Plantar Fascia injury
After spending most of last season on the injury reserve and missing 3 weeks of action this season, Greg Olsens’ 2018 season has come to an end after rupturing his right plantar fascia. While this was the main injury that officially derailed his season, it wasn’t the most prominent injury he was dealing with and the rupture may have been a by-product of other issues occurring. We will dive into those particular injuries and attempt to put the pieces together of what went wrong for the veteran tight end.
In 2017, Greg Olsen was diagnosed with a ‘broken foot’ and underwent surgery. This broken foot that he sustained is known as a Jones fracture.
What is a Jones Fracture?
It is a small break in the 5thmetatarsal bone (the long bone just before the pinky toe on the outside of the foot) and is one of the most common foot injuries in the athletic population.
It can occur as a direct contact injury, such as an excessive force applied to the bone, or as an indirect non-contact injury. During a non-contact injury, the most common proposed mechanism of injury is planting of the forefoot (“ball” or front of your foot) with simultaneous twisting of the leg and hindfoot (your heel).
This forefoot, hindfoot and leg positioning causes abnormal forces on the foot, placing excessive vertical (Fz above), medial-lateral force (Fx above), or a combination of both on the 5thmetatarsal (pinky toe), concentrating all of the forces on the bone and causing the bone to break under excessive load.
What happened after he was diagnosed with a Jones Fracture?
Jones fractures are commonly known for poor healing due to lack of blood supply to the area, so for competitive athletes and professional athlete a screw fixation of the bone break is highly recommended. In the general population, surgery can be avoided and the patient is put in a non-weight bearing cast for 6 weeks.
Once surgery was completed, Greg Olsen would’ve most likely been instructed to place no weight on his surgically repaired foot for 2 weeks. He then would have started a rehabilitation program that placed emphasis on being able to completely weight bear without any pain and then restore strength and balance in order to return to a competitive level.
In September 2018, Greg Olsen seemed to reaggravate his injured foot during a game, and after examination of his foot it was determined that after all his rehabilitation and surgery leading up to this season, he had refractured his previous injury. A refracture of a Jones fracture is uncommon, but not unheard of as the refracture rate is about 7.5% of those who undergo the surgery. Athletes are especially predisposed to refracture due to the repetitive stress the bone must endure, particularly football players as a lot of stress is being demanded of the foot each and every play. Greg Olsen took 3 weeks off, planned to have surgery in the offseason, and played through the refracture during the remainder of 2018.
On Dec 2, 2018,Greg Olsen heard a ‘pop’ and instantly knew something was wrong with his foot. The medical staff determined that he ruptured his plantar fascia in the same foot that is fractured and was ruled out for the remainder of the season.
What is a Plantar Fascia and how does it rupture?
The plantar fascia is the thick collection of connective tissue on the bottom of the foot that runs from the hell to all five toes, which supports and stabilizes the arch of the foot. When an abnormal, excessive or repetitive stress is placed on the foot it can lead to damage and subsequent inflammation of the plantar fascia. This is commonly referred to in the medical community and general public as "plantar fasciitis" (in medical terminology "itis" added to the end of the word means inflammation, as in tonsillitis, appendicitis, etc). Stresses that can lead to plantar fasciitis may be initiated by overuse, muscle imbalance, or biomechanics movement faults. Plantar fasciitis can become chronic and quite debilitating.
In Greg Olsen’s case, he had a complete tearing of the fascia and not just inflammation. This is a recognized phenomenon but is uncommon. It seems like a strange thing to occur and this is where speculation kicks in.
Greg Olsen may have been receiving cortisone injections in his foot after his refracture in September, as these injections help with reducing pain and inflammation. He may have been receiving injections due to the pain from the refracture, plantar fasciitis, or even from both pain generators. Either way, the downside of cortisone injections is that there is a risk of necrosis (cell death) of the connective tissue near the injection sites, which predisposes tendons, ligaments and fascia to a higher risk of rupture. This may have been why his plantar fascia finally gave way, ending his season.
1.) Foot fracture 2.) Surgery 3.) Refracture 4.) Cortisone injections to keep playing 5.) Rupture of plantar fascia 6.) done for the year.
The moral of this article was to try to show you that everything is connected. Just because you have pain in “X” area doesn’t mean that “X” is the cause. It may be stemming from a movement breakdown in area “Y” or “Z” or because there is something bigger going on. The plantar fascia rupture that Greg Olsen endured was just the final straw in a lengthy issue with his foot. Just like a spinal disc herniation or shoulder impingement that may be occurring in your own body may be the final straw in your body and a signal of something bigger going on, like a muscular imbalance or a strength deficit in a particular movement.
So, get yourself to a health professional like a chiropractor, physical therapist, or kinesiologist to prevent the final straw from happening and tackle your small issues before they become too big to handle. Whether your problem is from a joint, muscle, or strength issue, manual therapy and rehabilitation can help you get back on your feet.
Thanks for reading, tune in next month for the most recent injury in the sport world. Email us with any questions or injuries you want to hear about next @ firstname.lastname@example.org.
Stay strong, stay heathy.
Doctor of Chiropractic, B.HKin.