but he has decided to forgo offseason surgery as doctors have determined that his plantar plate should heal with adequate rest.
Garcon originally felt pain in his right foot during training camp, but he played through it. The injury flared up in the first quarter of the first game of the season, and he sat out the next two games. He played in Week 4 and Week 5, but then the Redskins shut him down for the next four games. He returned after the bye week to play in the final seven games of the regular season, but he always knew that the injury could require offseason surgery.
After consulting with team doctors, Garcon decided to see how his foot would heal in the early stages of the offseason before establishing a course of action. Doctors determined Garcon was dealing with a torn ligament in his foot, and the wide receiver said the pain centered around the second toe on his right foot.
Garcon hasn’t been running on the foot, and he’ll continue to take it easy so the ligament can heal. The five-year veteran expects to be “100 percent” by the beginning of the 2013 season.
Dr. Silverman comments
This is a very common problem among athletes and non-athletes alike, and it is most often cause by a foot deformity, like a bunion.
When your big toe crosses over towards the second toe, the second toe is pushed out of the way. The second toe moves upwards to create room for your big toe, which forms a hammer toe. When this happens, the ligament that connects the toe to the ball of your foot begins to tear, just like it did with Garcon. In Garcon’s situation, an acute tear or overuse stress caused the ligament damage to start.
Regardless of the cause, the end result will be the same. Garcon has torn the ligament, and will now develop the deformity of a hammer toe. There is no way that “rest” fixes this problem completely. The ligament tear will heal, but it will heal in a lengthened state. Garcon will lose push off power in his toe next season, and the toe itself will move too much for his comfort. He will likely have nagging pain in the ball of his foot, and he will develop a hammer toe deformity.
With that said, he will play fine with the hammer toe. I expect him to tape the toe down to help ease the discomfort. People can survive and thrive with this problem by treating the foot non-surgically. However, this ligament, like all ligaments, when lengthened in every joint of the body, does better when anatomically reconstructed.
It took years for the medical establishment to realize that you need to have an ACL (anterior cruciate ligament), and before they knew what to do, they forced players and patients to wear braces, watched arthritis rapidly appear and eventually did early knee joint replacement. We used to let young athletes dislocate their shoulders multiple times before Bankhart repairs. Now, if you dislocate your shoulder before your turn 21, we know it will happen again and reconstruction is recommended. Similarly, as the elbow has become better understood, Tommy John surgery has truly changed the natural history of elbow arthritis by rebuilding the ulnar collateral ligament.
It’s the same story around the body; bracing is recommended until someone figures out how to reconstruct the ligament. Once the complications of the surgery become less than the complications of “non-surgical treatment,” the treatment recommendations change.
Within the last two years, a minimally invasive procedure has been developed to treat this toe ligament with reconstruction. Through international cooperation, orthopedic surgeons from around the world have researched how to best treat this second toe problem. Garcon should seek advice from a foot and ankle specialist familiar with this procedure.
Related source: Washington Post
Lance Silverman, MD
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