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Shoulders and Ankles – Oh My!!!!

Dr. Beth Sullivan| September 10th, 2019 

The first full slate of NFL games for the 2019 season kicked off this past weekend and unfortunately, the injury bug decided it had to bite several big names. Shoulders and ankles seemed to dominate the injury news.

Nick Foles, QB, Jacksonville Jaguars

Foles, starting quarterback for the Jaguars suffered a broken clavicle following a tackle by defensive tackle Chris Jones of the Chiefs. He did manage to get touchdown pass thrown before the injury.

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[youtube https://www.youtube.com/watch?v=5BwmB6tn0VA&w=560&h=315]

Foles was scheduled to undergo surgery Monday morning to place a metal plate over the broken region to help stabilize the fracture as it heals. The Jags placed him on I.R. and set out to find a new backup quarterback as they have had to turn to their previous backup due to the injury to Foles.  A fracture like this will take 8-10 weeks to heal and maximize rehab before Foles will be ready to consider returning to the field.

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Tyreek Hill, WR, Kansas City Chiefs

Hill suffered a posterior dislocation of his sternoclavicular joint. This is a very unusual injury. Sternoclavicular dislocations represent approximately three percent of all shoulder dislocations. The most common cause of this type of injury is automobile accidents, but they do occur in rare instances from a direct blow with enough force such as during a football tackle. An SCJ dislocation can be further defined as anterior or posterior. Anterior dislocations are nine times more common than posterior ones. However, a posterior one is a true emergency and requires prompt emergent medical attention.

Posterior dislocation of the SCJ can be associated with life-threatening complications such as neurovascular, trachea (windpipe) and esophageal injuries. Due to the high mortality associated with such complications, these injuries need to be recognized immediately and managed promptly. This is the reason Hill was transported to the hospital for further evaluation and monitoring after the dislocation was identified.

Hill will be out while this injury heals. Normally a posterior dislocation is reduced and the patient is placed in a figure of eight-splint and a sling for a period of six to seven weeks while the torn ligaments heal. Once the joint has healed he will have to go through some rehabilitation to maximize the range of motion of the shoulder and ensure that the affected joint is not in danger of dislocating again. I would say all total Hill will be out eight to ten weeks to ensure complete recovery.

Tevin Coleman, RB, San Francisco 49ers

Coleman left the game early following an ankle injury in the first half.  He left the stadium in a walking boot and will undergo further testing when the team makes it to their layover sight in Youngstown, OH. He is believed to have suffered a high ankle sprain which is the more serious of the two types of ankle sprains. If you want more information on the difference between a low and a high ankle sprain you can find it in my previous article on the subject here. A grade one (mild) sprain would mean four to six weeks for recovery, a grade two (moderate) sprain requires 10-12 weeks for recovery and a grade three (severe) sprain needs six to twelve months for recovery and is usually season-ending.

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Rushing a player back before they have healed completely can result in further injury. This was what happened to Odell Beckham in 2017 when he had high ankle sprain in the preseason and returned for game two of the 2017 season then was lost for the year after fracturing his ankle in week five.

Patrick Mahomes, QB, Kansas City Chiefs

Mahomes suffered a low ankle sprain in Sunday’s game but was able to finish the game. With this type of sprain it is a question of managing the swelling and pain. Since he was able to play with it shortly after the injury occurred, I doubt he will have any issues with it this coming week.

Gareon Conley, CB, Oakland Raiders

Conley as hit by his own teammate and sustained a neck injury which resulted in him being taken off the field on a stretcher and transported to the hospital for further evaluation.

 [youtube https://www.youtube.com/watch?v=PUSSUNC62No&w=560&h=315]

He updated everyone on Instagram late last night that he had made it home from the hospital. Given the severity of the blow he received, I would suspect he would be held out at least one week to allow him to fully recover. The injury could have been much worse so only missing a small amount of time is preferable to the alternative. 

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