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Injury Thread

CloakNNNdagger said:
There are only about 24 cases of bilateral patellar tendon ruptures in the world medical literature. All but a handful were due to an underlying systemic disease that weakened the tendon, which Newton would have shown by his teen years. The couple of sports-related cases were incurred while coming down off a jump (non contact). The only NFL player that I can think of that has sustained simultaneous bilateral ruptures is a Vikings' WR (can't remember his name) in his rookie year during TC..........and as far as I know never played a down in a regular game.

Just like an Achilles tendon, overuse is usually the cause of a progressive tendinosis......degeneration of the tendon.........until ultimately it weakens enough to rupture, usually in a non contact scenaria. What is interesting is that an ankle injury not uncommonly precedes and promotes tendinosis (degeneration ) of the patellar tendon due to the compensatory stresses placed upon it. And that's why in the Injury Report I stated my concerns over the combination of ankle with an existing knee condition. That combination is never something to take lightly, especially since these type of injuries tend not to be isolated to that structure of the knee (PCL, ACL, [in fact any of the knee ligaments] meniscus, articular cartilage]).
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So Doc, this is a for sure career ending injury or would you say it was career threatening.
 
Here's what happened to a different dude with ONE patellar tear:

"Williams suffered a ruptured patellar tendon in his right knee while playing in a 2011 pre-season game against the Green Bay Packers. He described his kneecap being shifted into his thigh and that makes sense since the quadriceps muscle is powerful enough to pull it into the thigh"

Yeah that sounds painful. I'm guessing Newton's career is done. I was reading that he should be in a wheel chair for a month. Can't put any weight on it; much less a guy his size. Damn.
 
The leg/knee extensor mechanism consists of the quadriceps muscles and their tendon, the patella, and patellar tendon which attaches to the tibial tuberosity. Rupture of the patellar or quadriceps tendon or a fracture of the patella itself can all disrupt the extensor mechanism.

med-retinaculum.jpg




In the presence of a healthy patellar tendon, the patella is actually considered to be the weakest link in the extensor mechanism and tensile overload usually leads to a transverse fracture of the patella. The usual mechanism of injury is knee flexion combined with quadriceps contraction.



adult_knee_fx_types09.jpg


Disease conditions such as systemic lupus erythematosus (SLE), Diabetes Mellitus, rheumatoid arthritis, chronic renal failure, and patients on corticosteroids are susceptible to patellar tendon ruptures as these conditions are known to weaken collagen-based structures such as tendons and ligaments.

But a healthy normal patellar tendon requires a massive force to be disrupted and should not rupture under physiological loads. It has been determined that 17.5 times the body weight is required to cause the rupture of a normal patellar tendon. Of course, in athletes, as overuse with its degenerative effects on the tendon (tendinosis) enters the equation, a lesser although still an unusually heavy load placed on the tendon can lead to the disruption of this tendon

A00512F01.jpg
 
Insideop said:
So Doc, this is a for sure career ending injury or would you say it was career threatening.
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If you remember, Newton had an extremely difficult time coming back from his single patellar tendon rupture. A single patellar rupture is difficult enough for an NFL player to come back from in the first place. But in a 300+ pounder, it is not uncommon for it be career ending. A bilateral patellar tendon rupture in any NFL player must almost invariable be considered a career ender. In a 6'6" 315 pound lineman (at 29 years of age in 2 weeks), it is a career ender...........and if you really want to nail the coffin, top it off with a history of previous patellar tendon rupture.

Keep in mind that with bilateral patellar tendon ruptures, there is the potential for other devastating injuries to the knee joints (see MY POST above) that lead to the road to no return.
 
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Newton was ambulanced to the airport last night. He made the trip back to Houston with his teammates. Surgery should be performed as soon as swelling resolution allows, in that in general, the prognosis for the best functional results are associated with the shortest time delay from injury. After 3 weeks (considered a very long delay), results are expected to be quite poor.
 
The good news is that he'll get an injury settlement and a number of good benefits in the event of his leaving the game.

That and not having to be part of the current suckage. :kitten:
 
Man, I hope he can walk after this.
Best of luck to him with the surgery and post-op recovery.
 
As badly as Brown has been moving, it's hard for me to tell for sure, but it appeared to me that he may have re-injured his knee during the game.
 
I know Newton gets a bad rap from a lot of the fan base but you have to feel for that guy. He has done whatever the Texans have asked him to do play RT,LT,RG just wherever he was needed and to have his legs just give out on him is a tough one to swallow. I wish him the best in his recovery whether he ever plays another down for the Texans or not.
 
texanhead08 said:
I know Newton gets a bad rap from a lot of the fan base but you have to feel for that guy. He has done whatever the Texans have asked him to do play RT,LT,RG just wherever he was needed and to have his legs just give out on him is a tough one to swallow. I wish him the best in his recovery whether he ever plays another down for the Texans or not.
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Agreed, no one deserves that injury...







... Except Albert Haynesworth.
 
A single patellar tendon rupture is hard enough to come back from. Through a 10 year period, NFL injuries obtained from the NFL injury data bank were analyzed in a Sept 2016 study.

Players had a RTP rate of only 50 percent after patellar tendon repair (a rate of return comparable to a previously published NFL quadriceps tear study), which was significantly lower compared to all other procedures analyzed. Included in the study were players who had procedures for anterior cruciate ligament (ACL) tears, Achilles tendon tears, patellar tendon tears, cervical disc herniation, lumbar disc herniation, sports hernia, knee articular cartilage repair (microfracture technique), forearm fractures, tibial shaft fractures and ankle fractures.

The study found that players who had knee surgeries experienced the most significant decline in performance. Athletes who had surgery to repair the patellar tendon, the tendon connecting the knee bone to the shin, fared the worst with respect to the RTP..........and for those that were able to return, they fared by far the worst with respect to career length after surgery, games played and performance at one year, two years and three years after surgery.
 
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CloakNNNdagger said:
Newton was ambulanced to the airport last night. He made the trip back to Houston with his teammates. Surgery should be performed as soon as swelling resolution allows, in that in general, the prognosis for the best functional results are associated with the shortest time delay from injury. After 3 weeks (considered a very long delay), results are expected to be quite poor.
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As it turns out, Newton did not fly back last night with the team. It was felt that he could not tolerate the ride in the team charter. When it was first announced that he was taking the team plane, I had a tough time understanding such a move..........this type of injury is extremely painful and he would have had to been heavily narcotized, needing strict monitoring and placed in a totally stretched out position...............not usually accommodations available in a typical non-medical charter flight.

Aaron Wilson Verified account ‏@AaronWilson_NFL
Derek Newton unable to travel on charter last night w/ torn patellar tendons, to return to Houston today, legs immobilized, can wiggle toes
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Texans' Derek Newton faces uphill climb to play again after rare injury
By Aaron Wilson

October 25, 2016

Texans guard Xavier Su'a-FIlo, left, consoles fellow lineman Derek Newton after Newton was injured Monday night.
Bent backward awkwardly against the Denver Broncos, Texans offensive tackle Derek Newton suffered a horrific rare set of injuries Monday night that are regarded as serious enough to be considered career-threatening.

Newton traveled back to Houston on Tuesday after remaining in Denver overnight after tearing both patellar tendons while falling during his attempt to block Broncos star outside linebacker Von Miller.

Newton may have sustained additional damage to his knees, and a magnetic resonance imaging exam and X-rays will be performed in Houston, according to sources not authorized to speak publicly.

Newton was unable to travel on the Texans' charter flight back to Houston and has been experiencing severe pain. His legs have been immobilized. He can wiggle his toes. He will be placed on injured reserve.


Difficult rehab

Surgery will eventually be performed to repair a significant amount of damage. Renowned orthopedic surgeon Dr. James Andrews already has consulted with Newton.

"We're still gathering a bunch of information," Texans coach Bill O'Brien said. "He'll obviously be out for the season. I can't give you any specifics on the injuries and things like that because we still have doctors' visits.

"He stayed overnight in Denver and he's on his way back now. I feel bad, just a tough injury, but I know he's going to work hard to come back."

Newton is expected to be in a wheelchair for several weeks before progressing to crutches and then walking within three months as he starts rehabilitating from an injury that has prevented NFL players in the past, including former Chicago Bears wide receiver Wendell Davis and former Cleveland Browns cornerback Gary Baxter, from resuming their careers.

"I am not aware of an NFL athlete who came back to play at a similar level after this injury," said former San Diego Chargers team doctor David Chao, who doesn't treat Newton. "The injury is very rare. It's not a once-a-year injury. This is a once-every-five-years. This is harder to come back from than a torn ACL. To have two of them is devastating, but, yes, he should be walking in three months. There's a big difference between walking and playing.

"Look how long it took Duane Brown to come back from a torn quadriceps tendon, and this is much more serious. I wouldn't be shocked if there's also a torn ACL involved. I feel bad for the kid. A ruptured patellar tendon is three times worse than an ACL. Guys who tear an ACL like Geno Smith walk off the field. ACL surgeries are arthroscopic. A patellar tendon is an open surgery, a major reattachment. This is a very big deal for him to come back from."

The former seventh-round draft pick from Arkansas State was replaced in the lineup by veteran swing tackle Chris Clark.

Teammates were visibly distraught about Newton's injury.

Hard worker

In his sixth NFL season, Newton, 28, is playing under a five-year, $26.5 million contract that includes $10 million guaranteed and a $3.75 million signing bonus.

Newton faces an uphill fight to ever play again, let alone reach his former playing standard.

"Man, that hurt a lot," Texans left tackle Duane Brown said. "He's like a little brother to me. I know how hard he's worked and how much he puts into the game, battling through injuries quite a bit. I know how that feels. I went through something similar last year. My heart hurts for him. I'm praying for a speedy recovery for him."

The 6-6, 315-pounder missed the Texans' game last week against the Indianapolis Colts with an ankle injury. He has dealt with knee and ankle injuries this season. He was sidelined for the entire preseason with a hamstring injury.

In his sixth NFL season, Newton is playing under a five-year, $26.5 million contract that includes $10 million guaranteed and a $3.75 million signing bonus.

"To lose your brother like that, we hold him dear to our hearts," Clark said. "When that happened to him, we all felt that internally. That's not just another guy that went down. That's our brother.

"Can you bounce back from that? I'm not talking about the team. I'm talking about him as a player. How do you even start rehab? What doesn't kill you makes you stronger. We have a tight-knit group. We hold each other accountable and get things done together."
 
lol I remember how that smug prick Bill O'Brien was all "durrrrrrrr Newton hasn't even had an MRI yet so I don't know how anyone would know what happened" when questioned after the game.

Piece of crap.
 
TheMatrix31 said:
lol I remember how that smug prick Bill O'Brien was all "durrrrrrrr Newton hasn't even had an MRI yet so I don't know how anyone would know what happened" when questioned after the game.

Piece of crap.
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That may he because be was hoping the early reports were wrong.
 
TheMatrix31 said:
lol I remember how that smug prick Bill O'Brien was all "durrrrrrrr Newton hasn't even had an MRI yet so I don't know how anyone would know what happened" when questioned after the game.

Piece of crap.
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Coaches already dislike speaking publicly, and they especially don't like speaking on topics that they're lacking information on. All reasons why coach (and player) interviews are usually pointless.
 
Texas Jake said:
That may he because be was hoping the early reports were wrong.
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Nah. He was just trying to be secretive and whatnot like his asshole former boss. Blowing sunshine and trying to misdirect. Only makes him look like a fool and a liar.

He could have said "well we hope the early reports are wrong, but it doesn't look good."
 
On to another player player. AJ Bouye left game but cannot find out anything on him. He was having a very good season.
 
TheMatrix31 said:
Nah. He was just trying to be secretive and whatnot like his asshole former boss. Blowing sunshine and trying to misdirect. Only makes him look like a fool and a liar.

He could have said "well we hope the early reports are wrong, but it doesn't look good."
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You're just hating. OB didn't do anything bad at all with this. You're the asshole for being judgmental on this. Just say you hate everything about OB and be done with it.
 
Doc, what are your thoughts on the "sickle cell trait" that caused Cardinals WR John Brown to miss last week's game. Apparently he had leg pain and it was initially announced as a hamstring injury. Very unique situation as I can't remember any similar situations happening in the league. Maybe Rahim Moore had a similar leg issue?

Is that a type of injury he may be rushing back from to play this week?
 
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TheRealJoker said:
Doc, what are your thoughts on the "sickle cell trait"

Is that a type of injury he may be rushing back from to play this week?
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I'll be watching this closely as my 2 boys have the same trait. From the research I've done, it was my understanding that side effects are rare but most often show up as muscle soreness and fatigue from intense physical exertion if they do occur. I've been told that drinking lots of liquids can help and rest. I'm also interested in hearing doc's take or someone else with experience.
 
TheRealJoker said:
Doc, what are your thoughts on the "sickle cell trait" that caused Cardinals WR John Brown to miss last week's game. Apparently he had leg pain and it was initially announced as a hamstring injury. Very unique situation as I can't remember any similar situations happening in the league. Maybe Rahim Moore had a similar leg issue?

Is that a type of injury he may be rushing back from to play this week?
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Max said:
I'll be watching this closely as my 2 boys have the same trait. From the research I've done, it was my understanding that side effects are rare but most often show up as muscle soreness and fatigue from intense physical exertion if they do occur. I've been told that drinking lots of liquids can help and rest. I'm also interested in hearing doc's take or someone else with experience.
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The sickle cell trait is one that an athlete must understand its implications. That trait carries a deficiency of the hemoglobin in red blood cell. Hemoglobin is the protein component of blood the protein in red blood cells that attracts and carries oxygen to the tissues of the body. Sickle cell interferes with the release of the oxygen by the hemoglobin and the delivery of oxygen to the tissues. This is especially very problematic when athletes require large amounts of additional oxygen delivery to especially increasingly taxed muscle tissues. This can easily account for muscle cramping. If the athlete is poorly hydrated, the blood in sickle cell patients concentrate and become sludge-like instead of fluid-like..........thus further compromising circulation and the timely delivery of the oxygen to needed tissues. When th these low-oxygen conditions skeletal muscle breakdown occurs.............which in enough quantity can results in the release of substances that can be toxic to the cardiac (heart) and renal (kidney) systems......................large amounts of potassium that have been known to cause heart failure and sudden death in athletes...............and large amounts of muscle breakdown protein called myoglobin which can cause kidney failure. This is not even to include stroke secondary to sludging of the blood. These risks to a sickle cell trait athlete are particularly high during hot weather months and padded practices and games, when dehydration and therefore sludging is much more likely to occur. Football makes sickle cell trait particularly risky for a number of reasons: practice tends to start during some of the hottest months of the year and players often practice in pads, which can add to the heat stress. Finally, playing in high altitude venues such as Denver, where even "normal" athletes have trouble with sludging of their blood and the low oxygen conditions maintaining their expected normal functions presents another very risky situation to the sickle cell trait athlete.

Muscle cramping is a red flag that an athlete with sickle cell trait should never ignore..........a warning if not addressed may herald much worse things to come.
 
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CloakNNNdagger said:
The sickle cell trait is one that an athlete must understand its implications...
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Thanks for the response - this is very helpful. Do you know if the conditions you've described are common with those with this trait or simply risks? And you mentioned not ignoring muscle cramping - how should this be addressed?
 
Max said:
Thanks for the response - this is very helpful. Do you know if the conditions you've described are common with those with this trait or simply risks? And you mentioned not ignoring muscle cramping - how should this be addressed?
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Once muscle cramping occurs, hydration must be ensured and application of supplementary oxygen. If the muscle cramping is not quickly reversed, especially if the urine turns brown (a sign that myoglobin is being released in significant amount), a physician should be sought to monitor and begin appropriate blood testing to assess the extent of the pathological process.
 
CloakNNNdagger said:
Mods, please remove the above as obvious spam...........follow the poster's pattern and you find all of his 5 posts are the exact same posted in different areas........probably a good idea to remove his posting privileges.
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Wait..what..where..who?? How did I miss whatever I missed? Dang I never get in on the good stuff.
idonno:
 
I spent the weekend at a seminar listening to Derek Hansen (renowned track coach) speak on speed training. One of the topics that always comes up in these discussions is hamstring injuries. He had some interesting thoughts on the issue. A key concept in training is the SAID principle- specific adaptations to imposed demands, in other words the body adapts to whatever stress is applied provided its in a tolerable dose. Sprinting is VERY stressful to the body, in fact the forces WAAAY exceed anything done in a weight room. Long story short, he theorized one of the reasons we see so many hamstring/Achilles issues in FB has to do with the way teams conduct practices. In an effort to "condition" players or in an effort to get as much work in as possible (i.e. Run as many practice plays as possible) the players aren't exposed to enough peak velocity work and the tissues aren't as conditioned to handle it.

To fix it he suggested having athletes run as fast as possible with complete recovery, which for a 40yd dash would take 5 mins between reps. Running some full speed 40s at the beginning of practice might be all it would take to prevent or reduce the number of games missed to hamstring strains. He also disused managing the overall workload to control fatigue and provide more high quality work vs doing as much work as possible. I thought he presented some very interesting concepts.
 
otisbean said:
I spent the weekend at a seminar listening to Derek Hansen (renowned track coach) speak on speed training. One of the topics that always comes up in these discussions is hamstring injuries. He had some interesting thoughts on the issue. A key concept in training is the SAID principle- specific adaptations to imposed demands, in other words the body adapts to whatever stress is applied provided its in a tolerable dose. Sprinting is VERY stressful to the body, in fact the forces WAAAY exceed anything done in a weight room. Long story short, he theorized one of the reasons we see so many hamstring/Achilles issues in FB has to do with the way teams conduct practices. In an effort to "condition" players or in an effort to get as much work in as possible (i.e. Run as many practice plays as possible) the players aren't exposed to enough peak velocity work and the tissues aren't as conditioned to handle it.

To fix it he suggested having athletes run as fast as possible with complete recovery, which for a 40yd dash would take 5 mins between reps. Running some full speed 40s at the beginning of practice might be all it would take to prevent or reduce the number of games missed to hamstring strains. He also disused managing the overall workload to control fatigue and provide more high quality work vs doing as much work as possible. I thought he presented some very interesting concepts.
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Very interesting and timely......thanks for posting. I first became aware of the SAID principle around the time of the new CBA. The fact is that before this CBA, these type of injuries were not as prevalent..........and certainly so for recurrent strains. The SAID principle would not ignore the need for an adequate rest period following injury. Some teams arbitrarily gloss over this important phase of rehab. An acutely torn hamstring muscle does not tolerate too early applied stress. This goes along with what I've been saying forever.........you can't stress/rehab the hamstrings safely by less than a handful of "limited" practices during the week .............then throw the player into a real time game where the hamstring is exposed to closer to maximal stresses...........and not expect that something bad is more likely to happen on Sundays.

One last thought, as you've noted above, sprinting indeed seems to be an excellent tool for accelerated rehab of a hamstring. However, sprinting "protection" of the hamstring in football does not account for all the forceful intermittent and unequal forces applied to the hamstring when the player is required to repeatedly stop and accelerate and change direction..................and many times against great resistant loads. This is the same reason that when fans see players sprinting full out on the sidelines after severe knee injuries and get so excited about the player almost being ready to hit the field again, they don't understand how far away that player may be from returning to game play.......or even realistically ever returning.
 
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OK - I'm just trying to make sure I understand correctly what you are saying (I'm not a doctor, nor did I stay at a holiday inn express last night).

With the CBA limiting the amount of "real football" that occurs during practice in a hope to prevent more severe injuries during practice, they are opening themselves up to more of these type of hamstring or groin pull injuries?
 
FuzzyLogic said:
OK - I'm just trying to make sure I understand correctly what you are saying (I'm not a doctor, nor did I stay at a holiday inn express last night).

With the CBA limiting the amount of "real football" that occurs during practice in a hope to prevent more severe injuries during practice, they are opening themselves up to more of these type of hamstring or groin pull injuries?
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Yes.
 
Will Fuller's exit reported as a generic "leg injury," as I suspected is actually a re-injury of his hamstring..........he initially only missed 1 game and had since not participated in a contact practice up to this last game.
 
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