Dr. Dan’s Injury Updates

New segment coming to the Thunderblog – the injury update! All week-long we hear about the most recent season-derailing injuries to players all over the NFL – usually explained to us simple football watchin’ folk as “tears”, “dislocations”, or, for the Eli Mannings among us, simply as “injuries”. Well, we think you’re all a bit smarter than that! Ever wonder what those announcers are talking about when they say your favorite player is out for 4 weeks with a “knee injury” or when your fantasy starters are nursing “foot injuries” all week (I’m lookin’ at you Andre Ellington)?

Here at the injury update we’ll try to give you an overview of all the key injuries of the week, while focusing on a few particularly interesting ones to help you understand what’s really going on medically with your favorite players. Who knew you could read about football and educate yourself at the same time!

For the first installment, we’ll be focusing on three players (two injuries): Kansas City Chiefs’ linebacker Derrick Johnson and defensive end Mike Devito, who somehow both managed to tear their Achilles tendons in subsequent quarters, and Cincinnati Bengals’ TE Tyler Eifert’s particularly gruesome elbow injury.

Derrick Johnson and Mike Devito – Kansas City Chiefs

The Chiefs defense took a big hit Sunday with the loss of Derrick Johnson and Mike Devito – both of whom torn their Achilles tendon. While it is a fairly common sports injury, tearing your Achilles is still a big deal. To begin, a tendon is a tough, fibrous band of tissue, mostly made of collagen, attaching a muscle to a bone. The Achilles tendon is one of the longest in your body, attaching multiple calf muscles, including the gastrocnemius and soleus muscles, to your calcaneus, or heel, bone (see fancy picture below). You can feel it pretty easily if you reach behind your heel. Now imagine that snapping – when it does so, it makes an easily audible ‘pop’, something no player wants to hear. This is a complete tear of the tendon, which is what happened to both players this past weekend. The tension in the calf muscles is relieved when the tendon snaps, and the entire tendon and muscle basically curl up into a ball in the back of your leg (imagine a rubber band snapping and recoiling back, ouch!). If one partially tears the tendon it is still a tough road to recovery, but nowhere near as bad complete tear.

Achilles tears can occur for a variety of reasons, but in sports like football it is usually due to a sudden movement involving the Achilles tendon. The abrupt tensing of a player’s calf muscles, in this case that of the two of the Chiefs defenseman, was too much force for their tendons to handle, resulting in some nasty tears that will put them on the bench for the rest of the season.

For the most part, NFL players prefer surgery to repair the tear because it has proven to have a lower incidence of re-rupture and allows one to get back to pre-injury activities sooner than the alternative treatment, which consists of rest, casting, and rehab. Surgical treatment consists of suturing the two ends of the tendon back together (orthopedic surgeons aren’t rocket scientists, if it’s torn, sew it back together). Both players will be casted and then booted for up to eight weeks after surgery, which will be followed a few months of rehab. By month four, individuals are usually back to jogging, and by month six they can usually do all the activities they previously engaged in. However, it usually takes about one full year to return to football playing levels of strength and activity. In the meantime, at least the two players have each other…

 Tyler Eifert – Cincinatti Bengals

The Bengals were hoping for a big year from TE Tyler Eifart, who they drafted out of the University of Notre Dame in the first round of the 2013 NFL draft. Eifert put up decent numbers last year, including 39 catches for 445 yards and 2 touchdowns. However, his season was cut shut with what has been labeled a dislocated elbow.

Elbow dislocations are actually pretty uncommon in adults, but when they occur it could be bad news. The dislocations occur when an outstretched hand hits the ground, sending the force of the fall into the elbow joint. This is usually accompanied by some sort of twisting motion, effectively driving and rotating the elbow out of its socket. Sometimes dislocations simply need a little force applied to them to pop the dislocated bone back into its socket, however, there’s a lot more going on in the elbow than one would think. This could lead to some serious damage…

Surrounding the elbow joint are multiple ligaments which are usually stretched or torn as a result of the dislocation. This occurs in most dislocations and heals with time. Additionally, some of the muscles that attach to the joint could be damaged, but again, nothing that some physical therapy can’t usually fix. What one really worries about are the nerves and blood vessels that travel around the elbow joint, and there are multiple, seen below. At particular risk is the Ulnar nerve, which can become pinched or stretched as a result of the injury. An injury to the ulnar nerve leads to weakness in one’s ability to flex their wrist and complete loss of flexion in the pinky and ring finger. Numbness may also occur. Fun fact – when you hit your “funny bone” you are actually compressing the ulnar nerve in the notch that it sits in behind your elbow. The resulting tingliness gives you an idea of what parts of your arm and hand are innervated by that nerve, and what parts would be affected by any damage from an elbow dislocation. I said you would learn something by reading this! On a more serious note, damage to the median or radial nerves can also occur, leading to similar weakness and numbness in the wrist and other fingers. I’m pretty sure tight ends need to use their hands pretty often, so weakness and numbness sound like something that should generally be avoided. Similarly to nerves, arteries can get trapped leading to a loss of blood supply and permanent muscle damage. Nasty stuff.

If the dislocation is reduced quickly, as it probably was in Eifart’s case, most of these problems can be avoided. Still, recovery can take weeks, as one needs to allow time for the damaged muscles and ligaments to heal. Physical therapy usually allows one to regain full range of motion in the joint. It is likely that the Bengals will put Eifart on the injured reserve, allowing him to return to play in week 10.

 Other notable injuries

Texans OLB Jadeveon Clowney tore his meniscus in his right knee, and possibly has an MCL sprain. The meniscus will be at least a 4 to 6 week recovery, with more time needed if the MCL is torn as well.

Alshon Jeffrey (WR) of the Chicago Bears and Jordan Reed (TE) of the Washington Redskins are both suffering from hamstrings injuries, but the extent of the injuries is currently unknown. Keep on eye out for updates throughout the week.

Ben Tate, RB of the Cleveland Browns – not so notable – he’s always injured.

Update: Tate will miss 2-4 weeks.

Evan Mathis, the Philadelphia Eagles pro-bowl guard, sprained his MCL in the game on Sunday. It’s currently being reported as a complete tear, and could land Mathis on the sidelines for 4 to 8 weeks.

Andre Ellington, RB of the Atlanta Cardinals, will be wearing a boot this week after his start Monday night. He has a slight tear in his peroneus longus (his what?!?). If he is still injured next week, expect a more detailed report on what the hell a peroneus longus is.

Shaun HIll, St. Louis Rams 2nd QB since Sam Bradford’s preseason injury, is likely to sit this week after experiencing a strained quad in the season opener. It’s not looking good for the Rams offense.

Cleveland Browns punter – suffered kick to face – full physical recovery expected, pride may be permanently damaged.

Toby Gearhart, Jacksonville Jaguars RB, suffered a bad ankle sprain against the Eagles. He will not be fully practicing early this week but will probably start in week 2. Whether he is a good fantasy start is questionable.

Jordan Cameron aggravated a shoulder injury, but has offered little detail about the injury thus far. The Browns picked up a TE today, and worked out back up Kellen Davis on Monday. Keep an eye on Cameron’s status this week as well.

NY Giants – injured self-confidence and self-respect. Inability to play anything close to what we call professional football may persist for weeks.

Til’ next Week – Dr. Dan