Injury Expert on Cam Newton, Tony Romo, Jermichael Finley and Gronk

As summer quickly approaches, the NFL never seems to be too far from headlines on major sports networks around the country. The NFL does a great job of remaining relevant during a time when the NHL playoffs, the NBA playoffs, and MLB are all in full swing. With TV coverage and social media outlets constantly reporting on players, signings, impacts of coaches, offensive/defensive schemes, etc., this coverage has helped make the NFL the billion dollar industry it is today.

With OTA's underway and mini-camps right around the corner, there are injuries that fantasy players start to wonder about, as many players undergo off-season surgery to be ready for the start of the new football year. It is never too early to discuss the potential impact these injuries can have on your strategy leading up to fantasy football drafts, so let's dive into some big name players who have had offseason surgery and see where they are as they progress towards the season.

Cam Newton - Ankle Ligament Stability Surgery

Repetitive trauma (usually lateral ankle sprains) to the ligaments on the outer aspect of the foot/ankle over an extended amount of time can lead to the ankle becoming unstable and more prone to continued trauma. If the ligaments continue to be injured, laxity/looseness is created in those ligaments, which makes it more difficult to have the required stability to function during normal daily activity. Inability to perceive where the ankle/foot is in space (proprioception) and weakness developed from repetitive trauma to the ankle can lead to further instability.[1] Surgery is a likely option to tighten the ligaments and to re-stabilize the ankle to prevent further structural damage.

Bottom Line - Reports are that Newton shed his walking boot two weeks ago and that he is on track to be ready for the start of the season. The original timetable that was given for his rehab was four months from his surgery, which would put him on track to be ready without restrictions at the end of July. The foot/ankle is really important for a quarterback as shifty as Newton is, so barring any setbacks, I believe he’ll be fine heading into the season. Something that could pose a problem to Newton’s draft status is his lack of weapons on the offensive side of the ball. Newton’s limited participation leading up to the training camp/pre-season could make it tough to develop the chemistry needed with his new group of receivers that the Panthers have signed this off-season. Expect Newton to have to create more opportunities with his legs, making his ankle health even more important. Also, look for Newton to target Greg Olsen a lot, as he is his the only player that has remained from last year’s receiving corps.

Tony Romo - Lumbar Microdisectomy Surgery

The discs in between each vertebrae in your spine help with shock absorption and to help the spine function normally. Vigorous, high level, repetitive activity can lead to the discs to become more prone to injury over time. Some of the disc material can become irritated or can impinge/compress the corresponding nerves that exit the spine at that level. Inflammation around the nerve or prolonged compression on the nerve from disc material can lead to muscle weakness and/or tingling/numbness into the muscles that the nerve innervates. A microdisectomy can be performed to remove the disc material that is causing the issue and to debride any other tissues that could potentially compromise the nerve as it exits the spine.

Bottom Line – No specifics have come out about Romo's back surgery with regards to what level the surgery was performed on or if any other procedures were performed. Considering that Romo has had a previous back surgery to remove a cyst from his lower back last year, there is legitimate concern as to whether or not he will be able to hold up for the full season. Chronic low back pain is something that many people suffer through on a daily basis without having to play football as their profession, so the concern is very real. Reports are that Romo will participate on a very limited basis in OTA’s with his workload increasing slowly through mini-camp. No setbacks have been mentioned so far in his recovery, but going through off season workouts are a far cry from what his back will endure during a full NFL regular season. A study done in 2010 looked at the return to play rates of those who underwent a lumbar discectomy, with 78% of those players returning to play at least 1 NFL game after surgery. [2] Only a handful of QB’s have undergone back surgery, and with Romo’s mobility being key for his success, it’ll be interesting to see if he has the same type of movement that has helped make him a productive QB in this league.

Jermichael Finley - Cervical Decompression with Fusion Surgery due to Spinal Cord Contusion

Trauma to the spinal cord or spinal nerves (extend off the spinal cord at each vertebral segment of the spine) can compromise overall function of the body depending on what level of the spine is involved. Contusions of the spinal cord can lead to weakness, impaired function, and pain depending on where the contusion occurs.

Bottom Line – Last October, Finley was contemplating retiring after he suffered this neck injury. Many players have had the surgery that Finley has had (Peyton Manning had same surgery at different spinal level) and returned to the NFL to play at a high level. The main concern isn’t necessarily the fusion itself, it’s the condition of the spinal cord after the contusion. The most recent similar case was that of Ravens linebacker Jameel McClain, who suffered a spinal cord contusion in 2012. His contusion didn’t require surgery, but ultimately it took him 10 months to finally get back onto the playing field. When dealing directly with the spinal cord, no injury is the same, so recovery is based on a combination of diagnostic tests and the patients remaining deficits, if they are present. There have been rumors of certain teams interested in bringing Finley in to see what he is capable of doing, and if haven’t seen the vigorous rehab he’s been doing, check this article out:

http://mmqb.si.com/2014/02/19/jermichael-finley-injury-rehab/

Although Finley is still a free agent, I think once he is able to pass a team physical, someone will be willing to take a risk on him with the Packers being the favorites to bring him back. As long as his medical history checks out, consider Finley a sleeper as most people will be scared off by his surgery. Each team has different protocols in place that they use when examining the players current medical conditions and background. Finley seems to have progressed enough in his recovery process that NFL teams are starting to look deeper into his medical history. I wouldn't be surprised if Finley gains clearance to return to football activities before or during training camp, which would roughly put him 9-10 months from his surgery. When healthy, he can still be a very productive TE even more so if he comes back to the Packers with Aaron Rodgers.

Note: Finley has recently been medically cleared by his own surgeon.

Rob Gronkowski – ACL Reconstruction with MCL repair

The ACL is the main ligament in the knee that helps prevent rotational/twisting motions, and prevents the lower leg from moving excessively on the upper part of the leg. The medial collateral ligament (MCL) is the main stabilizing ligament on the inside part of the knee. Ligament sprains/tears occur to this region when an external force is applied to the outside of the knee, which causes the knee to buckle in towards the other knee.

Bottom Line – Here we go again. It seems that every year we are talking about whether or not Gronk is going to be ready for the start of the season due to a significant injury. Average time for recovery from an ACL surgery in the NFL is around 11 months, which would put Gronk “ready” to go in December. Since Adrian Peterson’s miraculous recovery from his ACL/MCL injury a few years back, the bar has been raised for athletes to recover at a faster pace from what used to be a career-threatening injury. It’s very unrealistic to think every athlete is going to recover at the speed that Peterson did, especially a player like Gronkowski, who has had his share of injuries in his short time in the NFL. The Patriots will be very cautious with Gronk’s return to the field, but with Brady being a year older, and the TE corps not what it used to be, it’s fair to wonder if the Patriots struggle out of the gate, if Gronkowski will be asked to make a comeback sooner. I can easily see him starting on the PUP list like he did last year to give him the time that’s needed to fully recover from this, but continue to monitor his recovery heading into training camp. If he’s partying out in Vegas with Johnny Manziel, his rehab has got to be going pretty well, right?

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