JOHN DOHERTY | SPORTS MEDICINE

JOHN DOHERTY: NFL injury practices far from letter perfect

2013-01-28T18:30:00Z 2013-01-28T23:18:04Z JOHN DOHERTY: NFL injury practices far from letter perfectJohn Doherty Times correspondent nwitimes.com
January 28, 2013 6:30 pm  • 

DEAR JOHN DOHERTY: The New England Patriots played tight end Rob Gronkowski in the divisional playoff game. And he breaks his arm AGAIN! Can you comment on whether a poor and rushed decision was made?-- Thomas Thiel

Dear Tom: The Patriots are notorious for revealing little about injuries. Consequently, I am unsure exactly where and what bone or bones Gronkowski fractured.

Given they did acknowledge the forearm as the site, I assume that the radius and/or ulna were involved. Those are defined as long bones … which take a long time to heal … even when the healing is assisted by surgical stabilization … which Gronkowski had.

Given all those facts, it is reasonable to assume Gronkowski’s arm would have been healed sufficiently in 4-6 weeks … for dressing, eating, and rehabilitation. It would then take another six weeks, at least, to regain relatively full muscular strength.

However, a gradual return to sports should not be allowed until x-ray evidence of full healing which, according to the medical literature, requires 3-4 months.

Gronkowski, though, returned to playing just six weeks after his injury. Used in a limited capacity against the Dolphins in the regular-season finale, four weeks ago, he caught a touchdown pass.

Thanks to the play-off bye the Patriots earned, Gronkowski was off the following week. So, it wasn’t until eight weeks post-injury that Gronkowski was re-injured.

Furthermore, the whispers are that the fracture wasn’t a true re-injury but a new one, at the end of the stabilizing hardware, where the bone is theoretically weaker and always will be.

So, was Gronkowski brought back too soon?

The easy answer is yes. However, in the Patriots' defense, similarly injured and treated players have been brought back in a similar time frame without consequences.

Forearm fractures are relatively rare in sports.

ACL tears/reconstructions are much more common and the experience of several prominent athletes may be instructive. The commonly accepted recovery time is 9-12 months.

Robbie Hummel, while still playing basketball at Purdue in 2010, attempted a comeback in seven months and tore the graft in his knee. Still, that same year, Patriots wide receiver Wes Welker returned from the same injury in just a month more.

This season, Vikings running back Adrian Peterson came within nine yards of breaking the NFL single-season rushing record after returning from his ACL tear as soon as Welker did.

It is worth noting that 2010 is the only year in the past six where Welker did not exceed 1,100 yards receiving, with only 848. Even Peterson struggled in the first six weeks of this season, exceeding 100 yards rushing only once. Thereafter, he was held under 100 yards only once.

Proof enough of the wisdom of the nine-month minimum for that injury for me. The statistics for large numbers of athletes are even more compelling. And while adults, fully informed of the possible consequences, are free to attempt quicker-than-advised comebacks, youth athletes should never be allowed to do so.

John Doherty is a certified athletic trainer and licensed physical therapist. This column reflects solely his opinion. Reach him at ptatcsport@sbcglobal.net. Follow him on Twitter @JDohertyATCPT.

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