January 23, 2017 - Dr. David Chao
Monday Morning MD: History repeats itself
Another AFC Championship game in Foxboro. Another opposing star running back is injured early and sits dejected on the sidelines with an oversized jacket to stay warm. The Patriots advance to another Super Bowl. When Le’Veon Bell left just after the start of the game with a groin injury, it reminded me of LaDainian Tomlinson’s early exit with MCL injury. Both came into the game with their injuries but could not continue. Both sat helplessly trying just to stay warm as their teams lost to the host Patriots. Both incidents just had the same look and feel. Injuries are always a big part of the game. Would the Steelers been able to hang tight with the Patriots if Bell stayed healthy? Would the Chargers have prevailed in 2008 if LT would have been healthy? A groin injury is debilitating for a running back. Not only does it make it hard to cut, it robs a player of his burst. The cold didn’t make it any easier. Bell could have limped through his game like LT could have hobbled through his, but clearly it was the better move in both circumstances to play their capable back-ups. Is it just luck for the Patriots that their path to the Super Bowl was made easier by the opposing team’s key injury? Certainly, to some extent New England makes it’s own luck by having the best record in the NFL. The only thing these Patriots have in common with the 2008 team is QB Tom Brady and K Stephen Gostkowski, plus of course the head coach. In fact, there are 30 new players out of the 53 since the last Super Bowl victory just two years ago. We shall see if it will yield the same results as the Falcons seem to be a formidable opponent. I provided medical coverage for two Super Bowls but my team never made it to the big game in my almost two decades. The Patriots had a new team doctor when they won it all in 2015. Again they have a first time team doctor this year. Will history repeat itself? MMMD 1: Everyone plays When it comes to the Conference Championship games, no one wants to miss the chance to help their team get to the Super Bowl. After all, next comes an extra week of rest before the big game or an offseason of rest. This is what drove Philip Rivers to play fresh off a knee scope and with a torn ACL in 2008. All three injured Packers wide receivers (Jordy Nelson, Davante Adams and Geronimo Allison) played. Also Morgan Burnett (quad) and Christine Michael (back) suited up as well. It was obvious that James Harrison would play and so did his flu-ridden teammates. I doubt a 3am wake up had much effect for an evening kickoff. Besides, in my experience, players don’t get up to leave their rooms with a fire alarm without team security personally performing the evacuation. MMMD 2: Everyone will be ready for SB51 Barring any surprises, it should be a healthy game in Houston. The additional week before the big game should allow all players to be near top form. Julio Jones with his turf toe/foot issues will be a player to watch but I anticipate he will be fine. Alex Mack finished the game with his ankle spatted and should be in good shape in two weeks. Martellus Bennett will need ankle surgery with his bone chips/fracture but that should be a minimal issue. Chris Hogan had a big game despite coming in with quad injury and then having hamstring issues where the two weeks will help here. Here is hoping both squads remain at full strength and the better team wins. MMMD 3: How did Jordy Nelson play with multiple broken ribs? When it was reported that the Packers WR was on the second bus on Sunday, that confirmed to me he would play. Players that are game-time decisions, arrive early on the first bus to test the injury out. Ones that know they won’t play take the 3rd bus. The much talked about Kevlar vest is not the main reason Nelson could play. Any protection doesn’t eliminate the pain of twisting, reaching, blocking or even deep breaths. Often rib blocks are utilized where the intercostal nerves are numbed with injections. This allows a player to move without pain and is an entirely legal form of medication in the NFL. Pain pills are used less frequently than people think, as a player’s mind needs to be clear to play this complex game. MMMD 4: Seahawks won’t be penalized Pete Carroll said Richard Sherman had a “significant” MCL but he was never on an injury report. This led many to expect a Seahawk penalty to come. I don’t think it will happen. Teams are not required to report all injuries. Trust me that every team’s injury list is longer than the one that is published. Only significant injuries are required to be reported. This is where the semantics come into play and Pete Carroll is obviously not a physician. Medically, it is impossible for any CB to play with a significant MCL injury. Of course you can argue that any mild MCL is a significant issue for a defensive back. However, if the MCL was medically graded as mild (even though the coach described it as significant), that will be the loophole that allows the Seahawks to escape league penalties. MMMD 5: Zach Orr gets lucky Unfortunately the Ravens budding star linebacker was forced to medically retire from football. In reality, Orr is quite lucky. He has a dangerous congenital C1 condition that was discovered after a routine work up for a stinger. He had unknowingly played his entire career with the potentially deadly problem. One wrong hit and a C1 problem could easily be fatal and there is no reason to take chances. In the end, Orr is lucky to have discovered the issue and that he didn’t play one play too many. That is the bright side of this unfortunate situation. MMMD 6: Pro Bowl replacement season This is the annual ritual where players tap out due to injury. The Pro Bowl game is always a game of musical chairs to the point that it is hard to keep up. Alex Smith and Dustin Colquitt are now in. Jadeveon Clowney, among others, is out. With the game now the week before the Super Bowl, Conference Championship winners will all be out, while many of the losers will choose not to attend. Also this week, many offseason surgeries were announced. Andrew Luck had a clean up throwing shoulder procedure. Meanwhile, Sammy Watkins finally had his much anticipated second foot surgery. MMMD 7: ProFootballDoc scorecard Sammy Watkins finally had the second predicted foot surgery. Ladarius Green missed as expected. James Harrison, Jordy Nelson, Davante Adams, Morgan Burnett, Julio Jones, Chris Hogan and Martellus Bennett all played as expected. Le’Veon Bell did not return. Alex Mack did injury his left ankle. I was wrong in too hastily opining on T.J. Lang’s injury with only one view. This slightly lowers the 203-10 (95.3%) record to 214-11 (95.1%).