MLB Baseball 3rd baseman has foot surgery

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As a huge baseball fan and fantasy player, this topic excited me.  Evan Longoria had a morton’s neuroma removed from his left foot back in November.  This may be a big reason why he only batted under 250 last year and only stole 4 bases.  He stole 10 the year before.  I’m expecting a big comeback season this year in BA and will also hit a few more HRs with a healthly left foot. Although I would like to up date all of you about morton’s neuromas and why you still should be worried if you are a Evan Longoria owner in fantasy baseball.

What is a Morton’s Neuroma?

A neuroma is a painful condition, also referred to as a “swollen nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes that brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.

The principal symptom associated with a neuroma is pain between the toes while running, walking, or putting pressure on the ball of the foot. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe.

What baseball fantasy owners really want to know?

How’s Evan going to do after the surgery to remove the neuroma?  Well that all depends on 2 factors (the 2nd factor we have no way of knowing due to HIPPA and confidentiallity, only the surgeon knows this answer):

  1. Did Evan take time off (about 2-4 weeks) after the surgery?  It is very important to not walk or put pressure on the foot following the procedure.  Compliant patients ALWAYS to better than noncompliant patients.  The 1st 2-4 weeks following any procedure of the foot and ankle will always swell (thanks to gravity) and swelling will slow the recovery.  With decrease activity on that foot after the procedure there will be less swelling and a faster recovery.  From what I heard, from his radio interview on SirusXM Fantasy Sports Radio on 2-13-2012 he DID take 4 weeks off from all activities.  That’s a great sign so far!
  2. How big was the nerve that was removed and did the surgeon tie the end of the nerve into the small muscle of the midfoot to decrease chance of a stup neuroma.  A stump neuroma is a complication of the surgery.  Bascially it is a reoccuring neuroma.  They are usually worse then the original neuroma.  There’s about a 7-24% chance of a complication occuring after neuroma surgery.

What to know going forward?

Evan will have to change his shoegear slightly and wear a widder shoe during the games.  Hopefully he finds one that fits him well so that he won’t develope blisters during the games.  Also, only time will tell if the surgery was successful and his foot pain is gone.  Removing the nerve will leave the inside of his 2 toes partially numb, but at least the pain is gone.  Small nerves take about 5-7 years to regenerate, so he may by ok until then, but hopefully never.  A simple metatarsal pad in his shoe and injections of corticosteriod  (up to 3 per year) will be needed if the pain returns.   So this should not cause a loss in playing time in the worst case scenario.

As a board certified foot and ankle surgeon (podiatrist), I have not performed many neuroma surgeries during my 9 year practice.  That’s not because I’m not trained, but it’s because of the 7-24% complication rate. I usually try to steer my patients away from the procedure unless that nerve is way too big as seen by a MRI.  My final thoughts, if Evan is available in the 2nd-3rd rounds of fantasy baseball drafts this year, pull the trigger!

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Dr. Dennis Timko, is a podiatrist in the St. Louis, Eureka, MO. area. Dr. Timko specializes in diabetic foot care, foot surgery, AFOs, and orthotics. Dr. Timko is the solo owner of Arch City Foot & Ankle, which has been in business since 2003.

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