Risk vs. Reward: Examining Eddie Lacy’s Toe Injury

Eddie Lacy’s feet will be under the microscope this coming season.

Matthew Emmons-USA TODAY Sports

It has been widely reported that Alabama running back Eddie Lacy, at one point considered a first-round NFL Draft lock, fell to the Green Bay Packers because a toe condition scared off interested teams. The New York Jets were one team that reportedly “loved” Lacy’s raw talent at one point, and the Steelers were also reported to be interested heading into the draft.

But after Lacy plummeted to pick No. 61 on Day Two of the draft, a report out of Pittsburgh said the Steelers‘ front office “would not touch” Lacy because his big toe had been fused last off-season. What was originally reported as a turf toe injury apparently was a surgical fusion of the big toe for stability.

James Starks missed six games due to turf toe last year, and was never really effective when he returned.

A legit concern? In the NFL, yeah. We saw what turf toe did to James Starks last year (he missed the first six games of the season, and was never truly effective when he returned), and Lacy’s condition included toe-fusion surgery on top of that?

Interestingly, there isn’t a lot of information available regarding Lacy’s reported surgery; one would think that a running back for a national champion team having surgery on his big toe would generate a lot of headlines, but that doesn’t seem to be the case. So, I decided to check into what toe fusion surgery actually is and what this could potentially mean for Lacy’s future prospects.

Lacy reportedly underwent the surgery in March 2012, and it was a procedure that apparently has been performed on very few world-class athletes. Why? Well, because it generally is used to help alleviate pain for people with severe, chronic arthritis, not to stabilize a joint to allow for the physical wear and tear football promises.

Why would this surgery be related to what was initially reported as turf toe?

Good question.

But according to WebMD.com, turf toe is described as “a sprain of the ligaments around the big toe joint.” The site also calls it “a condition that’s caused by jamming the big toe or repeatedly pushing off the big toe forcefully as in running and jumping.”

Eddie Lacy breaks away from the Notre Dame defense during the first half of the 2013 BCS Championship game. Matthew Emmons-USA TODAY Sports

Repeatedly pushing off the big toe is one of those things NFL running backs sort of have to do. Interestingly, it would seem that a toe fusion would severely limit Lacy’s ability to do so, especially repeatedly over the course of a 16-game season. It would be fairly clear, then, why teams might be leery of spending a high draft pick on him.

Interestingly, another college player had surgery related to turf toe in 2012. That player was Notre Dame linebacker Prince Shembo, according to AnkleFootMD.com. Was it the same surgery as Lacy’s? Maybe, maybe not. “They had to put a screw in there,” Notre Dame coach Brian Kelly confirmed at the time, saying a six-week recovery time was expected (Shembo went on to start all 13 games last season, with 51 tackles and 7.5 sacks. A year later, Shembo is looking forward to making the most of his senior season, saying he’s prepared to “smack the crap out of somebody” – that bodes well).

Similarly, a toe fusion surgery typically includes a pair of screws inserted to hold the big toe rigid, thus to relieve pressure and pain. FootEducation.com reports that some of the most common complications include “malposition” and “nonunion” of the joint.

Malposition would mean that the toe wasn’t fused in the proper position for maximum pressure relief; this would require a do-over. Nonunion is more common, it seems. Writes FootEducation.com: “This is because the joint itself is very small. Therefore the area across which we are expecting bone to heal is also small. In the event a patient is unable to successfully bridge this area with mature bone and it remains symptomatic, a revision procedure fusion with increased hardware and perhaps some bone graft can usually be effective in getting the area to heal completely.”

One must assume Mike McCarthy and the Packers’ brass knew the risk when they selected Lacy at No. 61.

One must assume Ted Thompson, Mike McCarthy and the entire Packers organization did their due diligence in checking out Lacy’s medical issues (he’s also had a lingering hamstring problem).

Packers director of college scouting Brian Gutekunst told AcmePackingCompany.com, “He’s a big back. He really hasn’t missed any time. I don’t think it’ll be a concern.”

Furthermore, an interview with an editor for the Alabama sports site RollBamaRoll.com unearthed this quote: “Probably not what you want to hear, but the nagging turf toe injury was really just one of several small, persistent injuries that hung with Eddie throughout his career. As such, the die-hard fans grew pretty accustomed over the last three years to seeing Eddie play with his foot taped, or knowing he had a plate in his cleat.

“I would wager, though, that more casual viewers would not even know he was ever injured. He never favored

is foot, never ran timidly, and never really indicated that he was in any pain over it. Most importantly, it never seemed to negatively impact his production.”

That point is the one that is most difficult to look past, fused toe or no fused toe. Here are Lacy’s stats from last season: 1,322 yards and 17 touchdowns on 204 carries, along with a BCS National Championship. That’s why he was considered a first-round talent, and doubtless is why the Packers couldn’t pass on him at 61. The value was just too great – risk or no risk.

What remains to learn is whether that toe can stand up to the rigors of an NFL season, or multiple NFL seasons. It appears we’ll see a full-strength or near near-full-strength Lacy out of the gate, but Packers fans will be holding their collective breath with every cut and every awkward tackle.

Perhaps this durability gray area is why the Packers also drafted Jonathan Franklin?