This week Tampa Bay Buccaneers placed left guard Carl Nicks on injured reserve with a torn plantar plate in his left big toe.
Nicks has been playing through the injury since the first week of the season. After toughing it out all season, he has decided to have surgery on the toe.
Teammate Ronde Barber described Nicks’ toe as “the size of two golf balls.”
Dr. Silverman Comments
A torn plantar plate is a dorsal (upwards) dislocation of the great toe. This happens when the big toe hyper-extends and the tissues on the bottom of the toe tear.
The plantar plate consists of a conjoined tendon and ligament (much like the patellar tendon about the knee). It has 2 bones within the tissue that stabilize the great toe and improve push off power.
When the plantar plate is torn, the prognosis is almost always poor. When treated non-surgically the toe usually remains unstable and lacks good push off power.
In a landmark 1990s study, Dr. Scott Rodeo showed that repair of these injuries in football players acutely and in a delayed fashion could be performed with good results.
Nicks’ swelling will need to resolve over the next few days before surgery can be considered. Many doctors treat this problem non-surgically. While this is reasonable, with clear plantar plate ruptures, my preference is an acute repair of the tissue.
Related Sources:
tbo.com