00:00This is the Injury Report, presented by NYU Langone Health.
00:05Giants wide receiver and return specialist Braxton Berrios has suffered another devastating injury.
00:10His 2026 season is over after undergoing surgery to repair a Lisfranc injury in his foot.
00:15But just how serious is this injury?
00:17What does the road to recovery look like?
00:19And can Berrios regain the explosiveness that made him such a dangerous return specialist?
00:24Joining me to break it all down this week on Injury Report is NYU Langone's foot and ankle surgeon,
00:29Dr. Kevin Schaefer, who joins me now.
00:31Dr. Schaefer, how's it going?
00:33Well, thanks for having me.
00:35I'm glad to have you here.
00:36Let me ask you this, Dr. Schaefer, we're going to start here.
00:39Braxton Berrios, he underwent surgery to repair a Lisfranc injury in his foot.
00:42For viewers who may not be familiar with this particular injury,
00:45what exactly is the Lisfranc joint complex and why can damage to this area be so serious for an NFL
00:51player?
00:53Yeah, that's a great question.
00:54This is a really critical injury, particularly for explosive athletes.
00:57It's, you know, the foot has 28 bones and a lot of them are really small.
01:01And if I hold this little model up here, you can see right in the middle of your foot is
01:06this row of bones,
01:07really two rows towards the middle.
01:10And that's what really allows you to transmit all of that explosive force from your toes back through your ankle
01:15and up your leg.
01:15And the Lisfranc complex, it's known as the tarsometatarsal joint complex.
01:22It really allows that shape of the foot to be maintained as you explode and drive through off your toes.
01:30So it's really important for football players, particularly dynamic players.
01:35You know, in terms of what the complex involves, it's these bones and these very, very, very stout ligaments and
01:42capsule that maintain the shape of the foot.
01:45And the problem with the Lisfranc injury is if those ligaments are injured, there can be pain and loss of
01:51explosiveness because the foot is not stable right in the middle.
01:54Not good for someone who returns kicks like Braxton Berrios.
01:58And we know that Berrios, his injury requires surgery.
02:01So what determines whether a Lisfranc injury can heal without surgery or requires an operation?
02:06And what does the need for surgery generally tell you about the severity of the damage?
02:12Right. So, you know, saying you have a Lisfranc injury is actually not very descriptive.
02:17It can mean a number of things.
02:18It can mean a sprain of a ligament.
02:20It can mean a fracture of a number of bones and those things behave very differently and have a very
02:26different recovery profile.
02:28In terms of non-surgical injuries, what we want to assess is that that Lisfranc ligament is complex and that
02:35those joints are stable.
02:37So the first thing that we do is we have patients stand in place in an X-ray and we
02:42usually compare their uninjured foot and we very carefully analyze the joint spaces.
02:47And we make sure that there's no evidence that the joint spaces are opening up.
02:51Sometimes we'll use what's called a weight-bearing CT scan, which is the next level.
02:56It's an X-ray that's in three dimensions and it allows us to analyze those spaces in greater detail in
03:013D.
03:02And if that space is not opening up on a weight-bearing scan, that's good.
03:06But sometimes we need to go the next level.
03:08And that's either an MRI where we look at the integrity of the Lisfranc ligament and some of the surrounding
03:12capsule or we do what's called a stress view.
03:15We take the foot and we do what's called a pronation abduction stress and we try to assess if those
03:21ligaments are still attached.
03:22So if we get an X-ray and we pull on the foot and those spaces open up, then a
03:26patient needs surgery.
03:28Process and seeing whether the patient needs surgery or not here with a Lisfranc injury.
03:33Thank you for that.
03:34Let me ask you this because Berrios, we know this, he's made his living as a kick and a punt
03:39returner where, as you mentioned before,
03:41explosiveness, quick cuts, change of direction, all those things are essential.
03:45Which of those physical abilities are most vulnerable following a Lisfranc injury and how difficult can it be for a
03:50player to regain his pre-injury explosiveness?
03:54Yeah, it's really critical for explosiveness and change in direction.
03:58And as you mentioned, for a kick returner who needs to kind of pivot, cut, and fool the defender, it's
04:03an absolutely essential part of their body.
04:06So, you know, whether or not he returns will be, to that level, will be based upon the severity of
04:11the injury,
04:12what surgery had to be done because there's a number of different ways of fixing it based upon the actual
04:17nature of the injury.
04:18And then, you know, there's some chance involved.
04:20Everyone heals differently.
04:21But, you know, we have had a lot of advancements in medicine and a lot of these patients and athletes
04:26will return to a very high level.
04:28So I'm hopeful that he'll be able to get back to doing what he does best.
04:30So the surgery for Barrios has been deemed thus far successful.
04:34And now that he's undergone that surgery, Dr. Schaefer, what does the rehab process look like over the next several
04:40months?
04:40What are the most important milestones that he's going to need to reach before he can begin some of the
04:44stuff we just talked about, running, cutting, and eventually returning to football activities?
04:48Yeah, again, that really depends on what exact surgery was done.
04:53But in general, after these injuries, we keep athletes not weight-bearing for six weeks.
04:57We start range of motion to get the ankle moving and some of the joints around the Liz Frank complex
05:02moving.
05:03But we don't want to stress those ligaments and those capsule ligament, those components that are stabilizing those joints that
05:09we've reduced surgically.
05:11But after six weeks, we'll start walking.
05:13And then it's a very slow progression of activity.
05:16A lot of athletes are not ready to return until at least six months.
05:19Some take longer, nine to 12 months.
05:22But usually at least six months is when we start thinking about clearing them for sports-specific activity, particularly football
05:28players with explosive push-off movements.
05:30Good there.
05:31And I guess last thing for me here is when you look at the history of NFL players returning from
05:37Liz Frank surgery, and I know it can differ depending on the injury and what kind of surgery they had,
05:41how optimistic should we in general, Giants fans, should be about Berrios getting back to his pre-injury form?
05:46And what would you need to see if you were treating him during his rehabilitation to feel confident that he
05:51can make a successful return in 2027?
05:55Yeah, I mean, I would have pretty reasonable confidence.
05:57Some athletes never return to their prior form.
06:00But along the way, we have a lot of fancy tools to evaluate athletes.
06:05We look at things called proprioception, which is their ability to have balance and coordination of their foot in space,
06:12and we compare it to their uninjured side.
06:14And once they've met a level where they're at their pre-injury threshold or similar to the other side, then
06:20we kind of let them go and see what they can do.
06:22So, again, I'm optimistic.
06:24I think we've come a long way with this injury.
06:26A lot of athletes do really well, and we'll have to see how he does, but I'm optimistic.
06:30All right, you're optimistic.
06:32Hopefully the Giants fans can be optimistic as well, too, in his return from surgery.
06:37Surgery has been deemed a success thus far for Braxton Berrios.
06:40That is Dr. Kevin Schaefer with NYU Langone, a foot and ankle surgeon specialist there with them.
06:46Dr. Schaefer, always a pleasure talking to you on Injury Report.
06:48Thank you for the time.
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