11/13/25: Dick Nick Gates from OrthoCincy

Dr. Nick Gates from OrthoCincy joined us to discuss Joe Burrow's return to practice, possible setbacks and ways to protect his toe. 

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Episode Transcript

Speaker 1 (00:00):
We do this every week we talk injuries with one
of the many experts from Ortho Sinsey Orthopedics and sports Medicine.
The great thing about Ortho Sincy is they have specialists,
locations and services all over the tri State, including walk
in orthopedic urgent care at five count them five locations

(00:20):
with extended evening and weekend hours in Edgewood and Anderson.
Learn more at orthosinc dot com. That's Ortho ci Ncy
dot com. Doctor Nick Gates from Orthosincy is with us.
So Joe Burrow is back and he's practicing. I have questions.
Let's begin with the basics, because it's been eight weeks.
The injury he is coming back from itself. What was it?

Speaker 2 (00:42):
So, injury is about eight weeks ago, surgery is about
seven and a half weeks ago. The injury is analogous
to a near complete dislocation of your knee, but instead
it's a near complete dislocation of the joint at the
base of your big toe. So if you think of
a knee injury, everybody kind of knows more about that

(01:03):
tear an ACL plus an MCL. You've torn two of
the ligaments to your knees. Kind of very unstable. When
you tear these ligaments in your big toe joint, the
big toe joint is very unstable and will not stay
in place. So that's kind of the severity. So I
would put the severia up as a multiple ligament injury
to the knee. Now, what happens down the road and

(01:25):
how that recurs in what you need out of your
toe is a little bit different. That's the severity of it.

Speaker 1 (01:31):
Let's talk about the timeline that he is on a
path for, and again this could change based on a
number of different variables. But we originally heard, you know what,
best case mid December. Now we're talking about late November.
So based on your experience with this injury, how surprising
is this?

Speaker 2 (01:49):
I don't think it's terribly surprising. I think a lot
of it's not a lot of it. Some of it's
coming out of some of the questions that the press
asked him about timeline. He's seven and a half weeks,
just getting out of his boots, starting to throw a
football with a shoe on. So while he is quote
unquote practicing, he's just tossing ball, tossing footballs this week

(02:11):
without doing eleven toll eleven drills at this point, so
he's definitely up a little bit ahead of schedule, but
in three weeks he's going to be out. He's done
this three week practice window, so that puts him at
ten and a half weeks at his latest point of
being on an active roster, So he's definitely he's on time,

(02:32):
if not early, for sure. That's a great sign.

Speaker 1 (02:36):
When he is doing what he's doing, throwing balls, that
sort of stuff. If you're monitoring him, what sort of
things are you looking for?

Speaker 2 (02:44):
I think you're watching how he walks. I just watched
a video this morning of him just walking out of
the locker room want of the field with a pair
of shoes on. You're watching how he walks. First, you
can't run without limping. If you can't walk without limping,
they're gonna watch how he plants. Right now, he's throwing,
it's minerstanding. It's his lead foot, so kind of a

(03:06):
good thing. He doesn't have to bend the toe as much.
And you're walking for any you're looking for any hesitation.
I think we talked about this on a previous conversation
about pain. It's hard to do things when things hurt
too much. And you're making sure the pain he's not
in so much pain that it's modifying how he throws

(03:26):
the football or how he walks, and then the next
step will be how he jogs.

Speaker 1 (03:30):
What are some of the possible setbacks that we hopefully avoid.

Speaker 2 (03:34):
Here, I think you're you're really bad. Setback is repeat injury,
and I'll make that a little bit different than just
persistent pain. I think he's going to have a sore
toe while he's doing these things, and that's okay. But
if he's having increasing amounts of pain as he accelerates

(03:55):
his activities, that's the setback. He's got to have pain management.
He's got to be healed and comfortable enough to do that.
I think a bigger issue that no one wants to
think about is repeat injury. Where he's feeling pretty good,
he goes through this recovery and he hits one of
these timelines, whether it's early December or this possibility that

(04:18):
people are bringing up about a Thanksgiving Day play, a
sudden repeat significant injury to the toe. Now, as you know,
it's not a terribly common injury, but bad things happen.
So a repeat, really bad hard bend to that toe
is his biggest setback. Those are the two things I
think that could Persistent pain clows him down, but I

(04:40):
don't think it's a long term issue. A repeat sudden
injury is the biggest risk.

Speaker 1 (04:45):
This might be kind of a stupid question, but are
is there an apparatus you could put in his shoe?
Is there a special design of a shoe that you
could sort of, I don't know, used to help mitigate
the potential risks of a recurrence the injury one hundred percent.

Speaker 2 (05:02):
We've touched on this in previous conversations. There is an
orthotic device that can be fashioned to fit inside of
a typical shoe and even inside of a cleat football
cleet that protects the toe from It minimizes motion, and
it minimizes stress. If there was an injury to that area.

(05:25):
If he comes down on that toe in a similar
fashion that he did with the original injury, and the
toe goes through a significant upward force, that device inside
the shoe minimizes that force. Very similar to if you
go back to play football after a knee injury with
a knee brace. The knee brace is going to minimize
the amount of force that's transmitted through those recently repaired ligaments.

(05:48):
The great news about the toe is it's really an
up You can protect it from an upward stress pretty well.
The big toe is not suspect to side to side stress.
And athlete all football field their knee tremendous risk of
side to side impact, not so much in the toe.
So you can do a pretty good job of protecting
it with this device inside the shoe. And it's already

(06:11):
been mentioned in a couple of reports, so I'm sure
they're doing that, hope.

Speaker 1 (06:14):
So that's our guy, doctor Nick Gates. Doctor Gates, we
appreciate the time Ortho Sincy. I say it every week
because I believe it. The great thing about Ortho Sincy
is they have specialists and locations all over the Tri State,
including walk in orthopedic urgent care weekdays nine a m.
To nine pm and on Saturdays nine am to one
pm at both Edgewood and Anderson. It's easy because you

(06:36):
never need an appointment and it is most definitely cheaper
than going to an er. Whenever you have an urgent
orthopedic injury, go to Orthosinc dot com. That's Ortho ci
Ncy dot com. It was about this time a year
ago that the folks at Ortho since he fixed my neck,
doctor angel Velaskez, And it was about two years ago

(06:57):
at this time that they helped my daughter's foot brokeer
foot at Recess Orthosinc. Dot com. That's Ortho c I
n c Y dot com. Eighteen away from six o'clock.
This is ESPN fifteen thirty Cincinnati sports station.