SPORTS MEDICINE: Injuries which are tough to stomach kneed watching

2013-04-29T17:00:00Z 2013-04-29T21:23:31Z SPORTS MEDICINE: Injuries which are tough to stomach kneed watchingJohn Doherty Times Correspondent nwitimes.com
April 29, 2013 5:00 pm  • 

Rather than Manti Te’o not being drafted in the first round, D.J. Hayden being taken by Oakland with the 12th overall pick should have been THE story of last week’s NFL draft.

Because rather than being a soon-to-be multi-millionaire, the 5-foot-11, 192=pound University of Houston cornerback should, by all rights, be dead.

Rather than suffering that fate, though, Hayden had the good fortune to have an experienced and observant athletic trainer present at practice on Nov. 6. Mike O’Shea, ATC just didn’t like the looks of that knee to the chest Hayden experienced while breaking up a pass.

Rather than recapping the entire story, I refer you to the column which appeared in this space on Jan. 22. Suffice it say, Hayden had suffered a torn inferior vena cava, just below its entry point to the heart, an injury which is fatal 95% of the time.

Rather than attributing the injury to football and writing it off to that sport alone, however, it would be wise to look at the current issues of Sports Health and the Journal of Athletic Training.

Sports Health tells the story of a female collegiate volleyball player who dove for a ball. Rather than landing cleanly on the floor, she struck a teammate’s knee with her abdomen. She had immediate difficulty breathing, nausea, and sharp pain to the right of her stomach. Profuse sweating and hypersalivation followed. With symptoms like that, the decision to have her transported to the nearest emergency room was an easy one. A CT scan there revealed a small laceration of the liver.

Rather than operating, because the 20-year-old’s vital signs had stabilized, the attending surgeon decided to wait 48 hours. At that point, a second CT scan revealed no further bleeding; nor did a third CT scan, five weeks later. Consequently, the athlete was allowed to return to play just six weeks after being injured.

The Journal of Athletic Training includes a similar case study. Rather than the liver, the injured organ was the pancreas – extremely rare. Once again, a knee is the culprit, this time from an opponent to the abdomen of a collegiate women’s soccer player.

Rather than an immediate onset of symptoms, the 18-year-old experienced real trouble only upon return to her own campus 4 ½ hours after she was injured. There, her pain had increased to the point of abdominal spasm and vomiting.

Rather than watchful waiting, this athlete needed immediate surgery because a CT scan revealed her abdomen was filling with blood and other fluid, apparently from the pancreas. The surgery revealed a relatively small blood clot which was removed, but its source was not identified.

Rather than closing the athlete completely, the surgeon left two drains in place. It was fortunate he did, as the pancreas was still leaking and an MRI identified a laceration to it near the spleen. A second surgery, four days after the first, removed the spleen entirely and 75% of the pancreas.

Rather than retiring from her sport, she was cleared to return – just like the volleyball player and Hayden, doing so in nine months.

A rather good outcome for all three cases but only because of vigilant athletic trainers, efficient emergency room physicians and nurses, and skilled surgeons.

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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