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Injury Thread

CloakNNNdagger

Hall of Fame
Garoppolo suffered a thumb injury during a sack in the 2nd Q of Thursday's loss. From what I have been able to determine, that injury is an ulnar collateral sprain of his right hand. Such an injury, even if mild, will affect his ability to grip and control the football for at least a couple of weeks. I see it as unlikely that he plays against the Texans. And if he does, I expect a compromised performance.
 

AcresHomesTexan

No Longer Arlington: Escaped From Jerry's World
Staff member
Garoppolo suffered a thumb injury during a sack in the 2nd Q of Thursday's loss. From what I have been able to determine, that injury is an ulnar collateral sprain of his right hand. Such an injury, even if mild, will affect his ability to grip and control the football for at least a couple of weeks. I see it as unlikely that he plays against the Texans. And if he does, I expect a compromised performance.
 

AcresHomesTexan

No Longer Arlington: Escaped From Jerry's World
Staff member
further info...I guess this should go on the game week thread

 

CloakNNNdagger

Hall of Fame
further info...I guess this should go on the game week thread

Garoppolo's injury is illustrated in the 2nd pic below. As I previously posted, playing Sunday should not be an option.

As pertains to Tunsil, what the team reports as a wrist/hand injury seems to actually be an injury involving his left thumb. At the top of my list would be an ulnar collateral ligament tear from having his thumb bent back and out, with or without fracture.

View attachment 9168

Sometimes the ligament itself will not tear but instead pulls a small piece of bone off the base of the thumb where it attaches. This is called an avulsion fracture. This can also lead to an unstable thumb joint if the injury is not repaired correctly.

View attachment 9169

We'll know more after x-rays, and MRI if needed, are performed.
 

CloakNNNdagger

Hall of Fame
1640884795343.png


Per Shanahan, Garoppolo has confirmed my information [https://www.texanstalk.com/threads/injury-thread.110817/page-71#post-3223387]that he is dealing with a Grade 3 sprain in his thumb where the ligament tore away from the bone and took a small chip of bone with it.

Garoppolo still thinks he will play Sunday. My opinion hasn't changed............he shouldn't. If he does, his grip strength and control/accuracy can be expected to be "interesting"...........likely more like a welcomed gift to the Texans.
 

CloakNNNdagger

Hall of Fame
Delusional 49ers beat writer for the San Francisco Chronicle trying to make a case for a Garoppolo playing............because he fist bumped with his right hand. Big news.........Fist bumping doesn't utilize any physical traits Garoppolo will need to throw a legitimate pass. :smiliepalm:

1640976901465.png
 

Texansphan

Hall of Fame
Kamu Grugier-Hill had what is being reported as a "minor cleanup" knee procedure after season. Dec 12 last season, he was carried off the field with a noncontact knee injury. What in fact occurred was that he suffered a medial meniscus tear and his knee locked up. The surgery he underwent was a meniscus trim.
That can result in a weakening of the knee right?
Commensurate with the amount removed.
 

CloakNNNdagger

Hall of Fame
That can result in a weakening of the knee right?
Commensurate with the amount removed.
Totally depends on the amount requiring removal. Small excisions can require only around 2 months to return to play. These players may be able to return to preinjury performance quickly. Long term prognosis is very good. Large excisions, 3-4 months. Their performance may be compromised to varying extent upon return, and their long term prognosis can see slow to moderately quick degeneration.
 

CloakNNNdagger

Hall of Fame
In light of the fact that there have been several players (specifically WRs) that have been taken high in the Draft, it would seem appropriate for me to point something out..........beyond the potential effect of the injury on future performance and longevity.

Several studies found in the orthopedic literature address the athlete's incidence of a 2nd ACL following an initial ACL rupture. They consistently report an incidence of 2nd ACL rupture at ~30%............~20% sustaining a contralateral tear and ~10% sustaining a retear of the ipsilateral repair...................within the 2 year period of the original repair.

Just because some players are making the news by pushing the envelope of quicker returns to play, ACLs have not magically become the benign injury that seems to be developing as the new narrative.
 

badboy

Hall of Fame
In light of the fact that there have been several players (specifically WRs) that have been taken high in the Draft, it would seem appropriate for me to point something out..........beyond the potential effect of the injury on future performance and longevity.

Several studies found in the orthopedic literature address the athlete's incidence of a 2nd ACL following an initial ACL rupture. They consistently report an incidence of 2nd ACL rupture at ~30%............~20% sustaining a contralateral tear and ~10% sustaining a retear of the ipsilateral repair...................within the 2 year period of the original repair.

Just because some players are making the news by pushing the envelope of quicker returns to play, ACLs have not magically become the benign injury that seems to be developing as the new narrative.
If I'm correct you are saying focus should not be on if a player gets back on field but on what he does when on the field.
 
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CloakNNNdagger

Hall of Fame
Receiver in a hurry: Texans rookie John Metchie III eager for knee to heal
Brooks Kubena, Staff writer
June 1, 2022


There paced John Metchie III, a black sleeve gripping a left knee that’s keeping the rookie Texans wide receiver sidelined during the franchise’s offseason workout program.

He twirled a towel restlessly with his right hand while his teammates ran through routes, drills and plays Wednesday at the practice facility. Sometimes he tossed a football to a team staffer on the sideline. Then, with one carefree sprint as the offense moved to the other side of the field, Metchie provoked a question that will likely last through the summer: Just how soon will the second-round pick recover from his torn ACL?

If you ask Metchie, he’d say he’s a month away from a full recovery. Minutes after the Alabama receiver was selected No. 44 overall, he told reporters he’d be “full-go football” in July, that he’d been running, cutting and jumping in the months leading up to the NFL draft and felt “better than I ever felt.”

General manager Nick Caserio later said not to “put too much stock” in Metchie’s projection. Caserio said “when he’s ready, he’ll be ready” and that the Texans weren’t “going to rush or push” Metchie.

Coach Lovie Smith has equally demurred when asked about his newest pass-catcher, who totaled 96 receptions, 1,142 yards and eight touchdowns last season before his left knee buckled while he was running a route just before halftime in December’s Southeastern Conference Championship Game.

But Metchie’s unassisted movements reflect a recovery timetable that was ahead of schedule when he declared early for the draft, says Dr. Lyle Cain, the Alabama team physician who conducted Metchie’s knee surgery.

“He’s beaten every timetable we normally have,” said Cain, the Crimson Tide’s team physician since 2001. “So based on how he does once he gets to Houston in his continued recovery, I think he has a good chance to be ready to play.”

Cain has seen Alabama athletes return anywhere between five to nine months based on how well their body responds to surgery. Since Metchie’s ACL tear was a noncontact injury, there wasn’t any other damage to the knee beyond the torn ligament. There also was very little swelling, which gave Metchie the illusion he was prepared to play in Alabama’s semifinal playoff game against Cincinnati.

“He actually thought he was OK,” Cain said. “It took a little bit of discussion and convincing that he wasn’t OK to continue playing.”
Cain repaired the ACL (which essentially stabilizes the knee and helps someone pivot and cut) by performing a standardized surgery in which the middle third of the patellar tendon — which stretches from the kneecap to the tibia — is cut out and used to replace the torn ligament.

Even post-surgery, Metchie’s knee looked “normal.” Cain said an athlete’s knee is typically still swollen for two to three weeks after an operation and has difficulty with range of motion. Metchie’s body “responded well,” Cain said, and the physician “could see early on that he was going to do well.”

“I think he’s able to hit all the milestones that the medical staff in Houston wants him to meet in terms of being ready to do things for the team this summer,” Cain said.

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


At this point in the preseason, it seems like players coming back from injuries are always "ahead of schedule."
 

Number19

Hall of Fame
Receiver in a hurry: Texans rookie John Metchie III eager for knee to heal
Brooks Kubena, Staff writer
June 1, 2022


There paced John Metchie III, a black sleeve gripping a left knee that’s keeping the rookie Texans wide receiver sidelined during the franchise’s offseason workout program.

He twirled a towel restlessly with his right hand while his teammates ran through routes, drills and plays Wednesday at the practice facility. Sometimes he tossed a football to a team staffer on the sideline. Then, with one carefree sprint as the offense moved to the other side of the field, Metchie provoked a question that will likely last through the summer: Just how soon will the second-round pick recover from his torn ACL?

If you ask Metchie, he’d say he’s a month away from a full recovery. Minutes after the Alabama receiver was selected No. 44 overall, he told reporters he’d be “full-go football” in July, that he’d been running, cutting and jumping in the months leading up to the NFL draft and felt “better than I ever felt.”

General manager Nick Caserio later said not to “put too much stock” in Metchie’s projection. Caserio said “when he’s ready, he’ll be ready” and that the Texans weren’t “going to rush or push” Metchie.

Coach Lovie Smith has equally demurred when asked about his newest pass-catcher, who totaled 96 receptions, 1,142 yards and eight touchdowns last season before his left knee buckled while he was running a route just before halftime in December’s Southeastern Conference Championship Game.

But Metchie’s unassisted movements reflect a recovery timetable that was ahead of schedule when he declared early for the draft, says Dr. Lyle Cain, the Alabama team physician who conducted Metchie’s knee surgery.

“He’s beaten every timetable we normally have,” said Cain, the Crimson Tide’s team physician since 2001. “So based on how he does once he gets to Houston in his continued recovery, I think he has a good chance to be ready to play.”

Cain has seen Alabama athletes return anywhere between five to nine months based on how well their body responds to surgery. Since Metchie’s ACL tear was a noncontact injury, there wasn’t any other damage to the knee beyond the torn ligament. There also was very little swelling, which gave Metchie the illusion he was prepared to play in Alabama’s semifinal playoff game against Cincinnati.

“He actually thought he was OK,” Cain said. “It took a little bit of discussion and convincing that he wasn’t OK to continue playing.”
Cain repaired the ACL (which essentially stabilizes the knee and helps someone pivot and cut) by performing a standardized surgery in which the middle third of the patellar tendon — which stretches from the kneecap to the tibia — is cut out and used to replace the torn ligament.

Even post-surgery, Metchie’s knee looked “normal.” Cain said an athlete’s knee is typically still swollen for two to three weeks after an operation and has difficulty with range of motion. Metchie’s body “responded well,” Cain said, and the physician “could see early on that he was going to do well.”

“I think he’s able to hit all the milestones that the medical staff in Houston wants him to meet in terms of being ready to do things for the team this summer,” Cain said.

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


At this point in the preseason, it seems like players coming back from injuries are always "ahead of schedule."
Seems to me a key point mentioned here is that there was no damage to the knee beyond the torn ligament.
 

CloakNNNdagger

Hall of Fame
Seems to me a key point mentioned here is that there was no damage to the knee beyond the torn ligament.
It's always good to hear that "there was no damage to the knee beyond the torn ligament." Just understand that means no obvious gross additional damage was appreciated, and there appears to be subsequent changes that are not appreciated right after the injury/surgery.

The mechanism responsible for cartilage breakdown and progression to degenerative changes following ACL injury is multifactorial and not completely understood. The development of these changes after ACL injury may be the result of the initial injury to the subchondral bone and hyaline cartilage. At the time of injury, the high force of the trauma iinvariably disrupt the intra-articular structures. Occult boney/cartilage lesions, or bone bruises, as measured on MRI, occur in 90% of patients with an acute ACL injury. These lesions suggest that articular cartilage sustains a considerable mechanical impact at the time of injury. These findings are not usually reported as "additional/associated" injuries, as are meniscus, or gross cartilage avulsion or tears, or fractures, or other knee ligament injuries. The hope is always that the progression of the damaging effects on the bone and cartilage are limited. In one publication concerning ACL rupture in young athletes in Arthritis and Rheumatology, it was estimated that an ACL rupture empirically ages the knee by 30 years.

But bottom line, like all injuries, only time will give us the answers we are seeking.
 

CloakNNNdagger

Hall of Fame
WR DaeSean Hamilton went down just a few minutes ago after making a cut with no contact injury. He clutched his right knee immediately and was carted off the field. From the limited information, I would suspect a ruptured ACL.
 
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CloakNNNdagger

Hall of Fame
WR DaeSean Hamilton went down just a few minutes ago after making a cut with no contact injury. He clutched his right knee immediately and was carted off the field. From the limited information, I would suspect a ruptured ACL.
Keep in mind that Hamilton suffered an ACL rupture May 2021 while training on his own.
 

CloakNNNdagger

Hall of Fame
Apparently, Hamilton did not rupture his ACL, but he will be undergoing surgery on his right knee and the team says that he is expected to be able to return this season. The only other injury that I can think of that can be noncontact and still return in the same season is a Grade III MCL (rupture)..........with a timeline of placing him on the PUP before the season. He would then not be able to practice with the team for 6 weeks, then after the 6th week, he must be allowed to return to practice, placed on injured reserved or released within five weeks. If he returns to practice, the team has three weeks to decide to place him on the active roster or on the injured reserve list.
 

CloakNNNdagger

Hall of Fame
Britt is reported to have suffered an "ankle" injury yesterday. From what I've been able to determine, he has unfortunately not experienced a low ankle sprain, but a high ankle sprain. I hope they go easy on his return. Even so, he is likely to feel its effects in the future, while being at significant risk for aggravation.
 

vtech9

All Pro
Britt is reported to have suffered an "ankle" injury yesterday. From what I've been able to determine, he has unfortunately not experienced a low ankle sprain, but a high ankle sprain. I hope they go easy on his return. Even so, he is likely to feel its effects in the future, while being at significant risk for aggravation.
Who is taking Britt's snaps at C?
 

CloakNNNdagger

Hall of Fame
Darius Anderson dislocated his knee and suffered other damage that required immediate season-ending surgery. This typically is a horrible injury. A knee dislocation would be expected to disrupt several or all of knee stabilizing ligaments [anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments].

1660157948854.png


1660157168683.png

As far as vascular structures are concerned, the popliteal artery is at the highest risk of sustaining insult due to a knee dislocation. The artery stretches across the popliteal space [back of the knee] and gives off several branches in a collateral system around the knee. Given its position in the popliteal space and the mechanism of knee dislocation, up to 40% of patients with a knee dislocation will sustain an associated vascular injury.

1660157383127.png


Peroneal nerve injuries can also occur in greater than 20% of knee dislocation patients, given the anatomic location of this nerve at the fibular neck. Injury to this nerve can lead to loss of movement or sensation in the foot.

1660157478773.png

Compartment Syndrome, swelling in the lower leg area is another potentially devastating part of this injury. The nerves and arteries in the lower leg are compressed within a nonyielding fascial compartment, and if not decompressed by surgically releasing [fasciotomy] the bordering restricting fascias in a timely fashion, nerves and arteries can die and the target distributions of the blood circulation is cut off and dies.


1660158943587.png

1660158669060.png

And another significant complication that occurs following such an injury is blood clots forming in the leg, with some potentially travelling up into the lungs [pulmonary embolus].........something I don't even want to further follow.

The next few days is the first critical period, but at least 3 more weeks until the second critical period may be passedn . Praying for this unfortunate young man.
 

CloakNNNdagger

Hall of Fame
I've been asked about Anderson's return. Without knowing exactly thus far what of the above injuries Anderson suffered, including what meniscus and/or articular cartilage may have occured, I cannot give exact prognosis. But it will be a challenging road back.

A study Return to Play After Multi-Ligament Knee Injuries in National Football League (NFL) Athletes published in Orthop J Sports Med.in July 2017......specifically followed 51 NFL athletes which were found to have multi-ligament knee injuries between 2000 and 2016 The overall return to play [RTP] rate following multi-ligament knee injuries [including those with 1, 2 and 3 ligaments] was 63%. Athletes with only ACL/MCL tears had an RTP rate of 72%, while the athletes with frank knee dislocations [in this series all having 3 ligaments torn] had a 50% RTP rate. Mean time to RTP for all 51 athletes was 11.9 months. The mean time to RTP for athletes with ACL/MCL injuries was 10.4 months compared to 21 months for those with frank dislocations. Athletes with ACL/MCL injuries were more likely to return to prior performance levels of 46% vs <15% for those with frank dislocations.
 


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