Ryan Kalil played one half of football Sunday against Seattle while dealing with a painful foot injury that eventually sidelined him for the season.
Originally, Kalil was thought to have a sprained foot, which was re-taped at halftime. But the Panthers’ starting center had actually suffered the more serious Lisfranc injury.
New York Jets wide receiver Santonio Holmes, Cincinnati Bengals running back Cedric Benson, Houston Texans quarterback Matt Schaub and Florida State University defensive end Brandon Jenkins are star football players who have had their seasons ended recently by the injury, named after a French surgeon.
Dr. Phillip Kwong is a foot and ankle surgeon at California’s Kerlan-Jobe Orthopaedic Clinic, and he said what once was referred to as an ankle sprain is now identified more readily as a Lisfranc.
“I’m sure it’s in large part due to more suspicion on the part of physicians who treat this condition. They’re more aware of it,” Kwong said. “The term Lisfranc is a term as common as high ankle sprain. People say that he has an ankle sprain, but no, it’s a high ankle sprain which denotes a different mechanism and more injuries. Whereas people say now it’s a Lisfranc, before they’d look at x-rays and say there’s probably nothing much to it.”
A Lisfranc injury is a mid-foot injury where typically a ligament that connects the midfoot to the forefoot is ruptured. Like in many cases, Kalil’s injury was first diagnosed as a sprain before further examination by Charlotte orthopedic surgeon Robert Anderson.
“It primarily involves the midfoot where the bone structure is held together by a combination of the contours of the bone, almost like a lock situation where everything fits into a jigsaw puzzle, and these are held in by ligaments,” Kwong said. “So when the foot is injured by twisting, spraining a certain mechanism, it can range from a spectrum of relatively minimal ligament injuries to very, very severe ones where if enough ligaments are torn and enough of the bone contours are damaged, then these bones are shifted and out place.”
How was Kalil able to put his 295 pounds on his foot for two quarters of football while going against two Seattle defensive tackles who each weighed at least 20 pounds more?
“There’s a spectrum of the severity,” Kwong said. “If you have a subpartial tearing of ligaments, then you may be able to (continue playing). But if you have a lot of tearing of various ligaments that supports this foot, and then you have also associated fractures of the bones that makes up these joints, then the more severe ones you’re not going to be able to continue.”
Since the Panthers placed Kalil on injured reserve, he is unable to come back to the team this season. The typical recovery time is 8 to 12 weeks, but with the season lost for Kalil, Kwong said that in five to six months Kalil should be able to return to football activity.
It’s an injury that Kwong said has been happening more and more in linemen, and Kalil is the latest to be diagnosed.
“It seems to happen quite often in the trenches, when they’re pulling on a running play or pass protecting. There’s a lot of shifting,” Kwong said. “There’s a lot of sideways movement, and people are stepping on you too. You’re trying to go one direction and somebody’s got 290 pounds stepping on your foot, and as a 300-pounder you’re trying to move this way but your foot is not. Something’s got to give.”