What's Up With Santonio Holmes' Foot Injury?

Since Sunday's game, when Santonio Holmes injured his left foot, there has been much speculation as to what could be wrong with it.

Jets Coach Rex Ryan has already revealed that X-rays are negative -- indicating that the foot in "not broken." He has already had an MRI -- results are pending.

There is speculation that Santonio Holmes may have a deep injury to the midfoot -- something called a Lisfranc injury. Lisfranc injuries are named after the arch joints involved in the midfoot (the Lisfranc joint) -- a complex interlocking articulation on nine bones with strong ligamentous attachments.

The challenge with Lisfranc injuries is that a negative X-ray does not truly indicate whether or not a small deep fracture is present -- typically the case in subtle injuries. The purpose of the MRI, in Santonio Holmes' case, is to look for a ligamentous injury with or without a small fracture (hidden from X-rays), and to check the alignment of the midfoot joints.

What would a Lisfranc injury mean for Santonio Holmes?

The fact that the X-rays are negative suggests that a major midfoot alignment issue is not the case. The MRI is critical to reveal a hidden fracture, which would make the injury much more serious and longer to recuperate. Nonoperative Lisfranc injuries take two months to heal, then require physical therapy. Surgery is typically reserved for people with a Lisfranc injury with instability, but fortunately for the Jets' wide receiver, his injury films did not indicate such an issue.

Hopefully for the Jets, the MRI demonstrates only superficial injury.

-- Dr. Blitz
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