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Tuesday, October 29, 2013
Fantasy injury report: Jimmy Graham

By Stephania Bell

The official diagnosis for New Orleans Saints TE Jimmy Graham is a partially torn plantar fascia. It hurts every bit as much as it sounds like it should. Here is what I wrote about the condition when another tight end, Antonio Gates of the San Diego Chargers, suffered a similar injury in 2010:

Normal humans are barely able to walk, let alone engage in athletic activity, after such an injury. The plantar fascia is the fibrous tissue along the undersurface of the foot which runs from the heel to the ball of the foot and reinforces the arch. The plantar fascia is placed under tension every time the foot hits the ground as the body weight is loaded through the leg. Imagine now that the tissue is damaged, the fibers are torn and frayed and every step tugs further, weakening that already impaired foundation. The pain is nothing less than excruciating. … This is not one of those “uncomfortable” conditions an athlete can simply push through, especially when running, pivoting and pushing off is integral to the position.

In Gates’ case, the tear was considered significant, and it hampered him for the better part of two seasons. Not all tears are created equal. In Graham’s case, he had made enough functional improvement over the bye week and a subsequent week of virtually no practice to be able to suit up last Sunday. While he was clearly not fully recovered -- and was utilized on a limited basis -- Graham was still able to contribute quite nicely for both his team and fantasy owners, as he tallied two touchdowns. He appears not to have taken a step backward.

However, his injury is going to be an ongoing management situation for the Saints, something coach Sean Payton acknowledged after Sunday’s game. They will try to help a player balance managing the condition -- and hopefully see some improvement -- while still allowing him to participate to the extent possible in game situations.

The problem with any partially torn tissue is that it continues to be painful for the remaining intact portion as it absorbs increased load and strain. For those who would suggest that a complete tear of the plantar fascia would be the best remedy, it’s a solution that doesn’t come without consequences. It’s true that a surgical release -- the equivalent of a complete tear -- can be performed in cases of intractable plantar fascia pain. When the fibers are no longer strained, the pain subsides. But all structures exist with a purpose, and one has to consider what happens when the fascia is cut. The arch loses some of its support and there can be a loss of arch height, leading to compromised foot mechanics. There can also be a risk of stress fracture and, perhaps most important, all foot pain is not necessarily alleviated.

If there’s the potential for healing of minor tears (although healing in this area is typically slow because of a poor blood supply, along with it being easily subject to repeated strain), then that is the best option for the long-term health of the foot. The medical staff will be key in helping Graham along, not only in terms of managing the symptoms and stretching and strengthening around the foot, but also in providing support for the arch, via taping or inserts, to allow Graham to function.