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MLB Injuries

What to make of the Justin Upton toe injury

Craig Lareau M.D.

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Los Angeles Angels’ outfielder Justin Upton suffered a turf toe injury when he jammed his great toe against the outfield fence during a spring training game.  He is in a walking boot and will begin the season on the injured list. His x-rays were negative and the team is awaiting MRI results.

 

A turf toe is an injury to the great toe plantar plate caused by a hyperextension injury. A grade 1 injury is a sprain, a grade 2 injury is a partial tear and a grade 3 injury is a complete tear. A player with a grade 1 injury can return to play as tolerated based on symptoms. For grade 2 injuries, a walking boot is required with return to play in 2-3 weeks and taping of the toe when returning to sport. For grade 3 injuries, immobilization in a boot or cast is required for 4 to 6 weeks and return to play is expected between 10 and 16 weeks. For some grade 3 injuries, surgery is required. When x-rays show proximal migration of the sesamoidbones, surgery is typically required. The fact that Upton’s x-rays were negative is reassuring.

 

Since the team expects him to miss 8 to 12 weeks, this is likely a grade 3 injury and MRI results will shed more light on his treatment and expected return to play. A realistic return to play after this injury is approximately 3 months (and longer if surgery is necessary).

 

Peter Bourjos is expected to fill in for Upton while he is on the IL.

 

Craig R. Lareau, MD is an orthopaedic surgeon who specializes in foot and ankle surgery. He graduated from Brandeis University where he played varsity soccer. A graduate of the University of Massachusetts Medical School, Dr. Lareau completed his orthopaedic surgery residency and trauma fellowship at Brown University/Rhode Island Hospital and his foot and ankle fellowship at OrthoCarolina in Charlotte. During his fellowship, he helped take care of professional athletes, including NFL, NBA and MLB players. Dr. Lareau is an avid sports fan and enjoys competing in daily fantasy sports.

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