Denver RB Ronnie Hillman suffered a foot injury in yesterday’s win over the Raiders. That much we can agree on. After nearly 24 hours, reports came out that Hillman’s injury was a foot sprain. Beyond that, things start getting a little dicey. The first (and most detailed) report was from the Denver Post’s Mike Klis. According to Klis, Hillman suffered a, “midfoot sprain,” in his right foot, and will be out, “at least two weeks.” According to others, the facts might be a little different. Broncos reporter Andrew Mason Tweeted this:
Ronnie Hillman has a left foot sprain and will be considered "day-to-day," Broncos coach John Fox said.
— Andrew Mason (@MaseDenver) November 10, 2014
Remember those games where you try to spot all the differences between two drawings? I can’t be the only one who played those while I waited for the dentist, can I? Try doing that here and see what you find. First of all, Mason (who is quoting head coach John Fox) leaves out the, “mid,” and just goes with, “foot sprain.” Second, Mason (or again John Fox) paints an entirely different outlook by referring to this as a, “day-to-day,” injury rather than something more in line with Mike Klis’, less-optimistic, “at least two weeks.” Third, Mason (or Fox… whatever) says that the injury is to Hillman’s left foot rather than his right foot. (Jene Bramel does some good injury coverage and he caught this one so I should give him credit.) Surprisingly, this flip-flop of which appendage is injured happens way more than you’d think. I even have a code for it in my database… “RBLR,” meaning, “reported both left and right.” I point all this out because what we have here is an injury that’s typically pretty murky, and is somehow even murkier in Hillman’s case.
As usual, this is a great argument for my injury database. Using this tool, I can bring up historical comparisons of players with similar injuries…. that is, if we can figure out what Hillman really has. The trouble is, we’re seeing a few different terms here. If this is a simple, “foot sprain,” then it’s not too messy. If we are indeed looking at a, “midfoot sprain,” well, that’s getting uglier. And, on the off chance that we’re looking at a Lisfranc injury, that’s just about the worst foot injury a player can have. Personally, I’m inclined to stick with Klis’ original call of, “midfoot sprain,” as it’s the most detailed.
Historical examples of midfoot sprains are not exactly easy to find. Often, teams never clarify things well enough for us to ever know which part of the foot was sprained. On injury reports, they are simply listed as, “foot sprains,” or, even worse, just, “foot.” Still, there are a few good examples. Just this year we saw Ravens DB Jimmy Smith suffer a midfoot sprain in Week 8, and he ended up going to injured reserve when it was determined that he’d need surgery. QB Kevin Kolb missed four weeks with what we know to be a midfoot sprain in 2011. Even if we open this up to the usually-less-severe category of, “foot sprain,” we can still find some extreme rehabs, such as when DeMarco Murray missed six games in 2012, or when Manti Te’o missed six weeks (three preseason and three regular season) with a foot sprain in 2013. In fact, if you average out the time missed by the twelve players in my database who suffered this injury between 2010 and 2013, you’re left with an average absence of of almost 3.5 weeks.
Before we go ballparking Hillman’s return-to-play though, we need to address the scary-ass elephant in the room. Lisfranc injuries. This all gets very confusing, so pardon me if I dumb it down…. like way down. Technically, the Lisfranc is a joint. It’s sort of where your toes meet your foot (seriously, way dumbed down but let’s go with it). Any injury to the Lisfranc joint is called a Lisfranc injury. You can have Lisfranc sprains, Lisfranc fractures, Lisfranc dislocations, but they all fall under the larger umbrella of Lisfranc injury. For all sorts of sciencey reasons, these are tough injuries to rehab. More frequently than other foot injuries, Lisfranc injuries often require a complete shut down on the injured reserve list, and often surgery as well. Sports medicine seems to have improved quite a bit here, but it’s still not exactly uncommon for Lisfranc injuries to be misdiagnosed as less-severe midfoot sprains. When this happens, the correct treatment is often delayed, and the injury is only compounded. All you fantasy players should be able to name two great examples of this. In 2011, RB Darren McFadden was diagnosed with a, “midfoot sprain.” Weeks later the diagnosis changed to a Lisfranc injury, and McFadden missed the final 10 games of the season. In 2012, a similar thing happened with RB Maurice Jones-Drew, and he also missed the final 10 games of the season.
I am not saying that Hillman has a Lisfranc injury. What I am saying is that there seems to still be some dispute about what he does have, and, as long as that murky cloud is hanging out there, we should keep in mind some of the more extreme possibilities. Even if Hillman “only” has a foot sprain, I think that the only correct part about the, “at least two weeks,” estimate is the, “at least,” part. Interesting to see how this one unfolds. If nothing else, maybe we can at least figure out which foot is injured.
