The Center for Podiatric Care and Sports Medicine

NFL News: Redskins Lose Two Players with Foot & Ankle Injuries in Preseason

Posted by on Wednesday, September 2nd, 2015

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The Washington Redskins seem to be one of the NFL teams worst plagued with injuries, particularly with key starters.1http://realredskins.com/2015/06/24/need-to-know-did-the-redskins-lose-more-starters-to-injuries-than-other-nfl-teams/ This year is no exception, with foot and ankle injuries hitting the team hard during preseason. This month, we learn that both tight ends, Logan Paulsen and Niles Paul, will be out for the season due to their injuries. NYC sports medicine doctors explore what went wrong.

Redskins player Niles Paul suffered a serious ankle injury in August. Image source: Wikimedia CC, Keith Allison

What Happened to Niles Paul?

“I broke it. This is supposed to be my year,” a teary-eyed Niles Paul told his teammate during the preseason opener Thursday, August 13th.2http://espn.go.com/blog/nflnation/post/_/id/174504/redskins-fb-darrel-young-on-niles-paul-he-started-crying-and-i-lost-it Though the Redskins squeaked out a 20-17 win against the Browns, they lost a key player with what Deadspin called a “gruesome ankle injury.”3http://deadspin.com/niles-paul-carted-off-with-gruesome-ankle-injury-1724009749 Though the full extent of the injury hasn’t been reported, Coach Gruden said it was a “season-ending ankle fracture and dislocation” and added that it was a big loss for the team to lose such “a great player and a great leader.”

The healing process for this type of football injury typically goes as follows:

  • A severe ankle dislocation with noticeable trauma, as you can plainly see in the video, requires surgical reset–with pins, screws, or plates–under light sedation. We used to cast these types of injuries, but now we find better results with a splint and walking boot. Unnecessary walking should be avoided for the first two to three weeks. The ankle should be iced three times a day (for 15 minutes per session) and elevated above the heart as much as possible to drive swelling down. The boot should come off for 20 minutes twice daily to encourage skin healing.
  • Range-of-motion exercises may usually begin at around four weeks. Biking, upper body training, straight-leg raises, toe curls, and toe spreads may be done during physical therapy sessions. Follow-up imaging is taken every few weeks to assess the progress of healing.
  • Between four and eight weeks, a night splint replaces the boot in the evenings. Soft tissue therapy begins.
  • Between eight and 12 weeks, we transition patients to functional weightbearing activities and more advanced range-of-motion exercises. The AirCast Stirrup is often used for stability while getting around.
  • After three months, we can begin more sport-specific training to restore lost skills and work on a gradual transition back to the game.

What Happened to Logan Paulsen?

Logan Paulsen injured his right big toe in what was believed to be a run-of-the-mill sprain at practice on August 6th. After the pain and swelling refused to subside, Paulsen was sent to an orthopedic surgeon and foot specialist in North Carolina for evaluation. As Paulsen ambled off the team bus in a walking boot last week, Coach Jay Gruden announced, “We’re going to make a decision on his status moving forward, whether he has surgery or not.” A knowledgeable source told The Washington Post that Paulsen tore a ligament in his toe.4https://www.washingtonpost.com/news/football-insider/wp/2015/08/12/logan-paulsen-could-need-surgery-on-big-toe-thinning-the-tight-end-ranks/

Most torn toe ligaments repair themselves without the need for surgery. The repair process usually goes as follows:

  • Inflammation and pain generally lasts three to five days, at which time ice, compression, elevation, and rest are required. Patients move around on crutches or use a walking boot.
  • The body then begins to restore itself by adding fibroblast cells to the area and laying down fresh collagen tissue, which takes up to 21 days. Our NYC sports medicine doctors find the use of electrotherapy helpful in speeding this process and improving results.
  • Lastly, collagen tissues matures and realigns to form a stronger matrix. Physiotherapy can last from a few weeks to nearly a year to improve balance, strengthen muscles, restore full range-of-motion, and prevent re-injury.

Surgery may be needed when a Type III sprain produces intense pain, swelling, and joint instability. The American Academy of Orthopaedic Surgeons recommends toe ligament surgery when there is:

  • A severe tear of the plantar complex
  • A fractured sesamoid
  • Vertical instability in the MTP joint
  • Loose bony chips in the joint
  • Damaged cartilage

Scar tissue and loss of full joint mobility are two of the risks associated with surgery. Healing takes a good 12 weeks, plus months of physical therapy, so we won’t likely see Logan Paulsen on the roster this year if his injury is indeed as bad as speculated.

Need Care for Foot & Ankle Injuries in NYC?

Here at The Center for Podiatric Care and Sports Medicine offices in Manhattan and Westchester, we treat professional, college-level, high school and elementary athletes for any type of lower extremity injury and work with them to maintain fitness throughout the season. We pay close attention to news stories such as these to understand the unique challenges faced by competitive athletes and offer the latest therapies for quick, effective recovery. Avoid long lines in the emergency room by contacting us for urgent care. You may also schedule an appointment for advanced treatment of chronic pain or to discuss injury prevention strategies with our team of experienced physical therapists, surgeons, and sports medicine doctors.

 

 

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1. http://realredskins.com/2015/06/24/need-to-know-did-the-redskins-lose-more-starters-to-injuries-than-other-nfl-teams/
2. http://espn.go.com/blog/nflnation/post/_/id/174504/redskins-fb-darrel-young-on-niles-paul-he-started-crying-and-i-lost-it
3. http://deadspin.com/niles-paul-carted-off-with-gruesome-ankle-injury-1724009749
4. https://www.washingtonpost.com/news/football-insider/wp/2015/08/12/logan-paulsen-could-need-surgery-on-big-toe-thinning-the-tight-end-ranks/

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.