The Center for Podiatric Care and Sports Medicine

MLB News: Did Yankee’s Catcher Brian McCann Sustain A Lisfranc Foot Injury?

Posted by on Wednesday, June 10th, 2015

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Last week, the Yankees were on the edge of the seats, wondering if heavy hitter Brian McCann was seriously injured. He left in the eighth inning on the May 24th match-up against the Rangers when his arch began to cramp. He started as usual on Wednesday but left after the second inning when pain in the bottom of his foot crept up his calf and became unable to bear weight. McCann worried that the pain was symptomatic of a dreaded Lisfranc injury — the displacement of the midfoot joints, which can take upwards of a year to heal or may never return to normal.

The board-certified podiatrists and sports medicine doctors from The Center for Podiatric Care and Sports Medicine in NYC treat amateur and professional athletes with foot pain and dysfunction, including Lisfranc injuries. “Lisfranc was a good guess,” said Dr. Ryan Minara, DPM. “Usually we see some bruising with Lisfranc sprains or fractures, but it’s good to see the Yankees are taking their players’ health very seriously and sending their players in to get the diagnostics they need.”

Another concern was that he may have plantar fasciitis. While it’s often referred to as “heel pain,” most plantar fasciitis sufferers suffer tremendous pain in the arch and have cramping that extends up into the leg. “Often, plantar fasciitis patients experience the worst pain first thing in the morning or after prolonged standing or running. If McCann says his flare-ups happen when he’s catching, I’d be inclined to say it’s not likely plantar fasciitis,” explains Dr. Minara.

Truly, the only way to know for sure is to get an MRI or CT scan, which McCann did last Thursday.

brian mccann foot
With nine homeruns this season, the Yankees were fearful of losing catcher Brian McCann with a foot injury. Image Source: Wikimedia.org

What Happened To Brian McCann’s Foot?

The Yankees catcher was relieved to see that no major structural damage was evident in his MRI and CT scans. According to McCann, the pain in his arch worsened when he was crouched down, catching — a position that undoubtedly puts a lot of stress on the midfoot.  “When it got inflamed… it felt like my foot was asleep, my leg was asleep,” he said.

After a professional evaluation, it was determined that all Brian McCann truly needed was a new set of custom orthotics. It had been three years since his last fitting and his arches had changed shape since then. “The arches on my old ones were pushing up against that muscle and it was causing it to spasm. Once that happened, it was hard to calm it down,” McCann said.

What Causes Fallen Arches & How Are They Treated?

“It’s not uncommon for athletes to see changes to their arches, given all the above-average pressures placed on the feet with dynamic sprinting, jumping, crouching and twisting,” explains Dr. Minara, who has treated cases like McCann’s. “Often the tibialis posterior muscle and posterior tibial tendon connecting the leg and ankle to the arch become overexerted and fail, which causes a slow arch collapse and what we call ‘adult-acquired flatfoot.'” The arch doesn’t always collapse completely, he adds, but smaller changes can still cause pain and warrant a trip to the podiatrist.

Fallen arches are most often treated with new custom orthotics, as in McCann’s case. Icing, stretching and physical therapy exercises are other first-line treatments employed at The Center for Podiatric Care and Sports Medicine. For a tiny fraction of very severe cases, next-level treatment may involve surgical procedures like fusions, bone grafts, tendon transfers, tendon cleaning, spur excision or osteotomy.

Can Orthotics Do More Harm Than Good?

There is some controversy in the podiatric world over the prescription of orthotics. Our NYC office has seen amazing results in patients with flat feet, plantar fasciitis, generalized arch pain, arthritis, tendonitis, forefoot pain, and Achilles problems. Yet, far too often, orthotics are used as a panacea for all foot ills — when in reality, more aggressive injuries require advanced therapies and sometimes even surgery.

Orthotics are no cure for biomechanical issues that may require physical therapy or strength training to correct. A visit to our gait analysis lab will let us know if you need more than just orthotics.

Furthermore, poorly formed orthotics can certainly do more harm than good. Thankfully, the new 3-D printing method of fitting we use in our office eliminates a lot of the guesswork and ensures a more precise fit.

“For most patients, a really good orthotic insole should last about three years before needing refurbishment,” says Dr. Minara. “However, we recommend that active individuals like Brian McCann be evaluated every six months to a year to be sure the orthotics are still functioning up to par. Hopefully this story gets out and serves as a reminder for other athletes to have their feet checked by a podiatrist before pain sidelines them.”

If you live in the New York City area, Dr. Ryan Minara invites you to stop by and see him at The Center for Podiatric Care and Sports Medicine for diagnosis and treatment of any foot or ankle injury. The practice specializes in sports-related injuries and chronic pain, offering all the most progressive therapies to expedite recovery.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. 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.