The Red Sox took their time evaluating J.D. Martinez’s medical file last week. We learned today that the reason for the delay in signing him was that they wanted to get a closer look at the right fielder’s foot. Martinez sprained the Lisfranc joint of the right foot fielding a ball in the outfield last March. He was treated in a non-weight-bearing cast and was on the disabled list from March 30th to May 12th last season.
Martinez went on to have a great season after the injury, with a .303 batting average and 45 home runs. So, why are the Red Sox so worried about his foot?
A Lisfranc injury is a big deal for a professional athlete. The Lisfranc joint is a crucial joint in the midfoot. It is responsible for maintaining both the longitudinal (toes to heel) and transverse (big toe to pinky toe) arches of the foot. A thick rubber band-like structure called the Lisfranc ligament stabilizes the joint. When the Lisfranc joint is injured, the structure of the entire foot is at risk. Doctors take these injuries very seriously.
This is (roughly) what an x-ray of a patient with an unstable Lisfranc injury looks like.
The Lisfranc joint on the right foot is widened (circled in red) in comparison to the same joint on the left foot. These x-rays are always taken with the patient standing, even if it really hurts! The act of standing stresses the joint and, if the ligament is torn, the joint will widen on x-ray.
An unstable Lisfranc injury needs surgery to be repaired. Recovery can be 4-to-6 months. A Lisfranc sprain, which Martinez reportedly had, often take 4-to-8 weeks to heal, depending on sport/position and severity of the sprain.
The most likely reason for concern over Martinez’s injury is the risk of recurrent foot pain and arthritis. It is possible that MRI images or x-rays obtained by the team revealed some instability or arthritis of the Lisfranc joint they did not expect to see. It is also possible that the imaging looked okay and the team just wanted Martinez to be evaluated by a foot and ankle specialist in Boston for another opinion.
While there is a chance the foot could be re-injured in the next few seasons, I’m not overly concerned. He looked healthy last season after the injury and now the team has protected itself with injury opt-out clauses. The Red Sox have been criticized in the past for not fully evaluating the medicals on incoming athletes. In the case of Martinez, the team did a thorough evaluation over a few days and, as a result, was criticized for taking too long.
Hahaha…welcome to Boston, Mr. Martinez!