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Injury Thread

badboy said:
So much to respond to, first I and most here don't disrespect JD & as you identify he's very good. His cap hit if tagged twice is close to $35-38 million so 20 million avg for first 2 years isn't that crazy and I think Gains would do that. Problem is of course Clowney wants more GTD and where talks break down. The knee doesn't get better sitting out. It's all risk and gamble for both sides. A player of his skill and productivity should sign an $80 million 4 year deal with say $20 GTD knowing second year will be GTD game one. He could sit out all off seasons and play sparingly some in preseason. He doesn't need practise to play well. Last two years could have incentives easy to reach + per game bonus of one million per. If used up after 2 seasons no one will offer much. Team will be good with JD but could be much better with what we get in trade now. If he's about money. I'm cool with it. Go to Gaines say" loved time here but need more than you want to pay. Get as close to this number for me and best deal for you and I sign tender and hope see you in Super Bowl."
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In order to try to better understand the Texans' reluctance to give Clowney a long-term contract with high guaranteed monies, it's important to understand the natural history of patients having undergone microfracture surgery on the knees............While reading this, keep in mind that in December Clowney will be 5 years post his microfracture procedure.

Despite the popularity, there is increasing evidence that also questions the value of microfracture in knees. Recent orthopedic reviews report that the long-term clinical results of microfracture are no better than those for patients who do not have microfracture, and that microfracture is not without risks

Orthopedists Goyal et al. reviewed all Level I and Level II studies (these are studies with the greatest confirmed validity) in the world medical literature and concluded that in the short-term, for young patients with small lesion sizes and low post-operative demands, microfracture was associated with good clinical outcomes. However ‘ beyond 5 years post-operatively, treatment failure after microfracture could be expected regardless of lesion size ’.

Another study has highlighted the risks associated with microfracture; that disruption of the subchondral plate (a support layer) upon drilling into the marrow predisposes the bone to the development of subchondral cysts and fragile or brittle bone, subsequently accelerating osteoarthritis.

4-Figure2-2.png



images
 
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CloakNNNdagger said:
In order to try to better understand the Texans' reluctance to give Clowney a long-term contract with high guaranteed monies, it's important to understand the natural history of patients having undergone microfracture surgery on the knees............While reading this, keep in mind that in December Clowney will be 5 years post his microfracture procedure.

Despite the popularity, there is increasing evidence that also questions the value of microfracture in knees. Recent orthopedic reviews report that the long-term clinical results of microfracture are no better than those for patients who do not have microfracture, and that microfracture is not without risks

Orthopedists Goyal et al. reviewed all Level I and Level II studies (these are studies with the greatest confirmed validity) in the world medical literature and concluded that in the short-term, for young patients with small lesion sizes and low post-operative demands, microfracture was associated with good clinical outcomes. However ‘ beyond 5 years post-operatively, treatment failure after microfracture could be expected regardless of lesion size ’.

Another study has highlighted the risks associated with microfracture; that disruption of the subchondral plate (a support layer) upon drilling into the marrow predisposes the bone to the development of subchondral cysts and fragile or brittle bone, subsequently accelerating osteoarthritis.

4-Figure2-2.png



images
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How old are these reports? Have advancements in medicine changed things?
 
JB said:
How old are these reports? Have advancements in medicine changed things?
Click to expand...
2016.............and microfracture is microfracture. It's a simple procedure that has itself essentially not changed since when first performed in 1959. And in Clowney's case, don't forget that originally torn meniscus was removed, not repaired. Deficiency of protective stabilizing meniscus is not addressed by microfracture surgery.
 
CloakNNNdagger said:
In order to try to better understand the Texans' reluctance to give Clowney a long-term contract with high guaranteed monies, it's important to understand the natural history of patients having undergone microfracture surgery on the knees............While reading this, keep in mind that in December Clowney will be 5 years post his microfracture procedure.

Despite the popularity, there is increasing evidence that also questions the value of microfracture in knees. Recent orthopedic reviews report that the long-term clinical results of microfracture are no better than those for patients who do not have microfracture, and that micro-fracture is not without risks

Orthopedists Goyal et al. reviewed all Level I and Level II studies (these are studies with the greatest confirmed validity) in the world medical literature and concluded that in the short-term, for young patients with small lesion sizes and low post-operative demands, microfracture was associated with good clinical outcomes. However ‘ beyond 5 years post-operatively, treatment failure after microfracture could be expected regardless of lesion size ’.

Another study has highlighted the risks associated with microfracture; that disruption of the subchondral plate (a support layer) upon drilling into the marrow predisposes the bone to the development of subchondral cysts and fragile or brittle bone, subsequently accelerating osteoarthritis.

4-Figure2-2.png



images
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So the literature indicates microFracture is a temporary patch, not a permanent fix.
You've probably said this before (many times) but it's just now sinking in.
 
CloakNNNdagger said:
2016.............and microfracture is microfracture. It's a simple procedure that has itself essentially not changed since when first performed in 1959. And in Clowney's case, don't forget that originally torn meniscus was removed, not repaired. Deficiency of protective stabilizing meniscus is not addressed by microfracture surgery.
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See this I don't understand. Instead of drilling holes why not insert an inert (Teflon?), artificial lattice thingee. A Teflon-based lattice between the two rubbing surfaces would provide more surface area for the cartiliage repairing mechanism to work with.
Unchanged after 60 yrs?!
What am I missing, Doc?
 
ObsiWan said:
See this I don't understand. Instead of drilling holes why not insert an inert (Teflon?), artificial lattice thingee. A Teflon-based lattice between the two rubbing surfaces would provide more surface area for the cartiliage repairing mechanism to work with.
Unchanged after 60 yrs?!
What am I missing, Doc?
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I'm not able to picture what you are proposing enough to comment on. Is the lattice floating between the apposing joint surfaces or attached, and how would it allow more cartilage repair?
 
CloakNNNdagger said:
I'm not able to picture what you are proposing enough to comment on. Is the lattice floating between the apposing joint surfaces or attached, and how would it allow more cartilage repair?
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between the opposing (sliding) surfaces....

Is the reason for drilling those holes to provide places for the cartilage repair mechanism to operate? If so why wouldn't placing a teflon lattice (thickness??) instead of drilling those holes work better and provide some cushion while healing takes place.
microfractures.jpg

If I'm off base say so.
...it's probably bad business for an engineer to try and solve a medical issue anyway
 
ObsiWan said:
between the opposing (sliding) surfaces....

Is the reason for drilling those holes to provide places for the cartilage repair mechanism to operate? If so why wouldn't placing a teflon lattice (thickness??) instead of drilling those holes work better and provide some cushion while healing takes place.
microfractures.jpg

If I'm off base say so.
...it's probably bad business for an engineer to try and solve a medical issue anyway
Click to expand...

A lattice of any sort cannot be completely smooth, and any rough surface would not allow the joint to function properly without further damage. In addition, secure attachment of a lattice that could not be displaced with joint movement would be be a big problem. "Healing" could not occur without drilling into the marrow, as the remaining outer bone with no cartilage cover has no true blood supply to regenerate even psuedocartilage. This is not to even mention the potential high risk of a fenestrated foreign body lattice. And if you used the lattice after performing classic microfracture, the psuedocartilage would be discontinuous and would then grow over the lattice no longer giving continuous nourishment (poor as it is anyway) from a solid base of underlying marrow . This would encourage the pseudocartilage to slide off and/or grind away from any underlying lattice work during joint function (as the teflon lattice, due to the type of metal material that it is, could never be expected to truly integrate with the pseudo cartilage.

I've probably totally confused you at this point.
 
CloakNNNdagger said:
A lattice of any sort cannot be completely smooth, and any rough surface would not allow the joint to function properly without further damage. In addition, secure attachment of a lattice that could not be displaced with joint movement would be be a big problem. "Healing" could not occur without drilling into the marrow, as the remaining outer bone with no cartilage cover has no true blood supply to regenerate even psuedocartilage. This is not to even mention the potential high risk of a fenestrated foreign body lattice. And if you used the lattice after performing classic microfracture, the psuedocartilage would be discontinuous and would then grow over the lattice no longer giving continuous nourishment (poor as it is anyway) from a solid base of underlying marrow . This would encourage the pseudocartilage to slide off and/or grind away from any underlying lattice work during joint function (as the teflon lattice, due to the type of metal material that it is, could never be expected to truly integrate with the pseudo cartilage.

I've probably totally confused you at this point.
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The only confusing part is why metal works in dental applications and hip replacements but wouldn't "fully integrate" in this application. But then lubricating sliding and load-bearing surfaces is a b!tch even when its not the human body so part of me get that. And I picked Teflon because its a fairly inert polymer, not strictly a metal like titanium or stainless.
...it was just a random thought.
 
ObsiWan said:
The only confusing part is why metal works in dental applications and hip replacements but wouldn't "fully integrate" in this application. But then lubricating sliding and load-bearing surfaces is a b!tch even when its not the human body so part of me get that. And I picked Teflon because its a fairly inert polymer, not strictly a metal like titanium or stainless.
...it was just a random thought.[/QUOTE

In dental and hip replacement, the materials are solid not fenestrated lattice and they are substitutes, not enhancements for natural repair.
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@CloakNNNdagger do you have any idea what knee issue Jawaan Taylor got flagged for? Nothing came out until the draft and a top 10-15 OT prospect is not taken in 1st round. Wondering what the issue is with his knee. As always, any insight you have is valued and appreciated!
 
Ryan Griffin has just recently undergone "sports hernia" surgery. Hopefully, he now has not suffered tendon lacerations which is very common from his most recent window smashing incident.
 
I actually came across an old injury report for Crawford in 2017 listing him as a "back injury." But I found a deeply buried reported that stated that he in fact suffered a shoulder injury that 5th game of the 2017 season. He was placed on IR as it required surgery (no more information). But he came back strong in 2018 without apparent ill effects...........earned an impressive 82.4 coverage grade across his 331 coverage snaps in 2018, allowing just 15 receptions from 38 targets for 162 yards and one touchdown in the process. The surgery was most likely labrum repair. If so, this season should yield his optimum recovery performance.
 
Sorry for this duplicate post [from the UDFA Thread], but I wanted to copy this into the Injury Thread for easier future retrieval.:tiphat:

I was able to find out about Dixon's real story behind his knee issues...........they've always been referred to in general terms as in "repeated injuries." In fact, he began experiencing knee pains in both knees in 2012. Despite long term conservative rehab, these pains gradually increased over time to the point that in 2015, he was unable to continue and was thoroughly worked up orthopedically and found to have a condition of both of his patellar tendons called patellar tendinosis. In the past, it would have been given the name of patellar tendinitis, except that it has been found that this, in most cases is a misnormer, in that this condition does not have an inflammatory origin as would be implied by the suffix "itis" label. Patellar tendinosis is actually degeneration due to chronic microtrauma (little tears which accumulate over time and lead to deterioration of the tendon tissue). The suffix “-osis” more accurately reflects this chronic degenerative pathology. It’s simply a wearing out of the over-stressed tendon. The tendon is most traumatized by repeated jumping (commonly called "jumper's knee, a subject I've addressed here in the past) and by quick directional changes, which could easily explain the condition in a wide receiver.

In mid 2015, he underwent a surgical procedure to address his problem. It entailed making muiltiple small incisions and light scrapings and debridement in both of his diseased patellar tendons in order to promote new blood supply and a naturally healing process that was no longer occurring on its own. During the surgery, they discovered that the articular cartilage on the back side/underside of his patellas (knee caps) were also significantly damaged and irregular in surface with the beginnings of underlying arthritis in these areas and the femoral contact points. Areas of the patellar cartilages required debridement to affect a smoother surface for the patella to glide over the femur.


annotated-knee-side-300x278.png



Usually in these cases, arthritis will not only form on the patella back/under surface, but also on the abutting femoral bone surface (because the irregularities in the back of the patella would then be constantly grinding the femoral articular surface)

knee-articular-cartilage.gif


Arthritis of both articular surfaces (patellar and femoral)

View attachment 4388


images



Dixon has continued to deal with increasing arthritis throughout his most recent season. Despite his condition, it appears that up to now, he has been able to fight through it and perform surprisingly well. Hopefully, he can continue his productivity with the Texans. But he is dealing with serious degenerative disease entities...........the big question is, under the circumstances, how long can he continue to be effective.
 
@CloakNNNdagger

Karan Higdon claims he went undrafted due to a surgery. Any idea what surgery he had done?

https://www.google.com/amp/s/wolver...fted-free-agent-houston-texans-nfl-draft/amp/

“To all my fans and supporters, thank you for supporting me this far. I know a lot of people were looking forward to hearing my name called but unfortunately teams were hesitant due to my surgery! In the end it’s all good because I can’t be stopped. I’ll be headed to the Houston Texans to complete this mission. Stay tuned!”
 
Lucky said:
There are good pass rushers coming from each side in the AFC West. And Miller should improve after struggling with a knee in his rookie season. Unless he doesn't. OTs get injured, whether it's in college or the pros. Part of the job.
Click to expand...

This is what happens when a player is not allowed to rehab:
https://www.profootballfocus.com/ne...d-to-kolton-millers-underwhelming-rookie-year
Injuries, steep learning curve lead to Kolton Miller's underwhelming rookie year
BY AUSTIN GAYLE • OAKLAND RAIDERS • KOLTON MILLER • DEC 31, 2018
 
TheRealJoker said:
@CloakNNNdagger

Karan Higdon claims he went undrafted due to a surgery. Any idea what surgery he had done?

https://www.google.com/amp/s/wolver...fted-free-agent-houston-texans-nfl-draft/amp/

“To all my fans and supporters, thank you for supporting me this far. I know a lot of people were looking forward to hearing my name called but unfortunately teams were hesitant due to my surgery! In the end it’s all good because I can’t be stopped. I’ll be headed to the Houston Texans to complete this mission. Stay tuned!”
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The only information that is given to the public is in his instagram.
To all my fans and supporters, thank you for supporting me this far. I know a lot of people were looking forward to hearing my name called but unfortunately teams were hesitant due to my surgery! In the end it’s all good because I can’t be stopped. I’ll be headed to the Houston Texans to complete this mission. Stay tuned!
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He never identified what surgery. You won't find it anywhere in print, but he played with bilateral "sports hernias" throughout most of his 2018 season. Early April of this year, after trying to conservatively rehab, he finally decided to undergo repair of the hernias. When you have one on one side, it is being found to be prudent to tighten/repair the other side at the same time (even if it is not symptomatic) since it is so common for one side to be followed relatively quickly by the other side. The thing about sports hernias is that once repaired there is an 85% return to play, most with return with ~10% deficit at 1 year compared to pre-injury level. However, as I have posted in the past, 86% of these have an underlying hip disorder (femoroacetabular impingement) which if repaired (alone many times or) together with sports hernia repair can be expected to attain close to close to 100% return.......with minimal chance of recurrence
 
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cuppacoffee said:
Damn..that's starting it early.

Being stashed?

:coffee:
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I doubt it. Feb 2018 before joining the Texans, he underwent shoulder labrum surgery. Early Nov last season just before the Bye, he re-injured the shoulder. He missed the next 4 weeks [including the Bye].........tried to come back in limited snaps for the last 4 games of the season plus the playoff game, but was entirely ineffective [being involved in a total of 2 tackles throughout that period]. Since we haven't heard of any recent surgery, it is likely that he is trying to conservatively rehab the shoulder. It must be kept in mind that nonsurgical rehab tends to be indicated typically only in non-throwing and non-contact athletes..............because failure rates are so high otherwise. It would not surprise me if in the future we will be hearing that Ejiofor is scheduled for surgery.
 
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HaveMercy said:
I hope they keep him around two years. It will take that long to see how far he can come back. But absolutely the best wishes go out to that young man. It also makes me wish we'd kept Christian Covington.
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I don’t see us letting him go this year. If he isn’t able to rehab and get back into camp by next season then he may be a cut. I know he’s a day 3 pick last year but I think he really has potential to be a starter if he stays healthy
 
281Texan said:
I don’t see us letting him go this year. If he isn’t able to rehab and get back into camp by next season then he may be a cut. I know he’s a day 3 pick last year but I think he really has potential to be a starter if he stays healthy
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If he stays healthy is the key............and it's important to remember that when he sustained his Achilles during a workout, he had still not rehabbed his shoulder injury from early Nov last season. That re-injury of his shoulder following previous labrum surgery is now just as worrisome to his future as is the Achilles rupture.

CloakNNNdagger said:
I doubt it. Feb 2018 before joining the Texans, he underwent shoulder labrum surgery. Early Nov last season just before the Bye, he re-injured the shoulder. He missed the next 4 weeks [including the Bye].........tried to come back in limited snaps for the last 4 games of the season plus the playoff game, but was entirely ineffective [being involved in a total of 2 tackles throughout that period]. Since we haven't heard of any recent surgery, it is likely that he is trying to conservatively rehab the shoulder. It must be kept in mind that nonsurgical rehab tends to be indicated typically only in non-throwing and non-contact athletes..............because failure rates are so high otherwise. It would not surprise me if in the future we will be hearing that Ejiofor is scheduled for surgery.
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CloakNNNdagger said:
If he stays healthy is the key............and it's important to remember that when he sustained his Achilles during a workout, he had still not rehabbed his shoulder injury from early Nov last season. That re-injury of his shoulder following previous labrum surgery is now just as worrisome to his future as is the Achilles rupture.
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Good news is he will have almost 2 yrs to rehab the shoulder. If it doesn't hold up then it never will.
 
steelbtexan said:
Good news is he will have almost 2 yrs to rehab the shoulder. If it doesn't hold up then it never will.
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Notwithstanding the fact the most negatively affected position for Achilles ruptures besides the running back being the linebacker, without a secondary shoulder repair, I doubt that his return even after 2 years will be a permanent one.......if he returns at all. Even with another shoulder repair, prognosis is still questionable.
 
Tom Zimmer‏@TZimmer1029


That Taiwan Jones injury looks about as bad as you'd expect it to... woof... feel better? #Bills



DnUDXmrVYAI5bXG.jpg



10:36 AM - 17 Sep 2018

Taiwan Jones shows off gruesome gash on head from brutal hit

Originally posted on The Sports Daily | By Matt Birch | Last updated 9/19/18

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


Houston Texans to sign running back Taiwan Jones
ByJOHN NEWBY 11 hours ago

The Houston Texans are bringing some much-needed experience to the special teams.

Monday night, Aaron Wilson of the Houston Chronicle reported that the Texans would be signingrunning back Taiwan Jones. The move was first made known by Jones' agent, Doug Hendrickson. The 30-year-old runner will now spend his ninth season in the league assisting on kick coverage.

Originally a fourth-round pick by the Oakland Raiders, Jones entered the NFL after a career at Eastern Washington. While he started his college career as a cornerback, Jones switched to running back and promptly became a dangerous weapon. He rushed for 1,213 yards as a sophomore and then accounted for 1,742 yards and 14 touchdowns as a junior. Jones entered the NFL following his standout campaign in lieu of returning for a senior season.

Despite boasting an impressive track record as a runner, Jones hasn't seen many attempts in the pros. In eight seasons, six of which were with the Oakland Raiders, he has tallied 44 rushing attempts for 183 yards and no touchdowns. He's been slightly more productive as a receiving option with 18 catches for 251 yards and one touchdown. These few carries would generally result in a short career, but Jones has been a productive part of the NFL due to his abilities on special teams. Plus, the New York Jets know that Jones can be quite dangerous as a receiver.

THE REST OF THE STORY

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

Jones essentially lost 10 games last season with what appears to have been a cervical disc injury originally suffered in the Sept "collision" noted above, then aggravated 4 games later leading to IR (could find not documentation of subseqent surgery).

He lost 8 games to a fractured arm in 2017.

After playing only 1 game in 2014, he was placed on IR for a "Jones" fracture...........the was a re-fracture of a Jones fracture he sustain near the end of 2010 in college
 
I wonder if it's too late for Taiwan Jones to convert back to a cornerback it would definitely be less stressful on his injury to his neck. He seemingly has kept his speed. Comments doc?
 
badboy said:
I wonder if it's too late for Taiwan Jones to convert back to a cornerback it would definitely be less stressful on his injury to his neck. He seemingly has kept his speed. Comments doc?
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Special teams is bound to test neck strength/stability...........but with neck conditions, it's pick your poison...............being the tackler vs being the "tacklee"...........both can involve serious collisions and stress on the neck.
 
CloakNNNdagger said:
Special teams is bound to test neck strength/stability...........but with neck conditions, it's pick your poison...............being the tackler vs being the "tacklee"...........both can involve serious collisions and stress on the neck.
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Bot anymore in God'ells NFL.
 
pirbroke said:
. Hoping just a rock in his shoe


Sent from my iPhone using Tapatalk Pro
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so he's not only injured but too stupid to remove rock? Seriously, I understood your post. Back to thread, Doc would not the risk of ST especially returns be a threat similar to concussions?
 
badboy said:
Sorry my concern for Taiwan Jones is playing on special teams where he runs high speed to tackle on returns would seem to be as dangerous as a concussion. He easily could have severe neck injuries including paralysis.
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Any collision would put him at risk for neck or concussion injuries.............but as a returner, the high speed collisions with both parties at full run,are more common..........and many times delivered by several "projectiles" and from different angles.
 
[WILL DUPLICATE THIS POST HERE AS A RESPONSE TO A QUESTION IN THE OTA THREAD.........FOR EASY RETRIEVAL PURPOSES]

maverick512000 said:
So question for you CnD, given the history and now the recovery what are the odds that Fuller and Coutee actually can make it through the season and are they rushing the recovery? I'll admit put a band aid on it and take Advil is about as far as my medical knowledge goes.
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I've written extensively re. Fuller's and Coutee's injuries in the Injury Thread. But to give a relatively quick answer:
Even if I were a gambler, I could not give specific odds for either making it through the whole season. However, relying alone on them to do so would not be the best strategy.

Fuller has had recurrent hamstring and knee problems since his rookie year.............studies has demonstrated that hamstring injuries increase the risk of ACL injuries, and ACL injuries increase the risk of hamstring injuries. So also consider Fuller a high risk for lower extremity injuries:

Oct 25, 2018 ACL Tear Grade 3 Fuller tore his right ACL

Aug 15, 2018 Hamstring Strain Grade 2 Fuller "tweaked" a hamstring in an August practice. He sat out the whole preseason (coming off January knee surgery) and missed the regular-season opener.

Dec 31, 2017 Knee Strain Grade 1 ..................He had "minor" surgery shortly thereafter.

Nov 12, 2017 Chest Rib Fracture left Week 10 and missed the next 3 games with cracked ribs.

Aug 2, 2017 Clavicle Fracture missed the entire preseason and 1st 3 games of the regular season.

Oct 30, 2016 Knee Strain Grade 1 left Week 8 with an unspecified left knee injury that cost him the game after the Week 9 bye.

Oct 11, 2016 NFL Hamstring Sprain/Pull Unspecified Grade 1 missed 1 game because of a setback with his hamstring injury.

Sep 7, 2016 Hamstring Sprain/Pull Unspecified Grade 1 popped up on the injury report leading up to Week 1 but played through his hamstring issue.


Coutee, with his multiple significant hamstring tears last season, will be considered a high risk for recurrent hamstring problems this season...........moreso, if the staff has missed an underlying functional trigger, be it anatomical or training related. As I wrote above re. Fuller, his history of hamstrings will place him at increased risk this season for other lower extremity injuries as well.
 
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