Can Lane Johnson make it back to the Eagles before the playoffs?

Lane Johnson reportedly suffered a Lisfranc sprain in his foot. It's a tricky injury, but the Eagles do seem optimistic that their star tackle avoided the worst.

By Nick Tricome
PhillyVoice Staff

Vincent Carchietta/Imagn Images

Lane Johnson has had multiple ailments this season, and now the latest – a Lisfranc sprain suffered Sunday night – stands to keep him out for at least a few weeks.

The Eagles, as has been the case for more than a decade, can ill afford to be without Lane Johnson at right tackle. 

The two-time All Pro left Sunday night's win against Detroit with a foot injury, though, and the initial diagnosis was a Lisfranc sprain that is expected to sideline the veteran offensive lineman for 4-6 weeks, per an NFL Network report from Monday.

That's a considerable amount of time to be missing a key piece of protection up front for the offense, and all in the home stretch of the regular season, while the playoff race really starts to shape up. But that also might be the best-case scenario for the Eagles. 

Johnson is still waiting to undergo X-rays, The Philadelphia Inquirer's Jeff McLane reported Tuesday. The inflammation in his foot still needs to go down, and once doctors are able to take the scans, there will be a clearer picture as to whether it's just a sprain that Johnson is dealing with or something greater that will require surgery and far more recovery time – possibly past this season.

Johnson and the Eagles are stuck in an anxious waiting period until then, with an injury to a part of the foot that can get tricky.

Dr. Dinesh Dhanaraj, the Attending Orthopedic Surgeon at St. Mary Medical Center in Langhorne, offered an outside explanation as to why, along with an estimation of what Johnson could be dealing with rehab and recovery-wise in the weeks ahead.

But before getting started, an important note: The views and opinions expressed in this article are those of the author and guest authors and do not reflect any official policy or position of any NFL team or a team's athletic physicians. 

Lisfranc injuries aren't unheard of in the world of professional sports, but that doesn't make them any easier to deal with, largely because of where in the foot those injuries happen, and what can get injured.

"It's a joint in the mid-foot," Dr. Dhanaraj explained. "It's on the medial aspect of the foot. It provides stability to the mid-foot. It also helps with the arch of the foot."

But it's also a part of the foot that has a lot going on.

"There are numerous small bones in the foot that are held together with key ligaments, one of them being the Lisfranc, which goes from the second metatarsal to the medial cuneiform," Dr. Dhanaraj continued. 

The Lisfranc ligament can get torn or sprained, and the bones themselves can get fractured, which cuts into the foot's stability.

For now, the initial ruling on Johnson is a sprain.

When he exited Sunday night's game, the NBC broadcast did show him walking back through the Lincoln Financial Field tunnel with trainers, though with a limp. 

"It's a good sign, usually, if they can put weight and walk off of it," Dr. Dhanaraj said of athletes immediately getting up from foot injuries. "It's usually a good sign in general because the body tells you how bad the injury is sometimes."

Plus, being able to walk points to optimism that the injury is less severe. "[The foot] might be more likely to be able to bear weight right off the bat," Dr. Dhanaraj said.

Tuesday's report of inflammation in Johnson's foot delaying an X-ray, though, is not a good sign. However, Dr. Dhanaraj speculated from the outside that those X-rays might be more about finding out what kind of level of weight the foot can currently bear.

"They probably want to do what are called weight-bearing films," Dr. Dhanaraj said. "They have him stand on a plate, and they see if there's any dynamic instability with weight bearing. That kind of determines how much of a severity this ligament, this injury is."

MRIs are helpful, too, for looking at the ligament itself and determining what kind of sprain has been suffered. Much like other sprains covered in the past across the Sixers, Eagles, and Phillies, Lisfranc sprains exist in three grades – Grade 1 is a strain, Grade 2 is a partial tear, and Grade 3 goes into the realm of a full tear or dislocation, where no athlete ever wants to be. 

Johnson and the Eagles seem like they avoided Grade 3 based on the initial report, and are probably holding out hope that if the sprain isn't a Grade 1, it falls into the low end of Grade 2. 

Even so, the middle of the foot is still tricky when it's injured.

The 4-to-6 week window is out there, but considering the typical recovery and rehab process from a Lisfranc sprain, that window does seem a little over-optimistic in Dr. Dhanaraj's view.

"Because the initial time period is a couple weeks of non-weight bearing to treat it," he explained. "So to jump right back into full force and full speed is sometimes tough. If you treat them operatively and you need a full recovery, they can be like ACLs, where they take six months to a year, if they are like that Grade 3 that requires surgery. 

"So I think they're being optimistic that it's a mid-foot sprain, and if it's a Lisfranc, then it's a probably very, very minor one. A period of boot and crutches may be enough to do the trick, but I think they would have to get advanced imaging, an MRI, or even what's called weight-bearing films, to determine that."

It's an anxious wait for the Eagles and their elite tackle until then.

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