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In Street Clothes

Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Understanding Caris LeVert’s Subtalar Dislocation

Just a little over a year after Gordon Hayward’s gruesome ankle fracture left the NBA and its fans stunned, Brooklyn Nets forward Caris LeVert crashed to the hardwood in Minnesota. Like Hayward, LeVert’s ankle was grossly distorted, leaving spectators and teammates visibly shaken. The medical teams for both the Timberwolves and Nets sprung to action, quickly running to LeVert’s side and taking him off the court on a stretcher. He was then transported to a nearby hospital where he was treated and evaluated.

Fortunately LeVert was able to travel home with the team and meet with team orthopedist Dr. Martin O’Malley, the same physician who performed LeVert’s previous foot surgeries. Dr. O’Malley’s evaluation produced surprising, yet encouraging, results as surgery will not be needed on the area.

To understand how an injury that looked as disturbing as LeVert’s would not require surgery, let’s examine the makeup of the foot and ankle. The ankle mortise is formed by the ends of the two lower leg bones, the tibia and the fibula. The two distal ends form a roof over another bone, the talus. The talus is first of the tarsus bones of the foot that make up the hindfoot and the midfoot. The talus sits atop the calcaneus (the heelbone) forming the talocalcaneal or subtalar joint.

When LeVert landed following his attempt to contest Josh Okogie’s shot, his right foot was violently forced into inversion. The force caused the subtalar joint out of alignment, bending the foot at a vicious angle. Given this mechanism of injury, the subtalar joint likely dislocated medially or inward. This direction of dislocation is actually advantageous as medial subtalar joint dislocations are less likely to be open or break through the skin. Furthermore, lateral dislocation are more commonly associated with fractures of the lower leg bones. While the injury was unsightly, things could have been much worse.

The favorable results were confirmed by Dr. O’Malley as no fractures were detected and surgery to mend the area would not be necessary. With the foot back in alignment, LeVert’s primary concern will be the ligament damage that occurred when the joint was forced out of position.

Determining LeVert’s return to play timeline is difficult as his injury is uncommon and varies considerably from the more severe injuries of Hayward and Paul George. While there appears to be no solid NBA comparison, multiple NFL players have sustained subtalar dislocations without fractures in recent years. Quarterback Robert Griffin III suffered a subtalar dislocation during the 2014 season and was back in action after six weeks. Last season Eagles cornerback Ronald Darby dislocated his subtalar joint in Week 1 and missed the following nine weeks recovering.

While these examples are encouraging, it’s important to remember the physical demands of basketball vary from football, especially on the lower extremities. Barring any setbacks or unforeseen complications, an eight-to-10 week window may be a best case scenario for LeVert. His previous injuries may also factor into his treatment plan to insure his surgically repaired left foot isn’t overworked while his right leg recovers. Fortunately, Brooklyn’s highly-respected medical team will carefully manage the situation and Nets fan should anticipate his return to remain fluid with routine evaluations to insure things are progressing smoothly.