St. Louis Post-Dispatch Quotes Dr. Kenneth Jung: Torey Krug on decision to undergo ankle surgery: ‘As far as pain level goes, it’s always there’

Torey Krug tried to push away surgery.

In the six years since he first fractured his ankle in an awkward collision into the boards, Krug successfully managed and dulled the pain. Over the years, he felt comfortable playing hockey, in part because the skate helped to support his ankle. And although the 2023-24 season was “definitely tough trying to manage the pain level,” Krug said, he was ready to return in the fall for another season wearing the Note.

“I felt good leaving St. Louis last year,” Krug said on Wednesday morning. “I thought the things that I was doing I’d be able to continue to progress and play hockey. The following few weeks after that when I picked up my training, there were some red flags where I had to get on the phone and talk to the Blues and let them know what was going on.”

But unlike before, Krug’s ankle was hurting when he was on the ice, and that sounded alarms. He tried to spend more time on the bike in order to keep weight off his ankle but maintain conditioning. He tried to give it some rest, but “almost immediately when you try to come back into the gym and put the skates on, it was one of those things where you realize it wasn’t going to work,” Krug said.

The official diagnosis was pre-arthritic changes in his left ankle, and the subtalar fusion surgery Krug will undergo will sideline him for the entire 2024-25 season. Krug said he will have the surgery in the coming weeks.

“It’s been something that I was going to have to do regardless at some point in my life,” Krug said. “Getting it taken care of as a 33-year-old professional athlete is a little bit different. I thought I would have to do it when I was 50 down the road and retired.”

The initial injury happened on May 4, 2018, when Krug was playing in a second-round series for Boston against Tampa Bay. During Game 4, Krug was pursuing a puck in the corner when Alex Killorn made contact with him and sent him crashing into the boards. Krug’s left ankle crunched into an unnatural position, and he “fractured a few bones,” Krug said.

Krug said that none of the other broken bones or fractures that he’s suffered impacted the pain in his ankle.

“It was one of those things that over time, it got worse,” Krug said. “Anyone with arthritis knows that there are some good days, then there are some bad days. I was able to tolerate it for so long, and we did many things to help with that, whether it’s different treatments, done injections to help with the pain. … To be honest, I don’t know what a healthy ankle feels like. As far as pain level goes, it’s always there.”

While Krug has become well-versed in the physical pain that the injury has brought him, the upcoming season will present him with a mental challenge.

In each of the previous 12 Septembers, Krug has been preparing himself for an NHL season. That won’t be happening this year. He won’t be around the Blues at every practice, every flight, every game. But Krug vowed to be present in some capacity.

“I’ll be around for sure,” Krug said. “That’s what I’ve known and loved for so long.”

On a personal level, Krug hopes the surgery will help him live his life more normally, the thought of which made him emotional enough to pause for about 20 seconds in order to compose himself.

“I’m going to feel better as a person,” Krug said. “I’m going to be able to carry my kids up and down the stairs, which I’m able to do it some days. Waking up, it’s tough.”

But what about Krug’s hockey future?

It’s unknown at this point whether Krug will be able to return to play in the coming years, and it’s something that Krug has thought about during this process and admitted that “looking forward, I can’t forecast too much.”

“I’ve always wanted my kids to watch me play and see how hard I work,” Krug said. “I think regardless of what you’re doing, they’re going to see that. Even if it’s away from the rink, how hard I work at being a parent, working on the house, doing stuff in the yard. They’re going to see that. I think it’s just in your DNA.”

Dr. Kenneth Jung, a foot and ankle surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles and for the Anaheim Ducks, called the procedure uncommon in professional sports. The most high-profile athlete who underwent the surgery was Tiger Woods.

The surgery will fuse the subtalar joint that involves side-to-side motion of the foot: “If you’re standing on uneven surfaces, walking on the sand, that side-to-side motion, that’s what that joint gives you,” Jung said.

The procedure will limit Krug’s motion in that area, which could have already been limited due to his injury.

“If he’s already been performing at a high level with minimal motion or little motion in that subtalar joint, having a fusion may not affect him too much,” Jung said. “It all depends on what his pre-operative range of motion is. Once it’s fused, that joint does not move anymore.”

There is also the possibility that there is a higher chance of pain developing in the nearby ankle or midfoot joints after the surgery.

“In general, we tell patients the stress of the activity doesn’t go away,” Jung said. “It just gets passed to the next joint. In general, you’re trying to avoid fusions if you can because adjacent joints will have increased stress. They will ultimately have increased chances of getting arthritis.”

Krug can no longer push away the surgery.

“You always try to hold out hope that you get healthy,” Krug said. “Obviously, at some point, you do have to commit to fixing it.”