Injury U

Ok fantasy football students, welcome to Injury Studies 101, where you can learn about all of the major injuries that strike down fantasy football athletes. Learn about ACLs, Concussions, Ankle injuries and more!

Click on the Injury Diagram, or use the drop down below:


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Knee Injuries

knee-diagram

What is an ACL Tear?

The ACL is one of the four main ligaments within the knee, all of which connect the femur to the tibia. The knee is basically a hinged joint that is held together by the medial collateral (MCL), lateral collateral (LCL), anterior cruciate (ACL), and posterior cruciate (PCL) ligaments.

How does an ACL tear occur?

In the NFL, ACL tears usually occur one of two ways: 1) A player changes direction, usually by cutting, and snaps/tears the ligament via unnatural twisting/bending/contorting of the knee, 2) A player is hit in the knee area, which has the knee twisting/bending/contorting in an unnatural way, which then snaps, or tears, the ACL. Like a door hinge on a door, the knee joint is designed to bend and function in one direction –- Forcefully bending the knee in another direction is damaging to the joint. Think of opening a door halfway (which is how the hinge is designed to function), but then imagine the person that opened the door grabs onto the top of the door and proceeds to hang all their weight on the door (causing the hinge to bend in a direction that it was not designed to move in). The major function of the ACL is to stabilize the knee. The femur (thigh bone) sits on top of the tibia (shin bone). The knee connects the two and acts as a joint. Without tight fitting ligaments to stabilize the knee, the joint would not be sound and would be subject to dislocations.

False Thinking Regarding Athletes Healing Quicker Today Vs. Years Ago

Dr. James Andrews, one of the most prominent orthopedic surgeons in the United States “They’re all different,” Andrews said. “There’s still a big spectrum in how they heal and how they come back . . . It’s hard to predict recovery from an ACL surgery, and to say that we’re getting them back quicker than we used to would be false information from my standpoint.”

What is a Meniscus Tear?

A person’s meniscus is the two cartilaginous structures that help provide stability to the knee joint. The knee twists and bends, and the Meniscus is essentially padding between the knee joint. as it twists. When severely damaged, the meniscus can be either repaired or replaced completely (meniscus transplant). Unlike many tendons, a torn meniscus tends to get worse with time rather than better.

As a result, surgery is more likely to be prescribed. Generally, when referring to a “torn meniscus”, one is referring to a torn medial meniscus as it is far more likely to be damaged than the lateral aspect. Someone whose knee tends to lock in place probably has a meniscus tear that extends along the circumference of the meniscus. Meniscus problems are more likely in older players as the meniscus loses its elasticity with age and is more susceptible to tearing as well as degenerative conditions. Meniscus problems earlier in life are closely associated with the development of knee osteoarthritis.

Duce Staley, Marcus Pollard and Jerramy Stevens have had injuries to their meniscus. Most recently, LenDale White was found to have played the 2007 season with a torn meniscus. Swelling in Donovan McNabb’s meniscus also delayed ACL surgery following his 2006 ACL injury.


Knee Injuries

knee-diagram

What is a concussion?

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What is a Migraine?

Migraines are a disorder common amongst the general population. Migraine symptoms include, but are not limited to: tremendous head pain, extreme sensitivity to light, noise, and sometimes even smells. Motion sickness, dizziness, and nausea are also fairly common. Terrell Davis (Super Bowl MVP) and Percy Harvin are two of the most famous players that suffered through severe Migraines, severe enough to take them out of entire quarters of play, and in many cases, entire games. Migraines can sometimes be treated, and sometimes even eliminated, with the treatment of sleep apnea. Diet has also helped in many cases. There are no absolute cures for Migraines, as each individual that suffers from the disorder could have a different reason for having Migraines. Some remedies and treatments will work for some sufferers and not for others, and some suffer more severe Migraines than others, despite how easily they are triggered. For the most part, it should/is considered a disorder that can sometimes be treated, but usually never fully controlled.


ACL (anterior cruciate ligament) Tears usually occur one of two ways in the NFL: 1) A player changes direction, or cuts and snaps/tears the ligament, 2) A player is hit in the knee area snapping, or tearing, the ACL, which connects . In football, athletes can often tear ACLs in other ways, ways which are often more damaging to the overall structure of the knee (which is why some ACL-related injuries are worse than others). For example, if the knee is hit from the side, more than just the ACL is being stressed and often torn. Like a door hinge, the knee joint is designed to bend and function in one direction – Forcefully bending in another direction is damaging to the joint. The major function of the ACL is to stabilize the knee. The femur (thigh bone) sits on top of the tibia (shin bone). The knee connects the two and acts as a joint. Without tight fitting ligaments to stabilize the knee, the joint would not be sound and would be subject to dislocations.knee diagram

The ACL, in particular, keeps the knee joint tight and does not allow the tibia to slide forward. An individual without an ACL is more prone to developing arthritis, cartilage tears and is more subject to dislocating the knee, which will often damage and tear the remaining three ligaments. Professional running backs usually cannot function fully without an ACL, because the position demands tremendous pivoting, deceleration, strenuous cutting and stopping — Again, all of which will ultimately lead to possible knee dislocation if an individual does not have an ACL — Dislocation would likely result in damage to the remaining knee ligaments.

It isn’t just the threat of dislocation that is the problem for a running back without an ACL — The knee is rarely ever tight fitting after an ACL tear and often feels “wobbly” and as if your knee will “give out” from under you. The instability has been said to feel like when one stands on top of a chair that feels unstable and could “give out” from under you.

It is possible, but extremely rare, that the thigh and surrounding knee muscles can alone keep the knee tight enough that an ACL isn’t necessary, but again, it’s so rare you will almost never hear about a running back having much success in such a situation. Broncos QB John Elway played through his entire NFL career without an ACL in one of his knees, but it would be almost impossible for a running back, given the demands of the position, to fully function without an ACL. Without an ACL, the knee just isn’t stable enough for the kind of cutting a rusher makes. So, getting back to running backs, the real question is: Can an NFL running back ever fully recover from a torn ACL?

The answer to that is yes, but on rare occasion, and a lot of factors are involved. For a full recovery to occur, the right combination of youth, NFL mileage (on the legs) and opportunity must be in place.

Looking for examples of full recoveries? Brian Westbrook, Priest Holmes, Willis McGahee and Frank Gore all suffered ACL tears before entering the NFL, or before playing an NFL game… clearly all four of those guys bounced-back and had elite fantasy careers, but youth was on their side. There are not a lot of examples out there of elite, yet older, fantasy runners returning to full strength… that was until this year. Ronnie Brown is the oldest player in recent history to tear his ACL and still be an absolute fantasy stud that very next season back from injury (tearing it at 25 and playing well his first year back at 26). Brown suffered his torn ACL in the middle of his 2007 fantasy season, yet he didn’t take the usual one year to get the knee right — He returned to form immediately, which is quite unusual, but being only 25 seems to have had much to do with his quick healing.

Clearly ACL injuries are NO LONGER career threatening, but most every bounce-back story involves a player that suffered the injury in college, or in between college and the pros. Ronnie Brown, who was 25 years-old when he suffered the injury and 26 his first year back (2008), is proof that full recovery is possible for players who are still in their first couple seasons in the pros. But again, don’t be fooled into thinking that an older player cannot return to form just because of their age, as often older players often get as much opportunity when returning from major ACL reconstruction. Take a look at some data on the injury:

MCL Tear
What is an MCL tear?

The MCL (medial collateral ligament) is the ligament that runs along the inner (medial) portion of the knee, connecting the femur to the lower leg at the tibia (shinbone). It is arranged in the form of 2 flattened bands of connective tissue, one on top of the other (deep and superficial). It also contributes to the formation of the knee joint capsule.

It is frequently injured in skiing as it is the ligament that helps maintain lateral stability in the knee joint. In football, a hard blow to the outside of the knee directed inward while the foot is planted can cause injury to the MCL. Typically, the MCL is injured together with the ACL as it is rare for a collateral ligament to tear by itself. Surgery of the MCL itself is usually not necessary, and when it is necessary is generally lacking in complication.

Recently, LaMont Jordan, Justin Fargas, and Ladainian Tomlinson suffered MCL injuries. Willis McGahee also tore his MCL in college during the Fiesta Bowl (along with his PCL and ACL). The injury that cut Priest Holmes’ incredible 2004 season short, allowing Larry Johnson to step in, was an MCL injury.

LCL Tear
What is an LCL tear?

The LCL (lateral collateral ligament) is the cord-like ligament that runs along the outside (lateral) portion of the knee, connecting the femur to the fibula, the skinny bone of the lower leg. Unlike the MCL, the LCL does not contribute to the formation of the joint capsule around the knee.

Although it is less frequently injured than the MCL or the ACL, the LCL is damaged most frequently in football when the knee buckles outward, either due to a faulty landing or from outward-directed contact just as the foot plants. Severe knee hyperextension can also result in an LCL injury. Similar to the MCL, an isolated LCL injury usually does not require surgery. Generally, the standard rest, ice, compression, elevation treatment is advised and a knee brace issued for one to several weeks. If the LCL is somehow severely torn in isolation from the other knee ligament structures, then surgery followed by a hard cast and several months of rehabilitation is frequently advised.

Adrian Peterson missed time in 2007 due to a mild injury to his LCL. Extremely uncommon and actually quite amazing he made a comeback in 2012-2013 better than ever. This has not been done before and may never again.

PCL Tear
What is an PCL tear?

The PCL (posterior cruciate ligament) is a very strong ligament deep within the rear portion of the knee joint. It maintains knee joint stability by preventing excess movement of the tibia backward relative to the femur as well as assisting the MCL and LCL in lateral knee joint stability. It attaches from the back of the femur to the back of the tibia just under the ACL. It is comprised of 2 bands of connective tissue wrapped together. The bands alternately tighten and loosen when the knee is extended and bent.

Serious PCL injuries are very rare because of the amount of force necessary to damage the PCL. Generally, significant trauma above and beyond what would occur during a football game is necessary to tear the PCL. In order to damage this ligament during a football game, the knee would need to be bent and the foot planted as a forceful blow to the front of the knee and/or shin is delivered. Due to its scarcity of occurrence, studies involving PCL damage are few and far between relative to the number involving the ACL and/or MCL. PCL surgery is relatively rare even when the ligament is ruptured. It’s location and complexity makes surgery a risky procedure from which many surgeons abstain.

Willis McGahee’s knee injury during the Fiesta Bowl involved the PCL. Reggie Bush’s lost time during 2007 also included damage to the PCL.

Meniscus
What is a Meniscus tear?

The meniscus refers to one of the two cartilaginous structures that help provide stability and integrity to the knee joint as it twists. When severely damaged, the meniscus can be either repaired or replaced completely (meniscus transplant). Unlike many tendons, a torn meniscus tends to get worse with time rather than better.

As a result, surgery is more likely to be prescribed. Generally, when referring to a “torn meniscus”, one is referring to a torn medial meniscus as it is far more likely to be damaged than the lateral aspect. Someone whose knee tends to lock in place probably has a meniscus tear that extends along the circumference of the meniscus. Meniscus problems are more likely in older players as the meniscus loses its elasticity with age and is more susceptible to tearing as well as degenerative conditions. Meniscus problems earlier in life are closely associated with the development of knee osteoarthritis.

Duce Staley, Marcus Pollard and Jerramy Stevens have had injuries to their meniscus. Most recently, LenDale White was found to have played the 2007 season with a torn meniscus. Swelling in Donovan McNabb’s meniscus also delayed ACL surgery following his 2006 ACL injury.

Microfracture Surgery
What is Microfracture surgery?

Microfracture surgery is essentially a surgical technique for cartilage repair. The procedure works by creating tiny fractures in the underlying bone in the knee, which then causes new cartilage to develop.

Microfracture surgery was developed in the late 1980s and early 1990s by Dr. Richard Steadman. Through steady research and testing (with horses), Steadman’s once “controversial” procedure has made its way into the microcosm of professional sports. In general, the procedure has had a high success rate, but because of the natural decline in an athlete’s performance, it’s tough to evaluate the rate of success with some older athletes that have had the procedure. While it’s concerning as to why younger athletes need Microfracture surgery to begin with, the younger an athlete is when he/she has the surgery the better.

In October of 2005, Suns star Amare Stoudamire became one of the highest profile players in professional sports to have Microfracture surgery. Stoudamire returned to the court in March of 2006 (6 months later), but due to stiffness in both knees, Stoudamire and his doctors decided to delay the stud’s return until the start of the 2006-2007 season (roughly 7 months after that). Stoudamire did in fact return to his old form during that 2006-2009 season (roughly one full calendar year after having his Microfracture surgery. Stoudamire is truly a success story.

Jason Kidd, Greg Oden, Zach Randolph, Steve Yzerman, John Stockton, Kenyon Martin, and Antonio McDyess have all had Microfracture surgery and just about all of those athletes have been able to return, or at least near, their pre-surgery form.

Professional athletes that have not had the same success include: Brian Grant, Chris Webber, Allan Houston and Penny Hardaway. And Tracy McGrady has recently had the procedure, but his return won’t be until the 2009-2010 season, so time will tell in his case.

Microfracture procedures are not that common in the NFL just yet (at least when it comes to impact fantasy players), but Saints WR Marques Colston reportedly had Microfracture surgery in January of 2009, so time will if Colston regain his elite form. The same goes for Saints RB Reggie Bush, who also had the surgery back in December of 2008. It’s worth noting that Colston’s procedure was thought to be somewhat minor — The receiver reportedly had a small hole in his kneecap, so our guess is that Colston will recover much faster than most.

Details of Microfracture surgery: Via arthroscopy, the surgeon creates tiny fractures in the bones (using an awl). Bone marrow and blood, which contain stem cells, seep out of the tiny fractures and this creates a blood clot. The blood clot then releases cartilage-building cells. The human body treats the microfractures (created by the surgeon) as bodily injuries, which is why the knee produces new/replacement cartilage.

Microfracture surgery is actually considered relatively minor as far as procedures go… it’s the restrictions that are placed on the patient during the recovery time frame. For optimal re-growth, patients usually need to be on crutches for four to six weeks and sometimes longer. Patients often feel that their knee(s) is doing fine and that they can skip extremely important recovery steps, and often times patients start running and jumping and even start playing sports before the knee(s) is ready.

Older patients, overweight patients and patients with significant knee degeneration issues have far less success with Microfracture surgery.

Will professional football players have as much success with Microfracture surgery as NBA players have had? Will football players need more recovery time due to the grueling nature of football? Time will tell — Marques Colston and Reggie Bush are two of the NFL’s highest profile subjects to have the procedure and their first seasons back from the surgery will be this 2009. We will report back after 2009 plays out. Stoudamire wasn’t ready after 6 months of recovery and Colston will be roughly 6-7 months removed from Microfracture surgery come August — But, again remember that Colston’s procedure might have been less intense and we might have to look at his case a bit differently when reflecting back. In case you were wondering, Bush will be roughly 7-8 months removed from surgery come August.

Hyper-Extended Knee
What is a Hyper-Extended knee?

A hyperextended knee occurs when the knee joint is forced to extend forcefully beyond its normal range of motion. Normally, this is simply painful and can cause swelling for one to several days or weeks. The real problem occurs when ligament damage occurs which may require surgery. A severe hyperextension frequently results in damage to the ACL. Hyperextension itself rarely causes more than a few missed games.

Head Injuries

Ankle Injuries

Neck Injuries

Foot Injuries

Shoulder Injuries

Toe Injuries

Groin Injuries

Chest Injuries

Elbow Injuries

Wrist Injuries

Forearm Injuries

Finger Injuries

Hip Injuries

Thigh Injuries

Bicep Injuries

Lower Leg Injuries