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Cam Newton's foot injury: What Carolina Panthers know and what remains to be seen

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Carolina Panthers quarterback Cam Newton suffered a Lisfranc sprain in a preseason game against the New England Patriots. On Tuesday, the team placed him on injured reserve. File/AP

The speculation swirling around Cam Newton intensified in recent days as reports emerged that the Panthers’ franchise quarterback traveled to get a third opinion on his foot injury. Now the team looks set to sit him out for the rest of the season.

In a video he posted on YouTube, Newton confirmed he suffered a Lisfranc sprain in the Panthers’ third preseason game against the New England Patriots. Admitting he hid the severity of the injury, Cam claimed he made the injury worse in Week 2 of the regular season in a loss to the Tampa Bay Buccaneers.

Stating his ultimate goal is to win the Super Bowl, Newton acknowledged he needed time to rest and get his injury to heal.

A Lisfranc injury is one in which a ligament in the midfoot, around the arch, is injured. When the Lisfranc ligament ruptures, the first and second metatarsals (the long bones of the midfoot) or other bones in the midfoot can separate.

While it’s not a very common injury, it more often occurs in football than other sports. The injury usually results from a twisting motion to the foot or landing on the foot with the ankle pointed toward the ground.

Treatment of a Lisfranc injury depends on its severity. A sprain of the ligament with no separation of the midfoot bones usually can be treated without surgery. But even a mild injury often requires the athlete to be in a boot or cast for weeks. If there is significant displacement of the bones, surgery to align the bones and hold them with screws or other implants is performed.

For weeks, fans have been frustrated with Newton’s seemingly slow recovery. Then news surfaced that he traveled to Green Bay to see renowned foot and ankle specialist Dr. Robert Anderson, who previously served as an assistant team physician for the Panthers.

On Sunday, NFL Network’s Ian Rapoport reported that surgery was not recommended or planned. Newton, doctors and the team hope more rest will help the Lisfranc injury heal without needing surgery that would keep him off the field for months.

Rapoport noted that placing Newton on injured reserve was an option, and on Tuesday, the team did just that.

Backup Kyle Allen has helped the team to a 5-3 record, and he looks set to guide the Panthers for the remainder of 2019.

Midfoot sprains, which Newton was initially reported to have suffered, are usually thought to be mild injuries. Two studies looking at midfoot sprains in football players show relatively quick times for return to play.

In one, athletes returned to practice in an average of 14 days and were fully healed in an average of just over 40 days. In the other study, players who didn’t need surgery returned in 12 days, while those who needed surgery were out much longer, if not the rest of the season.

Many surgeons, though, worry about a quick return after a Lisfranc injury for athletes who perform cutting and twisting movements, which are clearly an important part of Newton’s game.

A 2016 study in the American Journal of Sports Medicine looked specifically at Lisfranc injuries among NFL players. The data collected by those researchers is more discouraging.

NFL players with Lisfranc injuries treated without surgery missed an average of 6.2 months and seven games. Players who underwent surgery missed an average of 11.6 months and 10 games. The timing of the injury during the season and extension of the recovery into the offseason likely play a role in those return times, but it still suggests bad news for Carolina fans.

Fortunately, the authors of that study found that offensive players had no statistically significant drop in on-field performance or career length after a Lisfranc injury.

Carolina did not put Newton on IR initially, which suggests the team believed he could heal quickly. Now that we know he won’t take the field this season, fans can hope he finally gets healthy enough to return to the physical ability we saw in his 2015 MVP season.

Dr. David Geier is an orthopedic surgeon in Charleston and author of “That’s Gotta Hurt: The Injuries That Changed Sports Forever.”

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