Sunday, November 30, 2008

DALLAS COWBOY WITH TOE INJURY

While many were carving turkey, the Dallas Cowboys were defeating the Seattle Seahawks. Though a sweet victory, Marion Barber left the game with a foot injury. The Dallas Cowboy’s running back dislocated his right pinky toe. Now many wonder if he will be able to play in their next game against Pittsburg on December 7th. So what is a dislocated toe and how serious can it be?
Toe dislocations are very common in athletes and are often considered a minor injury. There are three bones that make up the pinky toe. A dislocation is a displacement of bones from their normal position. Depending on the severity of the injury, the dislocation may be associated with a fracture, ligament sprain, and other soft tissue damage. The x-rays of Marion Barber did not reveal any fractures.
Signs and Symptoms of a Dislocated Toe
Barber most likely felt excruciating pain in the toe at the time of injury and when he attempts to move the injured joint. Often, there is a change in walking and running patterns due to the pain. This was noted with the running backs injury after he returned to the game. Barber will experience tenderness, swelling, and bruising over the sight of the injury and if serious enough, there may be nerve damage and vessel damage. This will lead to numbness or paralysis in surrounding areas.
What the Doctor will Do
A Podiatric Physician or Emergency Physician will take x-rays and an MRI to exam the injury. The joint is manipulated to reposition the bones back to their normal alignment. At times, surgery may be needed to restore torn ligaments and tendons. After the joint has been corrected, it may require immobilization with a splint, taping, or special shoe for 2-3 weeks. If ligament damage is present, recovery will take a minimum of 6 weeks. During recovery, it is very important to follow instructions for R.I.C.E. which stands for Rest, Ice, Compression, and Elevation.
Rehabilitation and Medication
After the pain subsides, daily rehabilitation exercises should start. To recover normal range of motion, one should start with passive movement by moving the joint back and forth using your fingers. Over time the therapy should advance to active movement by scrunching toes against the floor or with a towel. Ice massages should be used before and after workouts. Local anesthesia and muscle relaxants are used to manipulate the joint. Acetaminophen (Tylenol) or Aspirin is used to relieve moderate pain. If the pain is severe, narcotic pain relievers are used.

Marion Barber’s Future
If the injury is not severe, the recovery should be fast. The most common complication is recurrent injury to the joint. Once a joint has been dislocated once, it is more likely to dislocate again. The joint may be unstable or arthritic fallowing repeated injuries. If Marion Barber returns to activity too soon, the healing process will take longer and he will have an increased chance of a repeated injury.
Since it has not been released how severe his dislocation is, we can only speculate whether or not he well be able to play in December 7th game. As long as there is no soft tissue damage, full rehabilitation may only take 2 weeks. It would be best if he sat out in the game against Pittsburg, but as professional sports go, there is a chance we will see him on the field!