The Yankees are still unsure of DJ LeMahieu’s health going into next season. LeMahieu was sidelined through the playoffs because of a broken sesamoid bone in his right big toe that led to ligament damage in his second toe.

LeMahieu opted for a non-surgical recovery plan — which mostly includes staying off his foot as much as possible — since the regular season ended. The toe injury became a more serious problem for LeMahieu in early August and caused him to miss just a handful of games before he returned, but he received a cortisone shot in his toe at the All-Star break in July. In August, LeMahieu said he felt discomfort in his foot while swinging.

When a person breaks their sesamoid bone, located at the bottom of a big toe, it’s caused by a stress fracture from constant and repeated weight transfer to their feet. In this case, because LeMahieu’s a right-handed hitter, the pivot after swinging is when he’d be susceptible to breaking his sesamoid bone, according to Deepak Chona, MD, founder of SportsMedAnalytics and a Harvard- and Stanford-trained sports surgeon. Even with the amount of force baseball players place on their feet, it’s not a commonly diagnosed injury because medical imaging usually doesn’t pick up any abnormalities of a bone as tiny as the sesamoid.

A broken sesamoid bone could zap a player’s production because of how painful the injury is, Chona said, which is what happened with LeMahieu in the second half of the season. In the 42 second-half games he played, LeMahieu hit .228/.308/.327 with just four home runs and four doubles. His second-half OPS was .635, down from .786 in the first half. The toe injury is the likely cause for his production getting zapped.

“Every time he would swing and try to hit, he would have this sudden twinge of pain,” Chona said when describing sesamoid injuries. “It does explain the performance dip. In the long term when people usually come back from this injury, they don’t tend to see a performance dip. It’s not a huge sample size because it’s not a common injury. You can continue trying non-operative treatment meaning rest and trying to get the bone to heal. If it’s still not healing, you will move to a surgery. They still have some time to make their decision knowing surgery is still an option.”

Surgery is still an option being considered, Yankees general manager Brian Cashman said earlier this month. It’s expected that LeMahieu will make a decision on pursuing surgery or continuing to rest by the end of the year. If LeMahieu needs surgery, the average timeline of returning is 10 to 12 weeks with the maximum recovery pushing five months. That means if LeMahieu does get surgery next month or in the beginning of January, there’s a possibility of him being cleared for baseball activities before the season begins.

Chona said sesamoid surgeries have over a 90 percent success rate for athletes returning to sports and getting back to pre-injury production. Sesamoid surgeries can be tricky for surgeons though because nerves run near the bone that control sensation and can end up being extremely painful if those nerves are impacted. Chona, who hasn’t seen LeMahieu’s X-rays or MRI scans and isn’t treating him, said another aspect that could make LeMahieu’s potential surgery a challenge depends on how big of a break he has in his sesamoid bone. If it’s a bigger break, it will make an impact on how he bears weight on his foot moving forward. But the benefit of cutting out the broken portion of the bone is it would no longer have to be monitored and there would be no additional worry if the bone will heal on its own, which is what LeMahieu is doing now.

The reason why LeMahieu hasn’t opted for surgery to accelerate the healing process is that it’s not an injury that automatically requires a person to go under the knife. It’s entirely possible to treat this injury with adequate rest, but it undoubtedly is cutting into his offseason training regimen the longer it takes to heal.

“The ideal outcome here is to not make a cut on the foot which might be painful,” Chona said. “If he could get it to heal with just rest, that’s the best possible outcome for him. If you do surgery on that part of the foot, the small nerves can become irritated and create a lasting painful sensation even if you fix the underlying problem, which is the fracture. That’s one reason to not do surgery on the foot. After you do that surgery, you will be off of it for a while and it has a high likelihood of curing the problem but the usual recovery is three months of not putting pressure on the area.”

LeMahieu’s health has given Yankees owner Hal Steinbrenner some pause when it comes to figuring out the team’s offseason priorities after re-signing Aaron Judge. When asked what he considered the team’s second biggest priority at the owners meetings earlier this month, Steinbrenner said it’s a question of if LeMahieu will be ready. If there’s still concern, the Yankees will have to “go out and get another contact hitter,” Steinbrenner said.

If LeMahieu will be limited in any capacity, it could mean the Yankees hold on to second baseman Gleyber Torres, who’s been a frequently mentioned trade candidate, until the deadline next season. Any LeMahieu absence also adds additional reliance on third baseman Josh Donaldson to have better results at the plate than what he produced this season, unless the Yankees find a way to offload his contract.

LeMahieu has missed back-to-back postseasons for the Yankees, as a core muscle injury kept him out of the one-game wild-card against Boston in 2021. Cashman said the team hasn’t considered limiting the amount LeMahieu, who will be 35 next season and is under contract for four more seasons, plays moving forward because he doesn’t believe it would have prevented either injury.

“With the two injuries he’s had, I don’t think anybody could have seen either one coming,” Cashman said. “When he’s healthy, he’s really good. We’ve been robbed of having his talents in the last two years when it counted the most, so it’s been frustrating for him and for us.”

(Photo: Jayne Kamin-Oncea / USA Today)