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From foot surgery to the football field

Toronto, November 2, 2016

By Kaitlyn Patterson

Dr. Timothy Daniels, head of Orthopedic Surgery at St. Michael’s Hospital

Dr. Timothy Daniels, head of Orthopedic Surgery at St. Michael’s Hospital, diagnosed Riley Manning’s football injury as turf toe. Dr. Daniels repaired the toe and a broken foot, allowing Manning to play out his senior season. (Photo by Katie Cooper)

When 17-year-old Riley Manning broke his right foot playing football in 2014, he thought it would be the end of his playing career, not just the season.

The broken sesamoid bone wasn’t the only foot issue that had impacted Manning’s play. At 16, his big toe began to curl up, causing him pain and instability when standing or walking. Running and turning sharply proved difficult.

“While the break itself wasn’t too bad, the shape of my foot and the way it absorbed pressure caused an underlying problem,” said Manning. “After consulting with three surgeons who all had different opinions, I finally met with Dr. [Timothy] Daniels. He prioritized my case because of its severity, which I was amazed by.”

Dr. Daniels, head of Orthopedic Surgery at St. Michael’s Hospital, diagnosed Manning with turf toe, a common sporting injury that is typically treated with rest and time away from the athlete’s sport.

“However, the instability and pain caused by Riley’s toe put him in the category of 20 to 30 per cent of patients requiring surgery for the problem,” Dr. Daniels said.

There are two joints in the big toe. Dr. Daniels took a tendon from one joint in Manning’s big toe to mend torn ligaments on the bottom of Manning’s foot. Dr. Daniels then fused the same toe joint to Manning’s foot. The procedure prevented the toe from curling any further and alleviated Manning’s constant pain. Since the surgery did not involve the second (or main) joint) in his big toe, Manning’s overall balance and ability to move the toe was not affected.

Immediately after the surgery, Manning had a pin in his big toe and a hard cast on the foot. He spent a month recovering on the couch, before the pin was removed. He was able to begin walking with the support of an Aircast afterward and spent a total of three months recovering.

In his followup appointments, Dr. Daniels advised Manning that the scar tissue could build up and he should massage it to increase the range of motion.

Manning’s work ethic, which he’d been honing by playing football since he was eight years old, kicked in.

“It’s important to listen to the doctor’s advice. If you don’t put the work in at home by doing the rehabilitation exercises, you’re not going to heal,” said Manning.

Less than a year after surgery, Manning was able to begin training for his final season of high school football.

“After his surgery, Riley recovered even faster than anticipated and was able to return to sports and his normal lifestyle,” said Dr. Daniels. “Without the surgery, Riley would have had trouble running and participating in high-contact sports for the rest of his life.”

Manning’s Oakville Trafalgar team had a successful season, winning the Halton senior boys’ Tier 2 football title in November 2015.

“When I played my final season, there was a 100 per cent difference to the pain in my foot,” said Manning. “The old pain was gone and it felt like I had a new foot.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.