As the Chicago Cubs celebrate their World Series win a few weeks ago, Toronto baseball fans are still mending their hearts over their beloved Blue Jays’ loss in the postseason to Cleveland. They, myself included, are also holding their breath awaiting any response to trade deals from Jose Bautista, affectionately known as Joey Bats, and his free agency status. The 35-year-old player has called Toronto home for some time now, and he has been an integral part of the team’s success.

But after an injury-filled 2016 season, including a bout of turf toe, it begs the question: how does injury affect a key player during the ever-important summer season, especially with the October hunt around the corner? How could a professional baseball player be on the disabled list for six weeks with a toe injury? It’s just a big toe, right? Could a toe injury possibly have spelled the Jay’s postseason downfall?

There’s more to the big toe than just being a toe. Most of us take for granted what our feet do for us day to day. That is, until injury strikes and we are left with a diagnosis, projected timelines and return-to-play management plans. Turf toe is an injury that can be extremely difficult to “bounce back” from quickly, and yes, can take as long as a broken bone takes to heal fully in order to return to full play action.

Medical terminology aside, turf toe is a sprain of the ligaments on the underside of the big toe where the ball of your foot lies. It is usually associated with some type of acute injury, like jamming one’s foot into the wall of the Roger’s Centre trying to make a highlight-reel-worthy catch.

Taking into considering that there are nine ligaments that surround the big toe joint at the metatarsophalangeal (MPT) joint … along with a joint capsule, two sesamoid bones and four muscles … you can quickly understand the complexity of “just a big toe.” When trauma occurs, the ligaments that provide stability to the bottom of the big toe are lengthened. This allows more motion and can initiate more injury as the tissues are continually stressed beyond their limits. Inflammation gathers in the already tight space of this joint, causing increased pain and difficulty walking.

The big toe plays a huge role in propelling you forward when walking or running. That single joint takes the body’s weight to get you to your next step. It’s the translation of force from heel to toe, and the associated momentum allows us to put one foot in front of the other. When running, we add 10-times our body weight with impact! This little joint has a big job, and is much more difficult to immobilize compared to an injured wrist or shoulder.

Bautista’s treatment plan called for immobilization in the form of a walking boot. Most individuals who wear one of these usually have a broken bone. The boot allows for physical therapy modalities to be applied with the added benefit of no cumbersome cast. This type of device allowed Bautista to walk without applying too much force and stretch on the MTP joint while in motion. Return-to-play protocols probably followed a progressive escalation of walking, running and sprinting. This would have ensured not too much pressure and force was applied to the joint too quickly, which could have resulted in re-injury. Taping the joint during practice and play would have occurred to reduce the amount of hyperextension. Footwear also would have been taken into account, as baseball cleats do not have much room or give when trying to add a toe device or post-injury bracing.

In the end, how could a toe injury force a professional athlete to take a step back (pun intended) from their training at such an important point of the season? Six weeks is a long time to be on the DL list; it can shift momentum and generate a different dynamic among players. Managers, like John Gibbons, are calculated in their line-up and tend to place players in certain spots in the line-up based on who will lead or immediately follow a specific athlete, or who is pitching. Simply placing another batter where one was removed isn’t usually what happens.

Along with the amount of publicity and the general hype that surrounds a player like Joey Bats, fans might lose hope and create a negative atmosphere for play. Reincorporating the player into the line-up again alters dynamics, especially if his DL replacement was doing well, as was the case with Ezequiel Carrera.

Six weeks is a long time to be out of the game and can alter routines for high functioning athletes. It can definitely throw them off, especially when just a few days after his return in August, Bautista was placed on the DL list again for a knee sprain. We were glad he came back healthy to give this city and country a great run at the World Series, but unfortunately it was not the year of the Bats, or Jays.

Here’s to hoping he signs again with the Jays to give us at least one more year, and a turf toe-free run at the World Series.

Visit the Michener Chiropody Clinic on the third floor of The Michener Institute to speak to a chiropodist about general and preventative foot care for a wide range of foot conditions. We treat at all the levels of the foot, from surface skin infections to bone and joint pain. The Michener Chiropody Clinic supports the Michener Chiropody program, offering hands-on training to Chiropody students and care to regional clients in a clinical setting under the supervision of faculty who are also certified chiropodists.

Image: Keith Allison on Flickr