This article is part of our Injury Analysis series.
Condition Critical
By Stephania Bell, PT, MS, OCS, CSCS
Orthopedic Clinical Specialist
Certified Strength and Conditioning Specialist
RotoWire Injury Expert
RotoWire Injury Page
"2-6" is 86ed
Clinton Portis left Sunday's game with a broken right hand and later underwent surgery to implant three stabilizing screws into his right ring finger. For good measure, Portis plans to undergo surgery to repair a torn labrum in his left shoulder, an injury we were led to believe was healed. Apparently Portis' shoulder had healed enough to play, but it wasn't 100 percent. As is often the case with subluxations (partial dislocations), there can be damage to the tissue surrounding the shoulder joint, of which the labrum is a component. The labrum is a piece of fibrocartilage that attaches to the rim of the glenoid (the circular hollow on the lateral aspect of the shoulderblade that forms the socket portion of the shoulder joint) and allows for increased contact surface of the humerus (arm bone). The capsule (fibrous tissue around the joint) as well as ligaments inside the joint are also stretched in a subluxation. In essence, these structures contribute to the overall stability of what is otherwise a relatively unstable joint. Trauma can cause the shoulder to feel increasingly unstable and intermittently painful, especially if repeated contact causes the shoulder to feel like it is slipping or pinching.
Truthfully, this just wasn't Portis's year. At least he can now take advantage of the break afforded him from the hand injury (no pun intended) to get the shoulder normalized also. Repairing the shoulder requires a gradual but uncomplicated rehabilitation, and since Portis is not an overhead thrower, this surgical procedure is not of grave concern. Portis had his right labrum repaired in the past so he is familiar with the recovery process. More importantly, "the 2-6" will only be 26 next year. He is still young enough to rediscover his running back magic and produce a stellar season next fall.
For Whom Does the Bell Toll?
It's never clear what's going on with the Bells (or with any running back for that matter) in Denver. We talked about the protracted nature of turf toe injuries two weeks ago. Apparently that news hasn't made its way to Denver yet. Tatum Bell, who was probably trying to impress the coaches with his pain tolerance, was ineffective. You can't blame him here. Pain will limit function, and the toe may even feel a bit unstable. Muscle soreness, fatigue – these are things athletes can push through. Jarring, stabbing, needle-like pain, all descriptions patients have used to tell me about their turf toe condition, is not something that can just be overridden. Remember, pain is the brain's means of helping the body to protect itself so as not to do further damage. I watched the game, and I swore I could see Tatum grimacing while on the sidelines. Is he doing more damage by playing? It's hard to say for certain, but it's a concern. My guess is that if he plays this weekend, he sees less than last week's 14 carries.
Rams not on Pace
Orlando Pace, the Rams Pro-Bowl left tackle, is now out for the season with a torn triceps. During the game, you could see Pace drop his arm to his side after coming off a typical pass blocking play, clearly in pain. This is not an atypical injury for an offensive lineman. That position requires repeated triceps use when blocking, as the athlete is repeatedly pushing off defenders (imagine you're on the triceps extension machine at the gym, loaded with 250-300 pounds, doing multiple reps). Just as the hamstring is to the wide receiver, so is the triceps to the offensive lineman. Pace will have surgery to repair the major muscle tear and then will undergo a lengthy rehab to regain his mobility first, then his strength. Fortunately, he should be ready to go by next season. Until then, expect a blitzing mania against the Rams front line, and less productive numbers from the offense.
Other News of Note
Weekly Shaun Alexander update – Will he or won't he play this week? Although he has been practicing some, it is unclear whether he will play on Sunday. If he does play, it is likely to be in a limited role as he gets his feet wet, so to speak.
Matt Hasselbeck (sprained (R) MCL) attempted to practice mid-week but was reportedly limping after several plays. Although his practice later in the week looked better, it still sounds as if his return for this week is tenuous at best. If the knee is still hampering him, it could result in him playing more cautiously, as in escaping the pocket more quickly to avoid a hit. It could also render his deep balls ineffective if he feels unstable on his right side. Watch the pre-game updates, but I suspect he'll be listed as the team's backup this week.
It's rumored that Willis McGahee might be out for the season. That his rib injuries were more serious than originally thought lends credibility to that notion. On top of that, Anthony Thomas is playing well, so there's no need to rush McGahee back. Keep in mind the fracture healing timeline (six weeks) when setting expectations for McGahee.
Niners running back Frank Gore had the game of his life on Sunday – only to see it cut short by a concussion. Gore was seated on the sidelines during the fourth quarter, looking like he wished he could get back in to add to his stats. Despite his extensive injury history, Gore had not previously suffered a concussion, and he has been able to practice lightly this week. Gore should get the start on Sunday.
In the tight end department, Vernon Davis could see limited action for the 49ers this weekend. The fractured fibula has healed, but as is often the case with these injuries, there is likely residual stiffness in the ankle after being casted that hampers the athlete's mobility and agility (think Michael Vick a few years ago). Davis will have to work this out gradually as he transitions back to play. His Chiefs counterpart, Tony Gonzalez, who sprained his left shoulder and was in a sling last Sunday, has gone from "out" at the beginning of the week, to "maybe" at mid-week. This would be a quick return, and I'm not buying it. Maybe next week.
Did I mention that Brian Westbrook is probable with that ailing knee? You've seen how he's performed so far this year. This week against the Titans should be no different.
Article first appeared 11/17/06
