What Is Going On With Donte Divincenzo’s Big Toe?

Donte DiVincenzo received an MRI Monday morning, which revealed crushing news for DiVincenzo and the Minnesota Timberwolves. Since becoming Minnesota’s starting guard, DiVincenzo has injected new life into a stagnant offense. The MRI revealed that DiVincenzo suffered a grade three sprain on his left great toe, which he likely sustained in Minnesota’s gut-wrenching 116-115 loss to the Golden State Warriors on January 15.

The injury forced the Wolves to change his injury status to indefinite as DiVincenzo looks for second opinions and confirmation of the diagnosis. Wolves fans wait with bated breath while he sorts through his options. In my attempt to put the best (foot) forward at figuring out his injury, there are some clues to his injury and commonalities in treatments we can study.

Big toes are like the feet’s thumbs. Well, kinda. Thumbs help your hands grip things, open doors and use everyday items. However, the big toe tends to get forgotten. Its role in the human body isn’t as visible as the spotlight-stealing hands.

The big toe is imperative for balance. It helps shift weight from the inner foot to the outer foot, pushing the foot off the ground when walking and helping to ground and plant the body onto the floor. Without the big toe, people usually have a long adjustment period before learning to balance and walk again without falling.

The big toe gets relatively little credit for its importance, largely due to its innate and automatic nature. For example, suppose you’re standing on a moving bus while reading this article. Your big toes, calves, and other parts of your lower body are all likely working in tandem without your knowledge or instruction to keep you standing as the bus turns and bends around corners and hops over bumps in the road. Conversely, your phone to read this is center stage, gripping the phone’s case and preventing it from falling to the floor.

Big toes are pretty important to being an upright bipedal human being. Therefore, spraining one can be detrimental to everyday life, even for people who aren’t world-class athletes like DiVincenzo.

A sprain is short is a stretching or tearing of a ligament. They are typically sorted into categories called grades. A Grade 1 sprain is considered a mild strain merely overstretching a ligament. Grade 2 reflects a partial tear to a ligament. Grade 3 is a complete tear or rupture of a ligament. As the grade level of a sprain increases, so do the associated symptoms. The most common symptoms are pain, swelling, and, likely in DiVincenzo’s case, trouble walking.

An MRI is the most clear-cut option for diagnosing a big toe sprain. The image after the scan can show the torn or damaged ligaments. The most common ailment, and most likely in DiVincenzo’s case, is that he sprained his metatarsophalangeal joint.

To explain that joint, it’s easiest to look at your hand and then your thumb. Now, bend your thumb into your palm.

The knuckle closest to your wrist is the notable area, not the one closest to your fingernail. The big toe has the same two joint structures as the hand. The metatarsophalangeal joint is close to the ball of the foot, as opposed to the joint closer to the nail, just like the one noticed in your hand.

The issue with spraining a big toe is not only how important it is to help humans function, but it also leads to unrealized compensation from the rest of the body.

For example, to alleviate the pain associated with toe sprains, the injured person might walk more on the outer side of their foot, which puts more pressure on the ankle. In turn, that puts pressure on the knee. Walking on the heel instead of the big toe leads to similar issues, as the height difference and posture can lead to hip pain.

As a result, the most common treatment is stabilizing the lower leg in a boot – a CAM boot, specifically. Typically, it’s a big grey CAM boot covered in velcro because the entire foot and ankle must be immobilized for the toe joint to heal. Due to the nature of the joint, that can take anywhere from a couple of weeks to six months. The rest of the treatment is RICE, a common acronym that means rest, ice, compression, and elevation.

There are other options. In Grade 3 sprains, surgery is always an option, and the ligament can be sutured together. Still, surgery is usually not a necessary option unless a bone is broken with the tear or in extremely rare cases. Some practitioners recommend platelet injections to bring nutrient-rich platelets to the affected area. However, due to the size of the big toe, that also is a rare occurrence. Regardless of the treatment chosen, the recovery time will likely be two to six months, largely depending on how fast DiVincenzo’s body can heal.

That suggests DiVincenzo’s recovery will likely be a case of hurry up and wait, as one of my former nursing instructors would say. Healing tendons takes time due to the poor blood flow to the joints and the tendons being made up of connective tissues, not muscle. The recovery journey will likely revolve around slow-progressing physical therapy, pain management, and a lot of waiting in a lovely grey CAM boot.