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Injury Thread

Later on Monday, as doctors prepared for surgery to repair the tibial plateau in Watt’s left leg, they told him they’d seen his sort of injury only in motorcycle wrecks. When he’d hit the turf, it set off a sort of explosion below his knee. Faced with the same sort of trauma, the typical professional athlete’s anterior cruciate ligament would have simply ruptured under the strain, doctors said. For someone of Watt’s fitness, that’s a six-month recovery process. But his ACL was too strong, they said, and the ligament refused to buckle, transferring the pressure throughout the knee, shattering the bone and cartilage. The great irony was that Watt’s maniacal devotion to strengthening his ACL—the single ligament that most often shortens careers—transformed what would have been a relatively routine injury into a uniquely devastating one.
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https://www.si.com/sportsperson/2017/12/05/si-sportsperson-of-the-year-jj-watt-houston-texans


Explosion doesn't sound good.
 
TejasTom said:
https://www.si.com/sportsperson/2017/12/05/si-sportsperson-of-the-year-jj-watt-houston-texans


Explosion doesn't sound good.
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Nice article, but have a couple of comments on statements made re. his injury.

Motorcycle (and auto accident) plateau fractures are high energy injuries (the type that I have operated on). Football plateau fractures are considered low energy injuries. The former are typically associated with much greater and complicated damage including ACL and other knee ligament ruptures. "Explosion" describes much more accurately what happens with the fractures of high energy types.

BTW, ligaments can't be strengthened to any real extent. They are non-contractile and pretty much avascular, so that means you can't strengthen them as you would muscles. Ligaments are solely protected from rupture by stability and balance of of the joints by the controlling muscles. That's why quad strength and balanced coordination between the quads and hamstrings is so important in maintaining the stability of the knee joint and preventing knee injuries. Keep in mind the ACL (BLUE in pic below) is only ~10mm in thickness/width.........not very hardy alone without the help of the aforementioned factors.

810px-Knee_diagram-de_ACL_PCL.svg.png
 
CloakNNNdagger said:
Nice article, but have a couple of comments on statements made re. his injury.

Motorcycle (and auto accident) plateau fractures are high energy injuries (the type that I have operated on). Football plateau fractures are considered low energy injuries. The former are typically associated with much greater and complicated damage including ACL and other knee ligament ruptures. "Explosion" describes much more accurately what happens with the fractures of high energy types.

BTW, ligaments can't be strengthened to any real extent. They are non-contractile and pretty much avascular, so that means you can't strengthen them as you would muscles. Ligaments are solely protected from rupture by stability and balance of of the joints by the controlling muscles. That's why quad strength and balanced coordination between the quads and hamstrings is so important in maintaining the stability of the knee joint and preventing knee injuries. Keep in mind the ACL (BLUE in pic below) is only ~10mm in thickness/width.........not very hardy alone without the help of the aforementioned factors.

810px-Knee_diagram-de_ACL_PCL.svg.png
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Man Doc, did you get this out of some German anatomy book? :D
 
Re. Watson:

Perki-Perk said:
It wasn't a "re-injury" It was a clean tear of the ACL in the opposite knee. He should come back without any issues.
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The 2014 study Performance and Return-to-Sport After ACL Reconstruction in NFL Quarterbacks published in ORTHOPEDICS followed 13 QBs with 14 knees that underwent ACL repair in years 1988-2013. Their findings showed that only 1 player did not return to play........and their performance was almost comparable to pre-injury level. Digging deeper into the study, things to keep in mind is that a pocket vs "running" ("mobile" , if it makes people feel better) QB was not specifically differentiated in this group. Other positions that rely on their feet such as WRs, DBs, TEs, LBs and RBs do not fare as well, demonstratiing in many studies a 20% or more decrease in performance. The other notable fact is the QBs in this study all had at least 2+ seasons of NFL experience........a factor that could very well influence return performance........and has been shown to do so in many studies looking at NFL injuries. At the same time, notable is that Draft round was not revealed, and could possibly have a positive effect on return performance, demonstrated in other NFL injury studies.
 
Sarah Barshop‏@sarahbarshop 2d2 days ago
J.J. Watt said he’ll be back for next season, but doesn’t know if he’ll be back on the field by OTAs. “I don’t know the answer to that one,” Watt said. “I’m just taking it one day at a time. That’s all I can do.”

Now, because of the type of incision that was utilized, that we know for sure that Watt underwent an open reduction internal fixation (ORIF) of his fracture, and not an arthroscopic assisted internal fixation (ARIF), we have some additional facts to suggest his rate of return and time of return.

According to a very recent systematic (multi-study) review of this subject...........Return to sport following tibial plateau fractures: A systematic review..........published in the July 2017 volume of The World Journal of Orthopedics............he return rate to sport for the total cohort of these fractures was 70%. For the conservatively-managed fractures (not requiring surgery), the return rate was 100%. For the surgically-managed fractures, the return rate was 70%. For fractures managed with ORIF, the return rate was 60%. For fractures managed with ARIF, the return rate was 83%. For fractures managed with FRAME (external fixation) was 52%. The recorded return time was 6.9 mo (median), from a study reporting on ORIF.
 
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From the Game thread right after the concussion play occurred:

CloakNNNdagger said:
Somebody missed an obvious concussion to Savage. Following his head bouncing off the ground, both of his arms went up in the air with his hands flexed and spastic muscular tentany.............classic "fencer's" pose for concussion. Our medical staff and neurologist need to be reviewed/re-evaluated carefully . The Concussion Protocol continues to be a joke.
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Our medical staff and the "independent neurologist" are both responsible for communicating with each other about a potential concussion occurring on the field.

From this most recent 2017 revision of the NFL Concussion Protocol (Note that the League must not have had enough "independent neurologists" be willing to participate in the coverage of all games..so they have now included non board-certified neurologists as well as a gaggle of non neurologists to take up the slack.):


[
Concussion Defined (Section IC)

For purposes of these protocols, the term concussion is defined as (adapted from McCrory et al. BJSM ‘17):

Sports related concussion (“SRC”) is a traumatic brain injury induced by biomechanical forces. Several common features that may be utilized in clinically defining the nature of a concussive head injury include the following:

  1. SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.
  2. SRC typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously [see photo of Savage in classic concussion posture]. However, in some cases, signs and symptoms evolve over a number of minutes to hours.
  3. SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
  4. SRC results in a range of clinical signs and symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive features typically follows a sequential course. However, in some cases symptoms may be prolonged.


Game Day Concussion Diagnosis and Management

Definitions/Responsible Parties

  • Unaffiliated Neurotrauma Consultant (“UNC”)
    During games, each team will be assigned an Unaffiliated Neurotrauma Consultant (“UNC”) by the NFL Head, Neck and Spine Committee and approved by the NFL Chief Medical Officer and the NFLPA Medical Director. Each UNC shall be a physician who is impartial and independent from any Club, is board certified or board eligible in neurology, neurological surgery, emergency medicine, physical medicine and rehabilitation, or any primary care CAQ sports medicine certified physician and has documented competence and experience in the treatment of acute head injuries (as evidenced by no less than monthly treatment of such patients). A UNC shall be present on each sideline during every game and shall be (i) focused on identifying symptoms of concussion and mechanisms of injury that warrant concussion evaluation, (ii) working in consultation with the Head Team Physician or designated TBI team physicians to implement the concussion evaluation and management protocol (including the Locker Room Comprehensive Concussion Assessment Exam) during the games, and (iii) present to observe (and collaborate when appropriate with the team physician) the Sideline Concussion Assessment Exams performed by club medical staff. These unaffiliated consultants also will be available to assist in transportation to an appropriate facility for more advanced evaluation and/or treatment as needed based on the EAP. These consulting physicians will work with the team’s medical staff and will assist in the diagnosis and care of the concussed player. The team physician/UNC unit will be co-located for all concussion evaluations and management both on and off the field. [1] The UNC may present his/her own questions or conduct additional testing and shall assist in the diagnosis and treatment of concussions. Regardless, the responsibility for the diagnosis of concussion and the decision to return a player to a game remains exclusively within the professional judgment of the Head Team Physician or the team physician assigned to managing TBI. The UNC will also be present for sideline evaluations for neuropraxia (“stingers” or “burners”) and other potential neck injuries.
  • Booth Certified Athletic Trainer Spotter (“Booth ATC Spotters”)
    Two certified athletic trainers will be assigned to a stadium booth with access to multiple views of video and replay to aid in the recognition of injury (“Booth ATC Spotters”). Booth ATC Spotters will follow the NFL Concussion Protocol and are charged with monitoring the game, both live and via video feed, to identify players that may require additional medical evaluation. Prior to the start of the game, Booth ATC Spotters will introduce themselves to the medical staff for both teams to discuss protocol and confirm that all communication devices are operational. The Booth ATC Spotters, UNC and the team physician shall be connected by radio communication. The Booth ATC Spotters shall also be connected to the on-field game officials by radio communication. The teams’ medical personnel may initiate communication with the spotter to clarify the manner of injury. The sideline medical staff will be able to review the game film on the sidelines to obtain information on particular plays involving possible injury. When the Booth ATC Spotter observes a player who is clearly unstable, or displays any other Potential Concussion Signs (defined in Section I.C. above) following a mechanism of injury (e.g., a hit to the head or neck), he/she will contact the team physician and UNC by radio to ensure that a concussion evaluation is undertaken on the sideline. The club medical staff will then verify to the Booth ATC Spotter that the evaluation has been performed. The Booth ATC Spotter shall note the time of his initial contact with the club medical staff and UNC alerting them of the need for further evaluation and also the time of the communication from the club medical staff and UNC confirming that an evaluation has been performed. This information is to be conveyed in the Booth ATC Spotter’s report following the game. If the Booth ATC Spotter observes a player who he has flagged for medical evaluation return to the game prior to receiving the confirmation from the team’s medical staff that an evaluation was conducted, the Booth ATC Spotter shall call a medical time out (see below). For purposes of clarity, this is intended to serve as a redundant communication from the Booth ATC Spotter with the team physician or UNC to confirm that a concussion evaluation has been performed. If no such confirmation is provided, the Booth ATC Spotter is required to call a medical timeout to assure the concussion evaluation occurs. Booth ATC Spotters shall file a report of their activity following each game for review by the NFL Chief Medical Officer and NFLPA Medical Director.
i-wHW7jwj.jpg
 
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The fencing posturing secondary to concussion (injury to the brain stem) demonstrated by Savage will be so strong as to occur whether the player is facing up or facing down.


A trained medical staff has to knowingly ignore this sign to "miss" a concussion. And this sign alone is enough to immediately pull a player..........and not allow him to return.......no matter what the sideline testing revealed.
 
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amazing80 said:
Why so many concussions for our team this season? Did the changes to the field make this drastic of a change?
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Shock absorbance has shown to be close to natural grass with the 3rd and 4th generation turfs. The main factor in the turf fields is the efficiency of the
"shock pads" placed beneath the turf. These pads are sold to high school, colleges and NFL. No matter how good this system of shock pads is, most experts feel that a one size fits all doesn't work well in that NFL players are so much heavier than high school or college players. Furthermore, many experts feel that in the NFL these shock pads need to be changed every season, something that apparently seldom occurs.

short SHOCK PAD VIDEO
 
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CloakNNNdagger said:
Shock absorbance has shown to be close to natural grass with the 3rd and 4th generation turfs. The main factor in the turf fields is the efficiency of the
"shock pads" placed beneath the turf. These pads are sold to high school, colleges and NFL. No matter how good this system of shock pads is, most experts feel that a one size fits all doesn't work well in that NFL players are so much heavier that high school or college players. Furthermore, many experts feel that in the NFL these shock pads need to be changed every season, something that apparently seldom occurs.

short SHOCK PAD VIDEO
Click to expand...

http://www.hellasconstruction.com/Products/Turf/

That’s the system we use. Looks like a rubber mat on gravel with rubber chips filling the void of the field. Sounds terrible
 
How is the NFL concussion protocol supposed to work?
9:27 AM CT

  • Kevin Seifert NFL Nation

The NFL's concussion protocol, authored and administered jointly with the NFL Players Association, has come under fire in 2017. The most recent criticism came this week, when Houston Texans quarterback Tom Savage returned to Sunday's game against the San Francisco 49ers after suffering a hit to the head so severe that he displayed apparent signs of what's known as the "fencing response," a classic indication of a brain injury that includes twitching hands.

Known formally as the "Game Day Concussion Diagnosis and Management Protocol," the policy in theory should prevent such health-threatening returns to play. That hasn't always been the case this season, as Savage is one of a handful of players who have remained in a game after a hit that was later identified to have caused a concussion.

Here's how the protocol is supposed to work:

Wait ... can we further clarify 'fencing response'?

Yes. Sometimes a concussion can induce the victim's arms to lock in an odd position, similar to a competing fencer: one arm at the side and the other extended outward. In Savage's case, both arms were extended. Regardless, it is considered a clear indication of brain trauma.

OK, thanks. So let's start from the beginning. How does the policy work on game day?

It begins with the positioning of four independent and dedicated medical professionals. Two certified athletic trainers (ATCs) sit in a booth above field level, acting as "spotters" equipped with video playback gear and a dedicated radio connection with the sidelines. Each team is also assigned an unaffiliated neurological consultant (UNC), who works alongside the team doctor.

'Unaffiliated'?

Yes. The point is to include a medical specialist who doesn't have a stake in the outcome of the game.

Does the NFL have video equipment on the sideline as well?

Yes. Because sideline views can be blocked, each UNC has access to video replays. According to the policy, they can "review the game film on the sidelines to obtain information on particular plays involving possible injury." This equipment is reserved for the medical staff, because football employees are barred from seeing replays on the sideline.

Who is responsible for initiating the process?

Players are encouraged to self-report, and the team doctor has ultimate responsibility for care. But the ATC spotters in the booth have the authority to call a medical timeout if they identify a player with symptoms. The referee also is asked to send players to the sideline if they see a player displaying symptoms. REST OF THE STORY

************************

Simply, for those saying that O'Brien should have seen his QB respond as concussed by video sideline film review, O'Brien as a coach does not have access to review sideline video film.
 
Something that I decided to look into because of my own personal observations.

There seems to be mounting evidence that player concussions are accompanied by significant increased risk to subsequently incurring musculo-skeletal injuries, especially lower extremity injuries. The medical literature has identified dynamic postural control deficits along with increased motor evoked potential latency (slow down of nerve responses) and decreased amplitude of nerve conduction) after concussion, suggesting that the brain may be unable to effectively coordinate movement.

A European study of 46 male elite football (soccer) teams in 10 European countries in the 2001/2002–2011/20122 seasons was published in the British Journal of Sports Medicine in July 2014. During the follow-up period, 66 players sustained concussions and 1599 players sustained other injuries. Compared with the risk following other injuries, concussion was associated with a progressively increased risk of a subsequent injury in the first year (0 to <3 months......1.56 times risk; 3 to <6 months.........2.78 times risk; 6–12 months, 4.07 times risk).

In Dec 2015, a study published in the Journal of Medical Scientific Sports Exercise, investigated collegiate athlete acute lower extremity musculoskeletal injury rates before and after concussion in athletes with concussion and their matched control. Nonconcussed college athletes were matched to individuals with concussion. Acute lower extremity musculoskeletal injury data were collected for 2 yr (±1 yr of the diagnosed concussion) using electronic medical records. Control participants' 2-yr window for exposure and musculoskeletal injury data were anchored to their match's concussion injury date. Pre- and postconcussion musculoskeletal injury rates were calculated for 90-, 180-, and 365-day periods for both study cohorts. Risk ratios were calculated to determine differences within and between groups for all periods. Within 1 yr after concussion, the group with concussion was 1.97 times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than before concussion and 1.64 times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than their matched nonconcussed cohort over the same period. Up to 180 d after concussion, the group with concussion was 2.02 times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than before concussion.

Next, a recent study published May 2017 in The Journal of Sports Medic`ine, collected injury data from 2006 to 2013 for men’s American football and for women’s basketball, soccer and lacrosse at a National Collegiate Athletic Association Division I university. Ninety cases of in-season concussion in 73 athletes (52 male, 21 female) with return to play at least 30 days prior to the end of the season were identified. A period of up to 90 days of in-season competition following return to play was reviewed for time-loss injury. The same period was studied in up to two control athletes who had no concussion within the prior year and were matched for sport, starting status and position. Lower extremity musculoskeletal injuries occurred at a higher rate in the concussed athletes (50 %) than in the non-concussed athletes (20 %). The odds of sustaining a musculoskeletal injury were 3.39 times higher in the concussed athletes.

All of these post concussion injury numbers are consistent with something neurological affecting the longer-term coordination of the concussed player leading to subsequent injuries.
 
CloakNNNdagger said:
Something that I decided to look into because of my own personal observations.

There seems to be mounting evidence that player concussions are accompanied by significant increased risk to subsequently incurring musculo-skeletal injuries, especially lower extremity injuries. The medical literature has identified dynamic postural control deficits along with increased motor evoked potential latency (slow down of nerve responses) and decreased amplitude of nerve conduction) after concussion, suggesting that the brain may be unable to effectively coordinate movement.

A European study of 46 male elite football (soccer) teams in 10 European countries in the 2001/2002–2011/20122 seasons was published in the British Journal of Sports Medicine in July 2014. During the follow-up period, 66 players sustained concussions and 1599 players sustained other injuries. Compared with the risk following other injuries, concussion was associated with a progressively increased risk of a subsequent injury in the first year (0 to <3 months......1.56 times risk; 3 to <6 months.........2.78 times risk; 6–12 months, 4.07 times risk).

In Dec 2015, a study published in the Journal of Medical Scientific Sports Exercise, investigated collegiate athlete acute lower extremity musculoskeletal injury rates before and after concussion in athletes with concussion and their matched control. Nonconcussed college athletes were matched to individuals with concussion. Acute lower extremity musculoskeletal injury data were collected for 2 yr (±1 yr of the diagnosed concussion) using electronic medical records. Control participants' 2-yr window for exposure and musculoskeletal injury data were anchored to their match's concussion injury date. Pre- and postconcussion musculoskeletal injury rates were calculated for 90-, 180-, and 365-day periods for both study cohorts. Risk ratios were calculated to determine differences within and between groups for all periods. Within 1 yr after concussion, the group with concussion was 1.97 times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than before concussion and 1.64 times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than their matched nonconcussed cohort over the same period. Up to 180 d after concussion, the group with concussion was 2.02 times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than before concussion.

Next, a recent study published May 2017 in The Journal of Sports Medic`ine, collected injury data from 2006 to 2013 for men’s American football and for women’s basketball, soccer and lacrosse at a National Collegiate Athletic Association Division I university. Ninety cases of in-season concussion in 73 athletes (52 male, 21 female) with return to play at least 30 days prior to the end of the season were identified. A period of up to 90 days of in-season competition following return to play was reviewed for time-loss injury. The same period was studied in up to two control athletes who had no concussion within the prior year and were matched for sport, starting status and position. Lower extremity musculoskeletal injuries occurred at a higher rate in the concussed athletes (50 %) than in the non-concussed athletes (20 %). The odds of sustaining a musculoskeletal injury were 3.39 times higher in the concussed athletes.

All of these post concussion injury numbers are consistent with something neurological affecting the longer-term coordination of the concussed player leading to subsequent injuries.
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Good lord, that is disheartening.

Is the term "motor evoked potential" the same as "action potential," meaning the signal that travels down the axon? (I remember the most random stuff from college biology).

I'm imagining it's similar to when I pinch my sciatic nerve, then a couple of days later I stumble because my toe slightly drags the ground as if the nerve didn't properly transfer the signal. Even though the root cause is downstream from the brain, it sounds like the same type of nerve impedance is involved.
 
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Brisco_County said:
Good lord, that is disheartening.

Is the term "motor evoked potential" the same as "action potential," meaning the signal that travels down the axon? (I remember the most random stuff from college biology).

I'm imagining it's similar to when I pinch my sciatic nerve, then a couple of days later I stumble because my toe slightly drags the ground as if the nerve didn't properly transfer the signal. Even though the root cause is downstream from the brain, it sounds like the same type of nerve impedance is involved.
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College biology served you well. That simplictically is essentially the same
 
I get the humor expressed but it's is difficult for me to laugh when I see Savage seizing. I've been around many people seizing most due to epilepsy but others from drug/alcohol abuse and others from damage to the brain often by others or vehicle wreckage. At none did I laugh. Again I get it just don't want to join in.
 
It's been reported that Hopkins has sustained a "sand toe injury." This is an unusual injury. A turf toe, not an uncommon sports injury is a hyperextension injury of the first toe. During forced dorsiflexion, the volar (underside) capsule of the first metatarsal phalangeal joint is stretched and strained/torn.

02_08_2017_OrthoticInterventionforTurfToeInjuries.jpg


A sand toe injury involves the opposite motion of the big toe. With either acute or chronic forced hyperflexion, the dorsal (topside) joint capsule is damaged. The toe is rolled under the foot during the injury with the full weight of the body, spraining/tearing the ligamentous joint capsule. This injury is not uncommonly associated with small metatarsal or phalangeal fractures.

PT0813Haddon1.png


Even Grade I or II tears of the dorsal capsule require several weeks of rest. Walking, let alone running or jumping are very painful. Likely he has been shot up quite well, but doubt we will see him doing much jumping for balls or toe tapping. Grade II may take several months.
 
CloakNNNdagger said:
It's been reported that Hopkins has sustained a "sand toe injury." This is an unusual injury. A turf toe, not an uncommon sports injury is a hyperextension injury of the first toe. During forced dorsiflexion, the volar (underside) capsule of the first metatarsal phalangeal joint is stretched and strained/torn.

02_08_2017_OrthoticInterventionforTurfToeInjuries.jpg


A sand toe injury involves the opposite motion of the big toe. With either acute or chronic forced hyperflexion, the dorsal (topside) joint capsule is damaged. The toe is rolled under the foot during the injury with the full weight of the body, spraining/tearing the ligamentous joint capsule. This injury is not uncommonly associated with small metatarsal or phalangeal fractures.

PT0813Haddon1.png


Even Grade I or II tears of the dorsal capsule require several weeks of rest. Walking, let alone running or jumping are very painful. Likely he has been shot up quite well, but doubt we will see him doing much jumping for balls or toe tapping. Grade II may take several months.
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IR him and give him the rest and treatment he needs.
 
It looked to me that Nick Martin's left ankle was both bent and twisted.............likely sustained another grade III high ankle sprain. He played through a good part of his college senior year with a high ankle sprain, then a grade III high ankle sprain that cost him the entire 2016 season, and early Sept this year suffered another ankle sprain which has limited his ability to hold back strong DL, and now..........

Although he has not been listed as a "knee" on the Injury Reports, he is wearing a left knee brace. He is not wearing one on the opposite knee, therefore you can pretty well deduce that it is not strictly "prophylactic" for an uninjured knee..........it is probably worn to protect an already injured MCL..............a perfect scenario for a compensatory injury (in fact, his knee is probably compensatory to the earlier season ankle injury).
 
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CloakNNNdagger said:
It looked to me that Nick Martin's ankle was both bent and twisted.............likely sustained another grade III high ankle sprain. He played through a good part of his college senior year with a high ankle sprain, then a grade III high ankle sprain that cost him the entire 2016 season, and early Sept this year suffered another ankle sprain which has limited his ability to hold back strong DL, and now..........
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And the hits just keep on a coming. The Texans should seriously consider playing 2nd and 3rd stringers the last two weeks.
 
Didn't watch the game, again, but this morning read about Martin's injury. It's described as a "cause for concern" and "pretty serious injury". It just keeps coming. Going to be hard to rebuild our line from the trash heap.

The Chronicle is also reporting Allen went out with a concussion. It just keeps coming.
 
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Still no update re. Martin, but I suspect it is a similar injury that previously ended his rookie season........Grade III high ankle sprain with associated fibula fracture.
 
CloakNNNdagger said:
Still no update re. Martin, but I suspect it is a similar injury that previously ended his rookie season........Grade III high ankle sprain with associated fibula fracture.
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Does the durability of the ligament degrade with each rupture? He seems to suffer these at an abnormal rate.
 
Brisco_County said:
Does the durability of the ligament degrade with each rupture? He seems to suffer these at an abnormal rate.
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For anyone who has ever had a significant ankle ligament sprain/tear knows that this commonly turns into a chronic recurrent problem whether in the form of pain, weakness or instability, or affect on associated structures. When ankle injuries are suffered in a sports setting,sSubsequent complementary injuries are always high risk. Unlike the knee joint, where large muscle groups (quads/hams) can be built up to improve joint stability, the ankle does not really have similar surround significant muscle groups that can be further developed to protect this joint.
 
CloakNNNdagger said:
For anyone who has ever had a significant ankle ligament sprain/tear knows that this commonly turns into a chronic recurrent problem whether in the form of pain, weakness or instability, or affect on associated structures. When ankle injuries are suffered in a sports setting,sSubsequent complementary injuries are always high risk. Unlike the knee joint, where large muscle groups (quads/hams) can be built up to improve joint stability, the ankle does not really have similar surround significant muscle groups that can be further developed to protect this joint.
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So even Brian Cushing does not know how to beef up the ankles?
 
PapaL said:
Doc - Not Texans related but any thoughts on Rockets CP3 latest injury? Being reported as "sore adductor muscle". Thanks!

http://www.chron.com/sports/rockets...l-s-leg-issue-against-Lakers-not-12446265.php


(Didn't want to make in the basketball forum as only a few of us frequent it; I apologize ahead of time)
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Paul's "adductor injury" has not been identified as muscular or tendinous. Either could be part of a developing or established "sports hernia." He has sustained at least 4 significant hamstring tears on each side since 2011 with loss of quite a few games along the way.........the more recent tear counts favoring the left side (the very most recent Dec 2016 lingering into the beginning of 2017...........the same side he suffered a significant knee bone bruise in early Oct this year..........the same side of his recent adductor injury..............and the same side for which Paul had undergone a lateral meniscus (the most common mensicus injury in basketball, as opposed to the medial meniscus, the most common footbal injury) repair in 2010 by Dr. James Andrews. You have to accept the fact that these injuries are feeding off of each other as a vicious circle of cascading compensatory injuries.
 
CloakNNNdagger said:
Paul's "adductor injury" has not been identified as muscular or tendinous. Either could be part of a developing or established "sports hernia." He has sustained at least 4 significant hamstring tears on each side since 2011 with loss of quite a few games along the way.........the more recent tear counts favoring the left side (the very most recent Dec 2016 lingering into the beginning of 2017...........the same side he suffered a significant knee bone bruise in early Oct this year..........the same side of his recent adductor injury..............and the same side for which Paul had undergone a lateral meniscus (the most common mensicus injury in basketball, as opposed to the medial meniscus, the most common footbal injury) repair in 2010 by Dr. James Andrews. You have to accept the fact that these injuries are feeding off of each other as a vicious circle of cascading compensatory injuries.
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Would rest help any or in your opinion this is just the nature of the beast? Older players will have more wear and tear on them especially as the season continues.
Thanks for the insight. Learning a little every day.
 
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