On Wednesday, June 14th, Myles Garrett exited practice early with an apparent left foot injury. The team did not initially offer clarification as to the nature and/or severity of the injury, however, the Browns indicated on Saturday, the number one pick in the 2017 draft had sustained a left lateral foot sprain. Garrett was evaluated by team physicians and received a second opinion from OrthoCarolina to confirm the diagnosis.
What is it? The foot is comprised of twenty-six bones and can be separated into three different regions; the hindfoot, midfoot and forefoot. The regions of the foot are named for their location, as the hindfoot refers to the portion of the foot towards the heel bone, the mid-foot refers to the portion of the foot in the middle and the forefoot refers to the portion of the foot closest to the toes. Furthermore, medial refers to the side of the foot with the big toe and lateral refers to the side of the foot with the fifth toe. A sprain refers to the over stretching of a ligament or ligaments past their anatomical threshold. Sprains are graded based on severity with grade one sprains being the least severe and grade three sprains being the most severe. Grade one sprains involve slight over stretching of the ligament(s) involved, grade two injuries involve partial tearing of the ligaments and grade three sprains consist of complete tearing of the ligaments. A lateral foot sprain refers to the over-stretching of the ligaments on the side of the foot with the fifth toe. Symptoms of a sprained foot include, but are not limited to, pain, swelling and decreased mobility/strength.
How is it fixed? Treatment of a lateral foot sprain is determined based on the severity of the injury. Less severe injuries can be managed conservatively via rest and rehabilitation, whereas more severe sprains may require surgery. Conservative management usually involves a period of immobilization and reduction in weight bearing status. This is often performed via utilization of a walking boot, as to minimize force and stress going through the foot/effected ligaments. It is also important during the early stages following a lateral foot sprain to effectively manage pain via ice and anti-inflammatory medication if needed. Immobilization causes a reduction in strength and range of motion of the muscles surrounding the injured joint; which therefore makes range of motion and strengthening exercises that much more important once pain is under control. A progression from non-weight bearing, to partial weight bearing to full weight bearing exercise is made as the individual is able to tolerate. The final stage in the rehabilitation process is sport specific activity. This phase is reached once the individual demonstrates full range of motion and strength of the foot/ankle as well as no presence of pain. Return to play clearance will be granted by the team’s medical staff when the individual can successfully complete all sport simulated activities. Surgical intervention for the management of more severe foot sprains is utilized to restore the structure of ligaments and provide stability to the foot. In surgical cases, rehab and the time it takes to return to playing is prolonged secondary due to the necessity for adequate healing.
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My take. Myles Garrett dodged a huge bullet here. When it comes to foot injuries, the fear automatically goes to mid-foot / Lis franc injuries, which can often require surgical intervention. As of now, surgery does not appear to be required for the Browns’ first round pick out of Texas A&M. Provided he does not experience an setbacks throughout the rehab process, the team expects Garrett to be ready for the start of training camp at the end of July. I don’t foresee any long term implications for the Arlington, Texas native, nor do I anticipate this injury having much of an impact of his rookie season.
We will continue to monitor the status of Myles Garrett as he progresses through the rehab process and will provide the most up to date injury analysis and breakdown as new information becomes available.
Brandon Bowers, PT, DPT, is a graduate of the University of Toledo, Doctor of Physical Therapy Program and currently practices in Columbus, Ohio. He is an avid Cleveland sports fan and has experience rehabbing athletes of all levels and from a variety of sports. Follow Brandon on Twitter for more Cleveland Browns injury insight and analysis: @blbowers12
The information provided is the professional opinion of Brandon Bowers, PT, DPT and is based on his clinical experience and the most current clinical evidence available. This information should not be interpreted as or substituted for medical advice for a specific condition or diagnosis.