MLB News: Los Angeles Angels’ Albert Pujols Recovers from Plantar Plate Surgery
Posted by Jenn F. on Monday, January 18th, 2016
Don’t expect to see Albert Pujols playing his usual first base post, according to a report from Real GM last month.1http://baseball.realgm.com/wiretap/44330/Angels-To-Play-Albert-Pujols-More-At-DH The Los Angeles Angels has slated Pujols as a Designated Hitter for the 2016 season following at least five months of recovery from plantar plate surgery. “The most we need from Albert is his 650 plate appearances and hitting in the middle of our lineup and being as productive as he is,” said team manager Mike Scioscia. “And if we can do that with him playing the Gold Glove-caliber first base that he can bring, great. But we definitely don’t want to jeopardize his ability in the batter’s box with what he does at first base.”
What Happened to Albert Pujols?
Pujols had a plantar plate on his right big toe surgically repaired to address chronic foot pain.2http://www.si.com/mlb/2015/11/09/los-angeles-angels-albert-pujols-out-foot-surgery According to the LA Times, “Pujols injured the area around his second toe in Cleveland on Aug. 28.”3http://www.latimes.com/sports/angels/la-sp-angels-20150906-story.html As the home-run leader with 35 homers and 80 runs batted in, the team certainly needs his hitting power for the 2016 season.
Pujols told reporters that his foot began bothering him after hitting the first base bag on a double-play in Cleveland. Since then, his condition has only worsened. Patients say the pain of a plantar plate injury is like “walking on the bones of the foot” without any padding.4http://www.myfootdr.com.au/conditions-treated/about-conditions-treated/plantar-plate-tear.aspx Sometimes the toes present with some type of deformity (like splaying or clawing) and show visible swelling and redness. The pain beneath the ball of the foot, extending towards the second toe, is persistent.
Often the damage is subtle and difficult to detect in scans. So while x-rays and MRIs showed no broken bones, Pujols knew he had to be serious about his treatment when the right knee he had surgically repaired began acting up. This is not the first time Pujols has struggled with setbacks related to his feet either. Back in 2013, he tore his left plantar fascia and underwent extracorporeal shockwave therapy, in addition to taking some time off to recover.5http://www.footankleinstitute.com/albert-pujols-foot-injury
Why Plantar Plate Surgery?
Dr. Robert Anderson of North Carolina recommended that Pujols undergo surgical repair of the plantar plate, a thick ligament structure that attaches the toe bones to the ball of the foot and protects the metatarsal heads from pressure. Damage to this crucial area of the foot can lead to all sorts of problems –“crossover toe, overlapping hammertoe, capsulitis, bursitis, pre-dislocation syndrome and metatarsalgia,” according to Podiatry Today.6http://www.podiatrytoday.com/emerging-concepts-plantar-plate-repair#sthash.Nqs8gMgT.dpuf
The injury has dogged Pujols all season, says USA Today.7http://www.usatoday.com/story/sports/mlb/angels/2013/08/19/albert-pujols-out-for-season-partially-torn-plantar-fascia-left-foot/2674771/ The $240 million heavy hitter was forced off his first base post for 65 of a career-low 99 games. “Pujols will finish with fewer than 30 homers for the first time in his remarkable 13-season career, along with career lows in batting average (.258), on-base percentage (.330) and slugging percentage (.437),” said the newspaper–adding that Pujols will be 34 years old in January with eight seasons left in his contract (the third largest in major league history). “It’s not an easy decision, as competitive as I am,” Pujols said. “But I also understand that we (need) to look beyond the season.”
More conservative treatments for plantar plate injury may include: anti-inflammatory agents for pain, compression therapy to control edema, ice to reduce swelling, shoe modification and off-weight padding to reduce pressure, and sling padding or taping to discourage worsening of symptoms or full dislocation.8http://www.podiatrytoday.com/emerging-concepts-plantar-plate-repair When caught early, some of these treatment methods (particularly padding and taping) can be very effective in facilitating the healing process. However, with professional athletes and many other patients, we don’t usually see the condition until it has progressed to a chronic state–at which point surgery may be the most suitable course of action.
What Is a Primary Plantar Plate Repair?
To perform a primary plantar plate repair, surgeons at The Center for Podiatric Care and Sports Medicine use a linear plantar incision under the metatarso-phalangeal joint to the weightbearing fat pad. After opening up the walls of fat, surgeons can inspect the fascia tissue, ligaments, and tendons. Sometimes we find layers of scar tissue, ruptures in the plate, or a pulling away of the plate from the base of the toe. The repair may require removal of diseased tissue, tightening laxity in the plate, debridement to clean up scar tissue and non-healing areas, and suturing to anchor the structures properly.
Following plantar plate surgery, the wounds are dressed with compressive gauze and wraps, which will need to be monitored by a professional and changed after week one and week two. After spending a few weeks on crutches, Pujols transitioned to a walking boot and will spend the winter in Kansas City undergoing rehabilitation.9http://losangeles.cbslocal.com/2015/11/09/albert-pujols-undergoes-foot-surgery-rehab-to-extend-into-spring/ He’s been able to do some light cardio, but full weight bearing is typically discouraged for at least six weeks. Rare complications include over-correction, re-dislocation, infection, vascular compromise, and scarring.
Contact our offices in Manhattan or Westchester, New York for more information on plantar plate repair and foot pain treatment in NYC.
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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.