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
Much Ado About Nothing
This sums up my assessment of the Terrell Owens situation in Dallas. Owens is one of several highly visible players dealing with a hamstring injury. But because T.O. is T.O., every nuance must be analyzed. From the point of view of the injury itself, there appears to be nothing serious, despite the team of specialists and a hyperbaric chamber. The MRI was negative, meaning there is no major structural damage or serious inflammation. In Owens' defense however (those are four words you never see together), a mild muscle strain in the form of microtearing can certainly cause pain, and the MRI will not be sensitive enough to register anything. Being the elite athlete that he is, Owens knows his body and can no doubt recognize when he is not 100 percent. Some would argue that many players still practice when they are not 100 percent. No one in Dallas however wants to run the risk of jeopardizing Owens' long-term health so that he can "build rapport" with Bledsoe and company now. Better healing now means less likelihood of a more serious or chronic injury during the season. Owens has always been a little fragile when it comes to injury, but his performance when he's healthy has always made it a worthwhile trade-off.
Same Time, Next Year
It doesn't seem fair for Bruschi - last year a stroke, this year a wrist fracture. Clearly, the stroke was by far the more serious health concern. Bruschi made an amazing recovery from that event and returned as an inspiration to his team. Scaphoid fractures (when the small wrist bone near the thumb breaks) are primarily a concern when they are missed. The scaphoid has a very delicate blood supply that can be interrupted when the bone is broken. If that should happen, a condition called avascular necrosis (bone death as a result of impaired blood flow) can occur, ultimately resulting in potential long-term disability. Surgery to insert a stabilizing screw is performed to help ensure that this does not happen. Standard fracture healing time, with or without hardware, is six weeks. Bruschi is projecting his return sooner because if the bone appears to demonstrate good healing, players can sometimes return to action in a hard splint or cast. The thumb would be immobilized though making it difficult for Bruschi to make a pick or grab an opponent. Even once he gets out of the cast, he will need work on his range of motion and overall wrist and forearm strength to allow him to tackle effectively. Regardless of when he is cleared to play, it is safe to assume that it will take a minimum of six weeks, but perhaps up to eight or nine weeks for him to truly return to form.
Play it to the Bone
Curtis Martin is certainly suffering with his knee problems. For the record, when a player is reported to have "bone-on-bone" in the knee, it means that the cartilage (the smooth shiny stuff that covers the ends of bones - think chicken) has worn away. There is no ability to repair that cartilage. When it's gone, it's gone. So why do these athletes have surgery to "fix" their knees? There are several procedures that can be done to try to help these knees, and the choice depends on how extensive the cartilage damage is. If the cartilage damage is relatively small, the surgeon may just shave down the rough spots, a procedure known as debridement. For the more extensively damaged knee, a technique called microfracture, or picking, can be done to bore some small holes in the ends of the bone, causing it to bleed. This results in the laying down of fibrous tissue in response to the bleeding. The problem is that the fibrous tissue that is created is not smooth and shiny like the original cartilage that is found in the joint. End result? Generally the athlete experiences less pain, at least for a while, but there are no guarantees. Judging from Martin's challenges this early on, it would appear that even if he is able to play, his knee is likely to give him trouble throughout the season.
Biker Boys
Ben Roethlisberger and Kellen Winslow both seem to have made full recoveries from their scary motorcycle accidents. Roethlisberger has been cleared to start which is amazing considering that he suffered multiple facial fractures only two months ago. The unknown is how he will feel when he absorbs that first crushing hit. Winslow, who has had multiple surgeries on his knee, including one to clear an infection, showed no ill effects in Thursday's pre-season opener. It remains to be seen how his knee will hold up throughout the season however to repeated landing, twisting and pivoting, not to mention contact. Durability may be a factor.
The Emperor's New Groove
Who said that shedding a few pounds during the offseason couldn't help a player's morale? McNabb shed about 225 in the form of Terrell Owens. Oh and yes, McNabb had that sports hernia repair from which he has recovered in fabulous fashion. In two consecutive preseason games, McNabb has looked sharp and strong. A sports hernia is particularly debilitating because of the weakness it causes in the trunk and pelvis. In McNabb's case it became difficult for him to throw hard and almost impossible for him to run as his injury progressed. McNabb's cross-body throws and efficient ball delivery in these early contests should leave no doubt that he is fully recovered.
Other news of note:
Brian Westbrook has another foot sprain. It's the other foot this time though, and it sounds much less serious. Most importantly, he looked to have no residual effects from the right midfoot (Lisfranc) sprain he sustained last year.
Chad Pennington looks to be starting the season opener, coming off his second rotator cuff repair to his throwing shoulder. He still has not gone to the ground yet, and his coaches and teammates hope that he doesn't in his first game. Landing on the shoulder is the most common way quarterbacks injure the throwing arm, not by throwing as is commonly believed. It is wise to be cautiously optimistic when it comes to Pennington.
Javon Walker is reportedly experiencing soreness intermittently in his right knee. Last week he was part of the amazing ACL recovery storybook. Now he has missed a few workouts. Although he is still on track to return at the start of the season, this is one of those reminders that the first year after ACL reconstruction is often a rebuilding year for a receiver or running back.
Article first appeared 8/11/06
