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Friday, November 23, 2007

Injuries at NFL level sound similar to Peerman's

Ex-Hokie Jones making successful return from foot surgery.

Doug Doughty

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I’ve never pretended to be a doctor, nor have I spent the night at a Holiday Inn Express lately, but I’ve got a theory on the injury that ended Cedric Peerman’s season after Virginia’s sixth football game.

While taking a break from Thanksgiving dinner and sneaking a peek at the NFL game between Detroit and Green Bay, I heard the announcers discussing the foot condition that has bothered Lions’ running back Kevin Jones for the past year.

(Of course, Jones is a former collegiate star at Virginia Tech, but I was interested mostly because he plays for my fantasy team.).

In any case, the commentators were discussing Jones’ return from a foot injury and how the same injury had sabotaged the career of former Philadelphia Eagles and Pittsburgh Steelers running back Duce Staley.

I didn’t catch the exact term until I did a Google search and found that Staley suffered from a “Lisfranc” dislocation.

“Without getting too medical here, Lisfranc is what happens to your foot if you fall off a horse with a foot in the stirrup,” John Clayton wrote for ESPN.com. “The twisting creates a separation the width of a dime in the top of the foot.”

Another publication said the injury frequently occurs in football when somebody steps on the back of a player’s heel when his toes are pointed upward.

“For years, players lumped those injuries with those painful turf toes, the gross hyperextension of the toe,” Clayton wrote. “Turns out, Lisfranc is a ticking time bomb for skilled players. Eventually, the arch falls, and in a matter of time the player loses the ability to explode. Soon, they are out of the league and into retirement.”

AGAIN, NOBODY HAS said that Peerman has Lisfranc, named for 19th-century French orthopedist Jacques Lisfranc de St. Martin, a surgeon in Napoleon’s army.

All I know is, Peerman required surgery last week for a condition for which coach Al Groh could not provide a name Tuesday.

“There probably is [a name] and it probably has 17 letters in it,” Groh said.

Groh said there was consultation with specialists from around the country before Peerman underwent exploratory surgery. When it was determined that the foot was not stable enough to heal on its own, corrective surgery was undertaken.

“It’s not a complicated surgery, as I’m told,” Groh said. “They’re optimistic on it. Obviously, it’s a weight-bearing injury and, with the cuts that a running back has to make and the delicate bone structure of the foot, we’ll all feel better when the actual test comes up.”

Groh has said the injury was to the ligaments, which would be consistent with a Lisfranc diagnosis.

“Lisfranc joint injuries are rare, complex and often misdiagnosed,” according to a 1998 article in American Family Physician. “Proper treatment of a mild to moderate Lisfranc injury improves the chance of successful healing and reduces the likelihood of complications.”

LET’S SAY PEERMAN does not have a Lisfranc injury. If not, a Lisfranc injury could be coming to a football player near you.

The good news is, a Lisfranc diagnosis is not the career-ending threat that it seemed at the time of Clayton’s original article. Jones originally was injured last season, had surgery in December and has played in nine of 11 games for the Lions. He had 20 carries for 93 yards and a touchdown Thursday.

(For fantasy purposes, I would have been happier with 100 yards and a bonus).

Other players who have had to deal with Lisfranc issues have included Staley, Atlanta Falcons linebacker Keith Brooking, Philadelphia running back Brian Westbrook, New York Giants defensive end Michael Strahan and now Kansas City Chiefs running back Larry Johnson.

Clayton has reported that Indianapolis Colts’ defense Dwight Freaney also has a Lisfranc injury.

Clearly, some of the injuries are fractures, while others are less-severe dislocations and sprains. While it would be fair to say that most football fans are unfamiliar with the term “Lisfranc,” the injury is not nearly as common as once thought.

No matter what Peerman has, it is almost certain that he will miss spring practice. He was the ACC’s leading rusher at the time of his injury, with three consecutive 100-yard rushing games, but the emergence of Mikell Simpson has helped soften the blow.

No timetable has been given a timetable Peerman’s return “but I would think, given that he’s a veteran player and knows the system and can play well in it, that we would be cautious with it in the spring,” Groh said.

Peerman is eligible for a fifth year in 2008.

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