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Injury Thread

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.
Rest always helps....................but for soft tissue injuries, it takes a LONG rest.........and even then they very likely to become aggravated within the same season (and into others as has been the case with Paul)........not to mention the compensatory injuries that will almost assuredly occur while the tissues are trying to heal.
 
Savage has finally been placed on IR.

It's way too late in coming.......and should have been based on common sense from the very beginning. In response to the ridiculous decisions made with Savage (and also Russell), the Concussion Protocol has been altered.

The important changes:

• A central UNC will be stationed in the NFL's command center to assist in broadcast oversight at each game;

• Any sign of impact seizure will be considered the same as loss of consciousness, and the player will be out for the game;

• A referee who removes a player from the game for suspected head trauma must notify the medical staff;

• A player who exhibits gross motor instability or significant loss of balance must be taken to the locker room for evaluation if it is not diagnosed as an orthopedic injury;

• A player who is evaluated for a concussion must be re-evaluated within 24 hours, even if the player has an off day;

• A third UNC will be on site for the playoffs and the Super Bowl, in addition to the two already assigned to each regular-season game.

LINK
 
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Savage has finally been placed on IR.

It's way too late in coming.......and should have been based on common sense from the very beginning. In response to the ridiculous decisions made with Savage (and also Russell), the Concussion Protocol has been altered.

The important changes:

• A central UNC will be stationed in the NFL's command center to assist in broadcast oversight at each game;

• Any sign of impact seizure will be considered the same as loss of consciousness, and the player will be out for the game;

• A referee who removes a player from the game for suspected head trauma must notify the medical staff;

• A player who exhibits gross motor instability or significant loss of balance must be taken to the locker room for evaluation if it is not diagnosed as an orthopedic injury;

• A player who is evaluated for a concussion must be re-evaluated within 24 hours, even if the player has an off day;

• A third UNC will be on site for the playoffs and the Super Bowl, in addition to the two already assigned to each regular-season game.

LINK

I guess the investigation was completed and found these errors.
 
can you explain why that is the case?
The most common knee ligament injury occurs to the Medial Collateral Ligament, since tackling in football usually occurs from an outside to inside angle (like the football and hockey puck examples below). The medial meniscus, located on the inside of the knee, is more of an elongated "C"- shape, as the tibial surface is larger on that side. The medial meniscus is more commonly injured because it is firmly attached to the medial collateral ligament and joint capsule.
figure5.png



unnamed-1.png


The lateral meniscus, on the outside of the knee, is more circular in shape. The lateral meniscus is more mobile than the medial meniscus as there is no attachment to the lateral collateral ligament (it is directly attached to the proximal fibula) or joint capsule.
3_4_view.gif

The medial meniscus bears up to 50% of the load applied to the medial (inside) compartment of the knee. The lateral meniscus absorbs up to 80% of the load on the lateral (outside) compartment of the knee. When basketball players jump, they usually come down on the outside leg, and usually place an inordinate amount of load on the lateral meniscus. In fact, while running, these forces on the knee increase up to 6 - 8 times body weight, there are even higher forces when landing from a jump. When such skewed concentrated compression force distribution comes down on the lateral meniscus with the knee somewhat flexed (as when a basketball player buffers his landing off of jumps) especially with the slightest of twist, the lateral meniscus is high risk to tear.
 
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The most common knee ligament injury occurs to the Medial Collateral Ligament, since tackling in football usually occurs from an outside to inside angle (like the football and hockey puck examples below). The medial meniscus, located on the inside of the knee, is more of an elongated "C"- shape, as the tibial surface is larger on that side. The medial meniscus is more commonly injured because it is firmly attached to the medial collateral ligament and joint capsule.
figure5.png



unnamed-1.png


The lateral meniscus, on the outside of the knee, is more circular in shape. The lateral meniscus is more mobile than the medial meniscus as there is no attachment to the lateral collateral ligament (it is directly attached to the proximal fibula) or joint capsule.
3_4_view.gif

The medial meniscus bears up to 50% of the load applied to the medial (inside) compartment of the knee. The lateral meniscus absorbs up to 80% of the load on the lateral (outside) compartment of the knee. When basketball players jump, they usually come down on the outside leg, and usually place an inordinate amount of load on the lateral meniscus. In fact, while running, these forces on the knee increase up to 6 - 8 times body weight, there are even higher forces when landing from a jump. When such skewed concentrated compression force distribution comes down on the lateral meniscus with the knee somewhat flexed (as when a basketball player buffers his landing off of jumps) especially with the slightest of twist, the lateral meniscus is high risk to tear.
Ahh, got it. thanks
 

I don't know if I'm the only one but I honestly am still disturbed by this incident. It's hard enough watching the Texans without Watson but then seeing a guy have a seizure on the field and get put back in the game on the next series is disgusting. I would've been perfectly okay if they had lost a draft pick over their handling of it and a substantial fine. This season has really tested my fandom with both on and off the field issues.
 
This is one of the lamest excuses I've heard so far. The spotter has direct communications with the head team physician and UNC. The fencer's pose was noted by everyone (certainly no doubt by the spotter) in the stadium on replay, and there is no doubt that everyone had more than ample opportunity to review the video and certainly the description of the response by the time that Savage was released to return to the game.

DSOdr9MVwAEm6tt.jpg
 
Texans' J.J. Watt (broken leg) on track for return by training camp
3:00 PM CT
  • Sarah BarshopESPN Staff Writer

HOUSTON -- Houston Texans defensive end J.J. Watt said he is on track to return from his broken leg by training camp and is “very pleased with the progress” he has made in his rehab.

Watt broke his leg in the Texans’ Week 5 loss to the Kansas City Chiefs.

After playing in all 16 games in the first five seasons of his NFL career, JJ Watt has missed the bulk of the past two seasons. Bob Levey/Getty Images
“It’s doing really, really well,” Watt said. “[I’m] very excited about where it’s going. It’s getting stronger every single day. They let me do a little bit more and more. I get to run again in a little while.

“I’m on track for training camp. But my assumption is that it shouldn’t be any problem, but if it needs a couple extra weeks, whatever, we’ll take it. From my understanding and from everybody here’s understanding, the way it’s looking, everything’s going really well. There shouldn’t be any issues.”

Watt said he does not know if he will be back for the Texans’ organized team activities that go from mid-April to mid-June.

“I’d like to, but I also know that I’m not going to push it,” Watt said. “If I can, I can. If I can’t, I can’t. My goal is to come back for training camp and be ready to go.”
THE REST OF THE STORY
 
As I predicted after Clowney repeatedly showed up on the Injury Reports with a "knee."


Mark Berman‏@MarkBermanFox26 2m2 minutes ago

#Texans star outside linebacker Jadeveon Clowney will undergo minor arthroscopic knee surgery and not expected to be able to play in the Pro Bowl.

Of course, it is "minor." He is likely having more meniscus (and probably with articular cartilage and bone spicules) being removed from his knee...........closer to more bone-on-bone..........with a future of additional instability and surgery. We know from several studies done over the last decade that surgery to “clean up” arthritis changes has little long-term benefit.
 
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As I predicted after Clowney repeatedly showed up on the Injury Reports with a "knee."




Of course, it is "minor." He is likely having more meniscus being removed from his knee...........closer to more bone-on-bone..........with a future of additional instability and surgery.

Can you say franchise tag?
 
I am really really concerned about these soon to be bone on bone knees. I hope he and Watt don't end up in wheel chairs.
 
I am really really concerned about these soon to be bone on bone knees. I hope he and Watt don't end up in wheel chairs.

I assure you that both Clowney and Watt already have some areas of bone on cartilage where one side is missing some articular cartilage. The bare bone (which many times develops spicules) and irregularities in the damaged articular cartilage and/or the meniscus (which encircles the articular cartilage on the tibial side) on one side will then wear down the articular cartilage on the other side.

meniscus-transplant-replacement-kevin-stone-ss_95147470.jpg


1-s2.0-S1063458414011029-gr1.jpg


osteoarthritis_victoria_bc.png


Clowney's and Watt's knee injuries/surgeries have left both looking at knee replacements when their careers are over.
 
I assure you that both Clowney and Watt already have some areas of bone on cartilage where one side is missing some articular cartilage. The bare bone (which many times develops spicules) and irregularities in the damaged articular cartilage and/or the meniscus (which encircles the articular cartilage on the tibial side) on one side will then wear down the articular cartilage on the other side.

meniscus-transplant-replacement-kevin-stone-ss_95147470.jpg


1-s2.0-S1063458414011029-gr1.jpg


osteoarthritis_victoria_bc.png


Clowney's and Watt's knee injuries/surgeries have left both looking at knee replacements when their careers are over.


Doc - We always appreciate the time you take to explain complex anatomy and injuries to the rest of us that don't have a medical background. JJ had described his own injury as "The top part of my leg basically got pulverized,” Watt says. “It was in a whole bunch of different pieces.” The meniscus tore, but not across the middle—it was severed from the bone. A large portion of the cartilage covering the top of his tibia tore in half. Doctors sliced him open and inserted a metal plate, along with nine screws, to hold it all together".

Would this indicate that the tibial (lower) side of your picture now looks like a steel plate with nine screws, and pretty much a total loss of all cartilage on that side of the joint?
If so, what happens as this steel plate comes in contact with the femur (upper) side of the knee joint? It seems like it would rapidly damage and wear down any remaining cartilage. Would it likely be that this side of the knee is already highly compromised too as far as loss of meniscus and articular cartilage?

How can an NFL interior lineman play with that 'rebuild', given the forces on the knee?
 
Doc - We always appreciate the time you take to explain complex anatomy and injuries to the rest of us that don't have a medical background. JJ had described his own injury as "The top part of my leg basically got pulverized,” Watt says. “It was in a whole bunch of different pieces.” The meniscus tore, but not across the middle—it was severed from the bone. A large portion of the cartilage covering the top of his tibia tore in half. Doctors sliced him open and inserted a metal plate, along with nine screws, to hold it all together".

Would this indicate that the tibial (lower) side of your picture now looks like a steel plate with nine screws, and pretty much a total loss of all cartilage on that side of the joint?
If so, what happens as this steel plate comes in contact with the femur (upper) side of the knee joint? It seems like it would rapidly damage and wear down any remaining cartilage. Would it likely be that this side of the knee is already highly compromised too as far as loss of meniscus and articular cartilage?

How can an NFL interior lineman play with that 'rebuild', given the forces on the knee?

This injury is too complicated to cover in more detail than I've done in multiple previous posts. But to answer some of your specific questions:

The plates and screws are always placed through the sides of the bone to create compression in order to bring back the bones into the best alignment possible. Screws and plates are never positioned in the top articular surface of the tibia, so cannot by themselves create articular or meniscus wear. No doubt, with multiple fractures, this realignment will be imperfect at best (not like the flawless precise pic below).............and the overlying articular cartilage is disrupted, and along with the meniscus damage (both structures having very poor healing properties) does not fair well for return to previous performance levels...........and many time for return to play at all. Watt's lay description of his injuries for sure does not present a pretty picture for the future. Short of a microfracture procedure or knee replacement there is little that can be done to "rebuild" the joint surfaces of the knee.


MyPortalFiles



Hope that this gives you a better understanding of what is probably going on with Watt.
 
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This injury is too complicated to cover in more detail than I've done in multiple previous posts. But to answer some of your specific questions:

The plates and screws are always placed through the sides of the bone to create compression in order to bring back the bones into the best alignment possible. Screws and plates are never positioned in the top articular surface of the tibia, so cannot by themselves create articular or meniscus wear. No doubt, with multiple fractures, this realignment will be imperfect at best (not like the flawless precise pic below).............and the overlying articular cartilage is disrupted, and along with the meniscus damage (both structures having very poor healing properties) does not fair well for return to previous performance levels...........and many time for return to play at all. Watt's lay description of his injuries for sure does not present a pretty picture for the future. Short of a microfracture procedure or knee replacement there is little that can be done to "rebuild" the joint surfaces of the knee.


MyPortalFiles



Hope that this gives you a better understanding of what is probably going on with Watt.

You could have had a poop picture hitting a fan .
 
This injury is too complicated to cover in more detail than I've done in multiple previous posts. But to answer some of your specific questions:

The plates and screws are always placed through the sides of the bone to create compression in order to bring back the bones into the best alignment possible. Screws and plates are never positioned in the top articular surface of the tibia, so cannot by themselves create articular or meniscus wear. No doubt, with multiple fractures, this realignment will be imperfect at best (not like the flawless precise pic below).............and the overlying articular cartilage is disrupted, and along with the meniscus damage (both structures having very poor healing properties) does not fair well for return to previous performance levels...........and many time for return to play at all. Watt's lay description of his injuries for sure does not present a pretty picture for the future. Short of a microfracture procedure or knee replacement there is little that can be done to "rebuild" the joint surfaces of the knee.


MyPortalFiles



Hope that this gives you a better understanding of what is probably going on with Watt.

Thank you - that was very helpful!
 
I reviewed the last Colts game to see how Will Fuller's knee was injured. He fell on an already bent knee........a classic mechanism for either a PCL (posterior cruciate ligament) tear or a quad or patellar tendon injury. Since he was walking off after the play, we can surmise that if it were a quad or patellar tendon tear, it would be a partial tear. A complete rupture of a PCL can still allow for a player to walk off, but he would lose knee stability any further actions required by a WR.
 
[Thought this post would be more appropriate in this thread]


After injuries, Texans' Watson, Foreman gear up for return

(VIDEO)

A frame pulled from the video:
3I3H9GC.jpg

iPqnDt5.jpg


There is no way Watson's condition is not affecting his visual fields if not corrected medically (if it can be) for games. Since this is a type of condition I have routinely performed surgeries for, I have to wonder why he has not had it addressed. I could swear that I posted about this back in April when I noticed the condition, but I can't seem to find it.
 
[Thought this post would be more appropriate in this thread]


After injuries, Texans' Watson, Foreman gear up for return

(VIDEO)

A frame pulled from the video:
3I3H9GC.jpg

iPqnDt5.jpg


There is no way Watson's condition is not affecting his visual fields if not corrected medically (if it can be) for games. Since this is a type of condition I have routinely performed surgeries for, I have to wonder why he has not had it addressed. I could swear that I posted about this back in April when I noticed the condition, but I can't seem to find it.
What condition are you referring to? Looks like Schaub in one eye.
 
I had the surgery as a teen. Purely aesthetic, didn't affect my vision.

Weird operation, didn't knock me out - got to watch the scalpel coming.
 
I remember some people saying it improved Tracy McGradys vision. But his condition may have been different
 
What condition are you referring to? Looks like Schaub in one eye.
Drooping Eyelid (Ptosis)

I hope it’s operable because the non-operable conditions all suck.

Without being able to examine him, my observations going through many photos of Watson, he seems to have a long-standing (probably congenital or early childhood onset left eyelid ptosis with external strabismus (pupil aimed somewhat outward/lateral) with accompanying lid retraction on the right. This could be what is known as a Horner Syndrome. Another condition that comes to mind is a variant of an auto-immune disease, myesthenia gravis, which can classically lead to weakening of eyelid muscles. The changes appear to be worse at times and better at other times (and can be affected when Watson is tired), but seems to have definitely progressed over time.
 
I had the surgery as a teen. Purely aesthetic, didn't affect my vision.

Weird operation, didn't knock me out - got to watch the scalpel coming.
Ptosis surgery is typically performed under local anesthesia, because there needs to be cooperation on the part of the patient (opening and closing the eyes while checking the patient also in a sitting position) to determine the correct amount of correction in attempt to avoid significant over or under correction. There is an element of intrasurgical "trial and error" tightening and loosening until the optimal position is accomplished.

The surgery can be performed strictly for aesthetic purposes as was apparently the case with your situation. However, Watson's photos clearly reveal that he has to be dealing with a functional decrease in field of vision.
 
I had the surgery as a teen. Purely aesthetic, didn't affect my vision.

Weird operation, didn't knock me out - got to watch the scalpel coming.

We've got a smilie for this post: :eek:

My family has a history of dermatochalasis (excess of skin in the upper eyelid) and my uncles have had multiple surgeries over the years to fix it. Is the eye thing with Watson similar?
 
We've got a smilie for this post: :eek:

My family has a history of dermatochalasis (excess of skin in the upper eyelid) and my uncles have had multiple surgeries over the years to fix it. Is the eye thing with Watson similar?

Good question! But the answer is essentially "No."

Dermatochalasis is strictly excess skin of the upper eyelid.........when the excess skin overlaps over some of the pupil, it becomes a functional problem.............yet the rim of the upper eyelid in this condition remains in normal position above the level of the pupil with normal range of movement. The treatment is simply to remove the obstructing excess overlapping skin.


Dermatochalasis.jpg


Watson demonstrates a weak or stretched out or torn levator muscle/aponeurosis (the tendinous structure that connects the levator muscle to the rim of the eyelid)............the structures that allow elevation of the upper eyelid. Note that in this condition there is not really excess overlapping skin.

6703853.jpg

main-qimg-4f6f55f8c0b48e2f0a7f1ed3b355eaef



The torn or stretched out muscle/aponeurosis must be repaired and/or shortened in order to elevate the eyelid to the normal baseline.

s42ptosissurgery.png
 
Doc I had the torn/stretched muscle/tendon.
Depending on how much it is comes down or doesn't come down over the pupil or how much or how little the muscle can lift the eyelid off of the pupil (especially when trying to gaze upwards), determines its functionality or lack thereof.
 
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Looks like he has that Matt Schaub eye
But Schaub has two of them lol
matt-schaub-Meet_The_Matts.jpg

Entirely different. Schaub has normal upper eyelid creases. Meaning that he can normally elevate his eyelids for a wide open appearance, as seen here in a pic (as in many other instances) taken in the summer of 2015 as a Raven.

bs-sp-ravens-matt-schaub-training-camp-0812-20150811


Watson, on the right eye, has lost his crease, a finding consistent with not being able to normally lift that eyelid. (see the pics I previously posted).

The normal upper eyelid crease reflect the point of strong attachment of the levator muscle/aponeurosis apparatus to just above the border of the upper lid. When you lose this crease, it signifies that either the attachment has torn away or the muscle/aponeurosis apparatus has become so stretched/weakened that the lid can no longer be elevated. [to give an analogy that may click for more people..................if an Achilles tendon is ruptured, the foot can no longer be pulled down by the strong contraction of the calf muscle. If the Achilles is then repaired, but not tightened enough or stretched out during rehab thus leaving too much slack, the foot will still not be able to be normally pulled down by the same usual contraction of the calf muscle.
 
I certainly don't disagree with the ACL situation. But if you are not interested in a valid observation about a very important aspect of an elite quarterback's tool chest
... his field of vision, then feel free to ignore my post(s).

Could it be that during games when the adrenaline is flowing his eyes are both wide open? Almost bug-eyed ala Singletary?
 
Could it be that during games when the adrenaline is flowing his eyes are both wide open? Almost bug-eyed ala Singletary?
No. Adrenaline can't have that effect on the eyelid. Its release has an effect on the pupil.......it will simply cause it to dilate.

One thing that you can count on is that eyelid ptosis to Watson's degree, will affect his depth perception. And it is also a known fact that significant eyelid ptosis applies abnormal pressures to the globe of the eye, over time resulting in distortions of its surface (astigmatism) with its accompanied blurring of vision.
 
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No. Adrenaline can't have that effect on the eyelid. Its release has an effect on the pupil.......it will simply cause it to dilate.

One thing that you can count on is that eyelid ptosis to Watson's degree, will affect his depth perception. And it is also a known fact that significant eyelid ptosis applies abnormal pressures to the globe of the eye, over time resulting in distortions of its surface (astigmatism) with its accompanied blurring of vision.
Define "over time".
We talking a rust-like slow degeneration that can be monitored and corrected or a sudden, catastrophic failure (one week he can see, the next he can't).
 
Define "over time".
We talking a rust-like slow degeneration that can be monitored and corrected or a sudden, catastrophic failure (one week he can see, the next he can't).
In young children, it can occur in terms of over weeks. In an adult, I have seen it occur as soon as 1 year following the diagnosis of severe ptosis. In other cases after several years.
 
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