Week 3 NFL Injury Review

Dr. Beth Sullivan | September 20th, 2019 

Another week down in the NFL schedule and some more big names to add to the injury book. It has been a tough couple of weeks for quarterbacks for sure. Nick Foles in week one and now Ben Rothlisberger and Drew Brees in week two. Let’s take a little deeper into these injuries.

Ben Roethlisberger QB Pittsburgh Steelers

Monday brought news that Ben’s elbow injury will end his 2019 campaign just as it was getting started. He suffered an elbow injury in his throwing arm that will require surgery to repair and will result in him being placed on IR. Given the nature of the injury and the need for surgery to repair, the outlook isn’t surprising. I suspect he suffered a UCL injury and possible ulnar nerve compression which is why he will undergo surgery to repair. Placing him on IR allows him to heal fully and regain his strength in his throwing arm.

Drew Brees QB New Orleans Saints

Brees underwent surgery to repair the Ulnar Collateral Ligament of the Thumb in his throwing arm. This injury is commonly called skier’s thumb because it is associated with the injury that happens to skiers when they fall and their pole strap causes the thumb to be forcefully pulled away from the other fingers. The UCL of the thumb is associated with the movement of the thumb needed to be able to grip things because it is involved along with the radial collateral ligament to stabilize the thumb joint and prevent excessive movement of the thumb joint as it moves. Surgery to repair the ligament takes approximately six to eight weeks to heal. Once the ligament tear has healed, therapy to restore the strength in the hand is needed to maximize function.

The initial reports on expected recovery time for Brees have been six weeks. However, since muscle strength is lost while the ligament heals, I suspect that Brees will not be 100% for the rest of the season. Even if he returns to the playing field, most athletes take two to three months to return to preinjury form because of the time needed to regain strength in the hand muscles. Athletes who aren’t required to grip a ball can return sooner with a cast to protect the healing ligament. Unfortunately, since Brees’ job requires him to grip the football to throw it, that isn’t an option for him. 

Cam Newton QB Carolina Panthers

Newton suffered a midfoot sprain during the preseason. I discussed the initial injury here. Since the injury was characterized as mild, it was assumed to be a grade 1 sprain. The normal recovery time is two to four weeks. Because this type of injury us associated with the LisFranc joint, if this “aggravation” is actually a further injury to the ligaments of this joint his full recovery could be months rather than weeks. In addition, if rest alone doesn’t resolve the problem adequately, other techniques including surgery could be considered.

Devin Singletary RB Buffalo Bills

Singletary suffered a hamstring injury during the Bills game against the New York Giants and has not practiced all week. A Grade 1 hamstring strain is a mild pull or strain that should not interfere with walking but will stop a patient from running at full speed. Normally recovery is anywhere from a few days to a couple of weeks. The main guideline is being able to participate without pain or swelling. Since Singletary has not practiced all weeks I would suspect he would be questionable at best for Sunday’s game against the Bengals. As of noon on Friday he had been ruled out from the Bills upcoming week three matchup with the Cincinnati Bengals.

DeSean Jackson WR Philadelphia Eagles

Jackson was already dealing with a mild groin strain, and now has an abdominal contusion suffered earlier in the week. The normal recovery time for the groin is two to three weeks and assuming the abdominal issue is mild, the same is also true for it. I would say his return to the field won’t be this week, and next is also iffy.

Trevor Siemian QB New York Jets

[youtube https://www.youtube.com/watch?v=GJSB9vsNpQE&w=560&h=315]

Siemian sustained a very unusual ankle injury in the Jets game against Cleveland last Monday night. The video above shows how the ankle was excessively flexed and everted during the tackle by Myles Garret. Normally when an ankle dislocation occurs one or both of the bones in the lower leg, the tibia and fibula, are broken from the forces inflicted on the joint. In Siemian’s case, he sustained a full ankle dislocation without any associated fractures. This occurs in less than one percent of all ankle dislocations. Unfortunately for Siemian, the ligamentous injuries he sustained in order to keep the bones from breaking are much harder to come back from than a simple ankle fracture. This injury like the injury to Rothlisberger is season-ending and will probably need surgery to repair the damaged ligaments. 

Hopefully, we can get out of the upcoming week without any other quarterback injuries. Only time will tell. 

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