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OFFSEASON INJURY UPDATES

It's funny how after the season is over, OB reveals that Ben Jones has been trying to play through an MCL and a bad back............neither has appeared on the Injury Reports.
 
Teams will game the system, as best they can, within the rules. I don't blame them at all. I blame the process. If teams had to report every injury a player endures, rather than the one most likely to keep a player from playing on game day, things would be different. I seriously doubt that the average fan and/or the media is ready for a full injury report.
I'm just thankful that my team has a Doctor that keeps us abreast of the situations, tempers our expectations and generally expands our knowledge of injuries and the healing process.
 
For those that are interested in the NFL INJURY REPORT POLICY, you can review the entire policy found in the link I supplied below.


Personnel (Injury) Report Policy

It is NFL policy that information on all injured players be supplied by clubs to the league office, the opposing team and local media each game week of the regular season and postseason(including for the two Super Bowl teams the week between the Championship Games and the Super Bowl). The information must be credible, accurate, and specific within the guidelines of the policy.

All players with significant or noteworthy injuries must be listed on the report, even if the player takes all the reps in practice, and even if the team is certain that he will play in the upcoming game. This is especially true of key players and those players whose injuries have been
covered extensively by the media.


This policy is of paramount importance in maintaining the integrity of the game.
LINK
 
From May 2, 2015:
Our first 3 picks have basically free of significant injury history. Unfortunately, I cannot say the same for Clett. During the 2013 season, he repeatedly dislocated his shoulder playing through it. December 2014, he underwent shoulder surgery. On October 2014, despite the surgical repair, he suffered a redislocation of his shoulder. Again, he continued to play through it and continued rehab thereafter in order to avoid further surgery.

My concern is that surgical failure (redislocation) for such shoulder surgery is 1-5 %, which he has already experienced may not be the end of the story. As with any shoulder dislocations, redislocations become more likely. Non operative treatment (conservative rehab alone) of a dislocated shoulder carries a high redislocation rate (especially in a young LB which would repeatedly exposed to shoulder trauma), some studies as high as 50% within 2 years. His next redislocation will likely meet the criteria for shoulder revision surgery.

Evidently, Reshard Cliett also dislocated his shoulder once again. Besides the ACL repair, he also underwent another shoulder surgery after going on IR. His recovery has been uneventful, and he should be ready by TC.

After torn ACL, shoulder surgery, Texans linebacker Reshard Cliett on the mend
 
Any update on Quessenberry?
Would not expect any until OTAs. Will likely end up continuing to courtesy work out with the team, attending meetings and training to return to the the field like last year.........and if so, it will still be an up hill battle to make it to or certainly through TC. His risks will also be determined by if his maintenance chemo will be discontinued as previously reported after 2 years, or extended to 3 years as followed by many centers. In the back of my mind, I am actually hoping that he chooses to purse another life's goal that avoids ongoing trauma to his body.
 
I'm kind of ok with them not releasing all the injury information as I wouldn't want someone to know I'm injured and use that to put me out of position in a game. We all know the injury report is for odd makers.
 
Any news on Kevin Johnson? At the end of the season he was playing with a broken hand that was going to require surgery.
 
Or the ring of recurrent groin injuries.

Going forward, I won't be expecting Watt to be the player who never misses a game.
What's interesting is that I went back into the past Injury Reports I keep record of and found that Watt could be found listed as far back as 2013 with "groin.
 
Any news on Kevin Johnson? At the end of the season he was playing with a broken hand that was going to require surgery.

Although his injury was reported as a fractured hand, specifically it was a left wrist bone fracture. And the most common wrist bone fractured in football is the scaphoid (sometimes referred to as the navicular) bone............the same fractured bone that Cushing played with the end of 2014 and went on to undergo as one of his surgeries after the season was completed.
that I wrote re. Cushing's injury should act as a good review for you.

For those interested, this post and some posts following it that I wrote re. Cushing's injury should act as a good review for you.
 
Although his injury was reported as a fractured hand, specifically it was a left wrist bone fracture. And the most common wrist bone fractured in football is the scaphoid (sometimes referred to as the navicular) bone............the same fractured bone that Cushing played with the end of 2014 and went on to undergo as one of his surgeries after the season was completed.
that I wrote re. Cushing's injury should act as a good review for you.

For those interested, this post and some posts following it that I wrote re. Cushing's injury should act as a good review for you.
Doc, was Johnson's injury same/similar to Hopkins this past off season? He seemed to have recovered well
 
Doc, was Johnson's injury same/similar to Hopkins this past off season? He seemed to have recovered well
As I stated before.........it was like Cushing's.

Hopkins was not a fracture of the scaphoid bone........it was a rupture of the scapholunate ligament that attaches the scaphoid and lunate bones of the wrist.

handout-sllig-12.jpg


From Feb 21, 2015 re. Hopkins injury:

The thumb spica is certainly consistent with a scaphoid fracture. If it were a tendon injury of the hand across the wrist, you would expect his entire thumb (including the distal joint) and/or MCP joints (fist knuckles) of the other digits to be immobilized. If anything, he might have a concommitant ligament injury at the scaphoid bone. The only unlikely tendon I can think of that would require a modified thumb spica cast would be the extensor pollicus (thumb) brevis.....and that wouldn't require a full hand cast pattern......just the thumb side of the wrist.

Hopkins, if anyone remembers was on the Injury Report of Dec 26, and limited in practice that week, with a wrist injury.

Then this was posted:


And my response to the reported link"

This link, if accurate, states that it is a "wrist ligament injury."

The above ligament I was referring to above (the SCAPHOLUNATE ligament) is the most commonly injured wrist ligament.

When the ligament is repaired surgically, stabilization is usually affected with multiple pins or a single screw. Depending upon circumstances, these pieces of hardware will be removed at varieable times.........the pins usually ~ 6-8 weeks (a cast will continue to immobilize the wrist until 12 weeks).......the single screw anywhere from 4-6 months, depending if there are any significant associated injuries. Theoretically, return could be a little earlier, if the player continues to be cast stabilized a longer period of time........however, in the case of WR, this would not be practical. Barring complication, most of these injuries require at least 4-5 months to gain optimal range of motion and strength, a significant number of patients may not ultimately be able to regain more than 75% of either.
 
Doc, was Johnson's injury same/similar to Hopkins this past off season? He seemed to have recovered well
This is the post I made re. Cushing's injury.........the one like Hopkin's:

To preface my post, keep in mind that I am using the limited information we are given about Cushing's wrist surgery and applying logic to reconstruct a scenario that in my mind is likely.

Sounds like Cushing may have been dealing with an unrecognized scaphoid (also sometimes referred to as "navicular") bone fracture that never quite healed (arrow in figure below points to fracture of the scaphoid bone).

images



Scaphoid fractures account for 2-7% of all orthopedic fractures, and they are the most common of all carpal (wrist)bone fractures. Symptoms of a "nonunion" of the scaphoid bone can be quite subtle. You may have pain when you use your wrist. However, the pain may be very minimal. It is isn't uncommon for "real world" doctors to see a nonunion of the scaphoid bone on X-rays, but the patient can't remember an injury. These patients usually suffered a wrist injury months or even years ago that they were told was a simple sprain. If x-rays are not taken at the time and then repeated 10-14 days later to account for resobtion of bone to identify a fracture, it can easily be missed. The MRI is the "gold standard" for picking up scaphoid fractures that are not defined on plain x-rays of the wrist. Still, the most common symptom of a nonunion is a gradual increase in pain. Over several years the nonunion can lead to degenerative arthritis in the wrist joint, accompanied by loss of grip strength. Scaphoid fractures are the most commonly undiagnosed fracture.......at least in the "real world." However, with MRI's so readily accessible to NFL teams and their players, overlooking this diagnosis may be considered less defensible.

As to why Cushing would have been initially told that his wrist would be in a cast for 4 weeks, then the time period extended to 8 weeks? Well, certainly not simply because they just wanted to keep him from pushing things too early. Keep in mind that the longer a joint is immobilized, the more difficult the rehab, the more atrophy of muscles, and the more possibility of loss of range of motion. No, this change of events could be more readily explained by the fact that going into the surgery, his surgeon believed that the fracture could be repaired with a simple screw......which would require only 3-4 weeks cast immobilization. Once being able to thoroughly assess the injury DURING surgery, a change of approach may have been indicated.

If there was no evidence that wrist arthritis was developing, a decision could likely have been made to get the scaphoid to best stabilize the fracture site and affect more reliable healing by using a bone graft in addition to a metal screw. Traditionally, the bone graft will be taken from the iliac crest (the rim of the hip bone) or the radius (one of the forearm bones, depicted in the figure below). Approximately 85% of scaphoid non union cases will heal with this treatment.


Image20744_opt.jpeg



After this type of surgery, a plaster cast is worn for............. ~8 weeks.

Actual bone healing and cast immobilization, if it does occurs at all, depends on the location of the fracture line of the bone..............distal 1/3 fracture>6-8 weeks; middle 1/3 fracture>8 to 12 weeks; proximal 1/3 fracture>12 to 24 week. Players can play with the cast in place by 4-6 weeks..............but this is totally impractical for a receiver. So this is a potential time table for his upcoming offseason participation.
 
Kevin Johnson's wrist surgery will not occur for another 2-3 weeks. But that "foot" injury for which he was listed on the Injury Report for the last 3 weeks turns out to be a Jones fracture (5th metatarsal).......similar to the stress fracture that James played with until it completed the fracture. He's traveled to Charlotte, where he will undergo surgery to repair it today.
 
Kevin Johnson's wrist surgery will not occur for another 2-3 weeks. But that "foot" injury for which he was listed on the Injury Report for the last 3 weeks turns out to be a Jones fracture (5th metatarsal).......similar to the stress fracture that James played with until it completed the fracture. He's traveled to Charlotte, where he will undergo surgery to repair it today.
It's going to be a rough offseason for that young man.
 
agreed but at least he doesn't have to worry about his roster spot while recovering and that is big.
 
Kevin Johnson I expect to break out in his 3rd season, much like Kareem did and at a time that would mesh well with any decision to move on from JJo. Hope he focuses on his recovery this offseason rather than pushing too hard for field time too early.

JJ Watt's recurring groin injury, I tore the right side of my groin playing soccer at the age of 15, the thing will still go pop without warning once or twice a year 13 years later, its the kind of pain that you can try to push through at first and usually leads to much worse pain down the line if i do try to work through it.

I'd hope that the millions spent on the Texans medical and S&C department would help to fix him up a bit better than the few quid I manage to scrape together for a physio session once every couple of years or so but who knows.
 

Texans rookie cornerback Kevin Johnson’s foot surgery was successful, according to a source not authorized to speak publicly.

The prognosis for offseason practices and a full recovery is positive, per the source.

Johnson underwent surgery to repair a stress fracture in his fifth metatarsal of his foot, which is known as a Jones fracture. Dr. Robert Anderson, the Carolina Panthers’ team doctor and a foot and ankle specialist, performed the procedure.

The injury was diagnosed with a month left in the season, and Johnson played through the pain.

Johnson isn’t done with surgical procedures. He’ll have wrist surgery in two to three weeks for a broken left wrist sustained late in the season that forced him out of the Texans’ 30-0 playoff loss to the Kansas City Chiefs.
link

 
Concerning Clowney, I was asked what a midfoot ligament sprain really is. Well to keep it very simple, it is essentially a term used when a ligament anywhere across the Lisfranc joint complex (see the first figure below) is usually only partially torn, and with no associated adjacent fracture. The term Lisfranc complex ligament injury and midfoot sprain has sometimes been used interchangeably with the classic Lisfranc Injury, but this classic injury is more correctly specific to one ligament (see the second figure below).......an injury in a football player that usually requires surgery to assure stability (although there are more atypical cases that are partial tears without displacement and without instability that have been treated over long periods of months to see if the joint "holds"........and if it doesn't surgery and its additive long rehab is then embarked upon, Midfoot sprains, on the other hand, are commonly treated nonsurgically. However, if instability is present or subsequently ensues, surgery is indicated. A Grade I midfoot sprain can usually keep a player off the field a couple of weeks. A Grade II is less predictable and can typically take anywhere from 4 weeks to 12 weeks. Grade III nonsurgically treated may take even much longer.

With Clowney, we don't know exactly at what position in the complex a ligament was torn. It could be a partial tear of the classic Lisfranc Ligament...........and no one at the Texans would want to use that term, even if it were a grade I......it would scare the heck out of the fan base. But even it were one of the other ligaments in the complex, there was no way Clowney after less than 2 weeks from the injury should have been playing in the playoff game........he was certainly not dogging it.


A00162F01.jpg


31.jpg
 
Concerning Clowney, I was asked what a midfoot ligament sprain really is. Well to keep it very simple, it is essentially a term used when a ligament anywhere across the Lisfranc joint complex (see the first figure below) is usually only partially torn, and with no associated adjacent fracture. The term Lisfranc complex ligament injury and midfoot sprain has sometimes been used interchangeably with the classic Lisfranc Injury, but this classic injury is more correctly specific to one ligament (see the second figure below).......an injury in a football player that usually requires surgery to assure stability (although there are more atypical cases that are partial tears without displacement and without instability that have been treated over long periods of months to see if the joint "holds"........and if it doesn't surgery and its additive long rehab is then embarked upon, Midfoot sprains, on the other hand, are commonly treated nonsurgically. However, if instability is present or subsequently ensues, surgery is indicated. A Grade I midfoot sprain can usually keep a player off the field a couple of weeks. A Grade II is less predictable and can typically take anywhere from 4 weeks to 12 weeks. Grade III nonsurgically treated may take even much longer.

With Clowney, we don't know exactly at what position in the complex a ligament was torn. It could be a partial tear of the classic Lisfranc Ligament...........and no one at the Texans would want to use that term, even if it were a grade I......it would scare the heck out of the fan base. But even it were one of the other ligaments in the complex, there was no way Clowney after less than 2 weeks from the injury should have been playing in the playoff game........he was certainly not dogging it.


A00162F01.jpg


31.jpg
Good grief! This guy is a walking "career threatening injury" machine. Or would that be a limping one? After Schaub, I cringe and run away any time I see or read Lisfranc injury.
:firehair::firehair::firehair:
 
Others now playing NFL with similar lymphatic cancer give me hope Q can return. I was so optimistic he could be an answer to OT when he was drafted. Of course, I am glad he is in recovery. Keeping him on roster and with insurance was good of McNair.
 
MOBILE, Ala. — Texans star defensive end J.J. Watt is diligently rehabbing after undergoing successful sports hernia surgery in early January.

Texans coach Bill O’Brien was noncommittal on exactly when the Pro Bowl pass rusher will return this offseason after having surgery in Philadelphia with Dr. William Meyers operating on him, but the reigning NFL Defensive Player of the Year is expected to make a full recovery in time for next season. Watt led the NFL with 17 1/2 sacks, 29 tackles for losses and 50 quarterback hits last season despite playing with the groin injury and a broken left hand.

[A somewhat strange statement. Sports hernia repair is usually a 6-8 week recovery, although more like a 10-12 week back to form. There is no reason that he should not be able to participate right after the Draft.......or his injury/surgery has involved something more extensive than what has been reported.]


“We’ve spoken a few times,” O’Brien said Wednesday at the Senior Bowl all-star game. I don’t think it’s easy anytime you go through the injury he had and the operation he had. He’s recovering and it’s going to take a while.

“He’ll be back. Nothing’s going to hold J.J. Watt back. He’s a great player. So, he’s in rehab mode right now. I think we have to play it by ear. He’s working hard to get back.”

O’Brien said that Texans outside linebacker Jadeveon Clowney’s foot is feeling better after being sidelined for the final game of the regular season and a playoff loss to the Kansas City Chiefs.

[Only "feeling better" at this point in time confirms that Clowney did not suffer only a "minor" Grade I ligament tear. It had to be at least a Grade II or a Grade III tear. If he is not back right after the Draft, he has likely suffered a Grade III tear.......and surgery is an outside possibility if joint stability is not maintained once he tests the foot out in drills/practice.]

Meanwhile, Texans rookie cornerback Kevin Johnson is recovering from surgery to repair a Jones fracture in his foot. Dr. Robert Anderson, a foot and ankle specialist and the Carolina Panthers’ team doctor, performed the procedure in Charlotte, N.C. Johnson played through the pain of the injury for the final month of the regular season. Johnson is also going to undergo surgery to repair a broken left wrist.

[If both injuries heal without problems with non-union of the bones (or in the case of the Jones fracture, a breaking of the screw hardware), he should be able to begin practice ~ 3 months following his wrist surgery (which will not be performed until mid February).]

“He’s mature beyond his years,” O’Brien said of Johnson, the Texans’ first-round draft pick who recorded 54 tackles, one interception and nine passes defended. “He came in here didn’t hit the rookie wall, came in here and worked really hard to get better and better every week, practiced hard and played through the injury. I think he’s got a really good future in this league.”[/QUOTE]link
 
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Good grief! This guy is a walking "career threatening injury" machine. Or would that be a limping one? After Schaub, I cringe and run away any time I see or read Lisfranc injury.
:firehair::firehair::firehair:
Gotta agree here. I'm not sure if he's "injury prone" or just plain snake-bit. Whatever the reason(s), the Texans ROI on that #1 pick is awfully low.
 
Texans Arian Foster Cleared For Light Jogging

Patrick Starr
9:22 AM

Arian Foster has been cleared by his doctor to start jogging after tearing his Achilles against the Miami Dolphins in a blowout loss on October 25th.

Foster has been rehabbing his injury and came out of his boot almost a month ago, now with Foster set to start jogging, his track to be back on the field for training camp is on schedule.

There have been plenty of rumors concerning Foster's future with the Texans but the 7-year veteran is planning on playing in 2016.

Hot stock tip!.........if Foster stock shares come up for a new offering........seriously consider passing if you didn't the first time around.
 
Good grief! This guy is a walking "career threatening injury" machine. Or would that be a limping one? After Schaub, I cringe and run away any time I see or read Lisfranc injury.
:firehair::firehair::firehair:
Clowney is the most injury prone person who ever put on a jock strap. And now they're saying his name and Lisfranc in the same sentence? Shudder! We just wish he had some trade value.
 
Patrick Starr reports:

Watt played in over 1,001 defensive snaps (96.2% of total defensive snaps) for the Texans, which was tops for the defense. Watt was 1 of 49 defensive players to play over 1,000 snaps in 2015 and of those 49, only two were defensive lineman. Watt’s injuries and his high snap count almost got the better of him this past year.

Keep it up and Watt is likely to quickly follow in the foot steps of Foster.
 
We need to create a different coaching position or perhaps the strength coach will do; this person will race out to field, throw Watt over his shoulder after putting him in a strait jacket and force him to sit on bench so he can get some rest. Actually we might want to use more than just one of these guys in case Watt disagrees about coming off field.
 
Caught JJ on the Dan Patrick show. Sounds as if it was more involved than what they originally thought it would be. Skip to 3:15.

If you've followed my posts re. sports hernia, you will remember that a sports hernia is not uncommonly found to occur bilaterally (as we now know is the case with JJ), or will develop a contralateral sports hernia later. With a single sports hernia, presence of a hip pathology is extremely common. There is a triad of abdominal tear, adductor tear and hip labrum tear that is referred to as the "sports triad."

You may be interested to review this previous post of mine the details the above relationships.......one that emphasizes the importance of addressing the underlying hip pathology.

With JJ having bilateral sports hernias, you can be sure that he also has underlying hip pathology. Because of the core and hip mechanics being affected, the appearance of back issues is not unexpected (Last October, you may remember that JJ was listed on the Injury Report as "back."

His groin injuries have been building up since at least week 4 of 2014............remember this pic?:
635678123355118460-jjwatt-twitter.jpg
 
If you've followed my posts re. sports hernia, you will remember that a sports hernia is not uncommonly found to occur bilaterally (as we now know is the case with JJ), or will develop a contralateral sports hernia later. With a single sports hernia, presence of a hip pathology is extremely common. There is a triad of abdominal tear, adductor tear and hip labrum tear that is referred to as the "sports triad."

You may be interested to review this previous post of mine the details the above relationships.......one that emphasizes the importance of addressing the underlying hip pathology.

With JJ having bilateral sports hernias, you can be sure that he also has underlying hip pathology. Because of the core and hip mechanics being affected, the appearance of back issues is not unexpected (Last October, you may remember that JJ was listed on the Injury Report as "back."

His groin injuries have been building up since at least week 4 of 2014............remember this pic?:
635678123355118460-jjwatt-twitter.jpg


finally opened up about that mystery bruise he posted on Instagram last week. Last season, he suffered a hit to his right thigh during the first half of the Texans Week 4 game against Buffalo. The result was a monster-sized purple splotch starting from his upper thigh to his knee.

“That was a beautiful block by Fred Jackson," Watt said Wednesday. "He did what anybody would have done which is exactly what I would have done. I had to make a decision between trying to block the pass or trying to protect myself. I decided to try to block the pass and Fred made me pay for it which is what he’s known to do, so he got me pretty good.”....

The bruise didn’t appear to affect him in the weeks that followed, but did linger for while before it eventually dissipated.

“It took about a month and a half, two months for it to completely go away," Watt said. "It hasn’t been any problem at all since. I was just looking through my phone the other day and saw the photo. Obviously, I didn’t post it during the season because I didn’t want people to know too much about it. Now there’s no problems and I haven’t had a problem with it since maybe a month and a half after it happened.”
full article here http://www.houstontexans.com/news/a...r-bruise/8c902b5f-f25d-467d-9496-1c4d1e2756c5
 

When I first posted on this injury, I identified the groin muscle most likely involved (through the distribution of the bruising) as the sartorius muscle, although other adductors could have also incurred injury. Violent direct hits to muscles will commonly cause muscle tears with subsequent hemorrrhage into the muscles and surrounding soft tissues.

A groin injury is a layman’s term for a muscle strain of the adductor muscles. A strain is a stretch or tear of a muscle or tendon. The muscles in your groin help bring your legs together. There are two muscles that may commonly get injured in a groin strain: the adductor magnus (the muscle running down the inner side of the thigh), and the sartorius (a thinner muscle that starts on the outside of your hip, crosses your thigh, and attaches near the inside of the knee).

link
 
Regarding JJ, the review below is why I am concerned about the ignoring of an underlying hip pathology (femoral acetabular impingement....FAI) of which in another often-quoted study was found in 86% of sports hernia cases, and deemed it to be a significant contributing cause. The study illustrated that those patients with FAI tend to have a change in hip biomechanics which in turn leads to increased stress across the groin. With these stresses a sports hernia (tear to the oblique abdominal muscles), is much more likely to occur. [Understand that the vast majority of labral tears which is part of the infamous "sports triad" are from femoral acetabular impingement]


Sports Health. 2014 Mar; 6(2): 139–144.
doi: 10.1177/1941738114523557
PMCID: PMC3931344
Sports Hernia/Athletic Pubalgia
Evaluation and Management

In 37 hips of primarily Division I and professional athletes that presented with sports hernia/athletic pubalgia and intra-articular hip/FAI disorders with pubalgia surgery alone, 25% returned to sports.16 When only arthroscopic FAI correction was performed, 50% returned to sports. When both conditions were surgically managed in a staged manner or at the same setting, 89% returned to sports without limitations. The mean modified Harris hip score improved from 75 points preoperatively to 96 points at a mean follow-up of 29 months. In 38 professional athletes with both sports hernia/athletic pubalgia and intra-articular hip/FAI disorders, FAI surgery alone resulted in a resolution of athletic pubalgia symptoms in 39%.10 No patient returned to their prior level of activity after athletic pubalgia surgery alone. With combined FAI and athletic pubalgia surgery, they all returned to professional competition.10 The proposed concept is that motion-limiting FAI can increase compensatory stresses on the adjacent pubic symphysis, lower abdomen, and proximal adductors, which might contribute to the development of sports hernia/athletic pubalgia in a subset of athletes. Of interest, 39% to 50% of athletes had resolution of their pubalgia symptoms after arthroscopic FAI corrective surgery (Figure 5). Therefore, it may be reasonable to consider FAI corrective surgery with later pubalgia surgery if symptoms do not subsequently resolve. In higher level athletes, however, management of both disorders surgically, in a staged or concurrent manner, may allow for a more predictable return to sports with less time lost from athletics secondary to persistent symptoms and increased rehabilitation time.
 
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Patrick Starr reports:



Keep it up and Watt is likely to quickly follow in the foot steps of Foster.

Seeing jj this week he does not look well. He has lost weight, is pale, and he just wasn't himself.

Nothing scientific just an observation
 
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